ARRA: Web-Based Substance Abuse and STD/HIV Prevention

The spread of HIV and sexually transmitted diseases (STD) remains one of the most serious threats to general adolescent health. The severity of the STD/HIV threat increases significantly for adolescents when the intercorrelated use of illicit drugs and alcohol is taken into consideration. Unplanned and unprotected intercourse is strongly correlated with adolescent substance abuse. The spread of STDs and HIV through unplanned and unprotected intercourse due to impaired decision making as a result of substance use is a prominent risk for adolescents. Current prevention efforts to curtail HIV/STD risk among adolescents has shown some efficacy, but interventions that are both more effective and more easily diffused still need to be developed and carefully evaluated. At the same time, prior research on media and classroom preventive interventions has shown that interventions designed to be more novel and participatory are more effective in altering a number of crucial adolescent health risk behaviors. Research examining the effectiveness of tailored web-based programs on adolescent health behaviors have demonstrated that behaviors were successfully changed by including elements designed specifically to attract, hold the attention of, and persuade those most likely at risk. These highly interactive, vivid, quickly-paced stimuli may be effective in eliciting the attention of the population-of-interest for this research project: those most likely to take risks that increase the likelihood of HIV/STD exposure. Our overall objectives are to 1) adapt the successful Reducing the Risk (RTR) sexual risk behavior prevention curricula to a self-administered Web-based curriculum that will target high sensation-seeking and low sensation-seeking youth with separate messages; 2) implement the model program in the early high school environment. The website intervention will promote abstinence among youth who have not yet started having sex and promote condom use and other safe-sex practices among those who are engaging in sex and intend to continue for the goal of prevention/reduction of HIV/STD transmission among youth. The first phase of a two-phase project is planned to address these aims, with the first phase of the project underway for the current funding period. The first phase will involve intervention development through focus and reaction groups that help refine issues and design effective curricular materials and multimedia production and programming in the Internet environment. Employing website design principles developed in previous research on Internet-based tobacco and risky alcohol consumption prevention, the HIV/STD prevention program will tailor messages intended to prolong sexual abstinence for students who are not yet sexually active and messages to increase condom use, and reduce other risky sexual behaviors (e.g., having unprotected sex) for those who are sexually active. Usability and navigability research procedures will be employed on beta website modules to ensure a high level of usability of the website for users. At the end of this first phase, a beta test of the developed website will be undertaken in a limited number of schools (these schools will be excluded from subsequent phases of the overall investigation). Any final revisions or adjustments to the website will be made as a result of the beta test of the website. The deliverable website will then be readied for implementation in the second to-be-funded phase of the project. That phase of the project will examine the impact of the intervention on HIV/STD prevention skills, behavioral intentions, and sexual risk-taking behaviors within a randomized school trial. The current project's outcomes will include the developed and beta-tested website, as well as developed research procedures that will enable the rapid implementation of the second phase of the website.