Reducing Adolescent Sexual Risk: A Theoretical - ETR Associates

4. Have youth identify and describe commonsituations in their lives or in the lives of theirpeers that may lead to undesired, unplanned orunprotected sex. To avoid sexual risk behaviors,youth must be able to recognize and assess conditionsthat might lead to sexual risk (Millstein2003). Youth are more likely to personalize therisks if they build upon their own experience orthose of their peers by having the entire class orgroup identify and describe all of the commonsituations that might lead to undesired sex orunprotected sex. When describing these situations,each of the elements that increase the riskshould be identified. For example, one commonsituation that can lead to sexual risk-takingamong youth is: Young people are at a party. Noadults are present. Alcohol is available and peopleare drinking. There are rooms or other placesnearby where people could have uninterruptedsex. Some youth are sexually attracted to otheryouth at the party.After youth have described several different situationslike the above that might lead to unprotectedsex, their common elements (e.g., drinkingor lack of supervision) should be noted.It is extremely important that youth describemethods of avoiding these situations or gettingout of them if they get into them. This can bedone both by verbally describing the strategiesand by conducting roleplays to build skills andchange norms. However, those are covered in thechapter on skills. (See Activity 7-1: Lines ThatPeople Use to Pressure Someone to Have Sexand Activity 7-2: Situations That May Lead toUnwanted or Unintended Sex.)5. Throughout the curriculum, repeatedly emphasizea clear and appropriate message about theneed to avoid sexual risks and how to avoidthem. For many young people, an appropriatemessage might be: “It is very important to avoidunintended pregnancy and STDs. Abstainingfrom sex is the safest method. If you have sex,females should always use hormonal contraceptionto prevent pregnancy and males shouldalways use condoms correctly to prevent STDs.”How has perception of risk been measured?Table 4-5 lists items that have been used to measureadolescents’ perceptions of risk. These are meant tobe illustrative, not comprehensive.Nevertheless, these items may help curriculumdevelopers identify some of the more specific elementsthat programs and their associated researchhave addressed (e.g., perceptions that having a babywould mess up their life or that having a baby wouldmake them feel like an adult). These items also mayhelp researchers conduct formative evaluations ofentire curricula or specific activities and therebyimprove their effectiveness.ConclusionsToo often, youth give too little attention to the risksof sex and unprotected sex, either because of a senseof invulnerability, “just not thinking,” brains thatare still maturing, or for other reasons. Fortunately,multiple studies and different kinds of evidence havedemonstrated that 1) programs can increase perceptionsof sexual risks and 2) increasing perceptions ofrisk can reduce the chances of unprotected sex. Toincrease perceptions of risk, programs should clearlydescribe the risks of unprotected sex, includingunintended pregnancy and STDs—in terms of bothsusceptibility and severity. Programs also shouldhave youth identify the common situations thatmight lead to undesired, unplanned or unprotectedsex and describe methods for both avoiding andgetting out of those situations. Activities should beinteractive and designed to have youth personalizethese risks. Finally, a clear message about the bestmethods of avoiding risks should be emphasizedrepeatedly.48 Reducing Adolescent Sexual Risk: A Theoretical Guide for Developing and Adapting Curriculum-Based Programs