Behavioral interventions to reduce incidence of HIV, STD, and pregnancy among adolescents: a decade in review

J Adolesc Health. 2004 Jan;34(1):3-26. doi: 10.1016/s1054-139x(03)00244-1.


Purpose: To review adolescent sexual risk-reduction programs that were evaluated using quasi-experimental or experimental methods and published in the 1990s. We describe evaluated programs and identify program and evaluation issues for health educators and researchers.

Methods: We systematically searched seven electronic databases and hand-searched journals to identify evaluations of behavioral interventions to reduce sexual risk behaviors among adolescents. Articles were included if they were published in the 1990s, provided a theoretical basis for the program, information about the interventions, clear aims, and quasi-experimental or experimental evaluation methods. We identified 101 articles, and 24 met our criteria for inclusion.

Results: We reviewed these evaluations to assess their research and program characteristics. The majority of studies included randomized controlled designs and employed delayed follow-up measures. The most commonly measured outcomes were delay of initiation of sexual intercourse, condom use, contraceptive use, and frequency of sexual intercourse. Programs ranged from 1 to 80 sessions, most had adult facilitators, and commonly included skills-building activities about sexual communication, decision-making, and problem solving. The programs included a wide range of strategies for content delivery such as arts and crafts, school councils, and community service learning.

Conclusions: Analysis of these programs suggest four overall factors that may impact program effectiveness including the extent to which programs focus on specific skills for reducing sexual risk behaviors; program duration and intensity; what constitutes the content of a total evaluated program including researchers' assumptions of participants' exposure to prior and concurrent programs; and what kind of training is available for facilitators.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology
  • Female
  • HIV Infections / prevention & control*
  • Health Promotion / methods*
  • Humans
  • Pregnancy
  • Pregnancy in Adolescence / prevention & control*
  • Risk-Taking
  • Sex Education / methods*
  • Sexual Behavior / psychology
  • Sexually Transmitted Diseases / prevention & control*