Reducing the Risk High School Programs: Building Skills to Prevent Pregnancy, STD and HIV

Problem Overview:

Unwanted pregnancies and sexually transmissible infections among youth.

Helping youth avoid unwanted pregnancies and sexually transmissible infections is a challenge that faces communities around the world. Children having children is a problem with dire consequences for both the young people themselves and for society as a whole. Young people with children have sharply reduced education and employment opportunities and a poorer quality of life. Meeting their needs places a severe burden on both families and public resources. Moreover, sexually active teens are at great risk of contracting AIDS and other sexually transmitted diseases.

Background:

Sex education is a very controversial issue in many school districts throughout the United States, and choosing the appropriate curriculum when sex education is taught is a difficult decision. Recent studies offer no definitive answers but do present findings that are contrary to beliefs held by many. The results strongly suggest that: 1) sex education programs do not lead to increased sexual activity and may in fact delay the onset of sexual intercourse, and 2) some sex education programs that stress abstinence without providing information about contraception have been shown to have no impact on sexual activity.

"Reducing the Risk" (RTR) is a 17-lesson curriculum developed by Richard Barth, MSW, PhD, with the help of staff from ETR Associates in Santa Cruz, California, a nonprofit health education organization founded in 1981. In use since the early 1990's, RTR is specifically designed to delay the onset of sexual intercourse and to increase knowledge about pregnancy risk, contraceptive use, and protection against sexually transmissible infections.

Three major concepts provide the foundation for this curriculum:

1) Abstaining from sexual activity or refusing unprotected sexual intercourse are the only responsible alternatives for teens.

2) Correct factual information about pregnancy, protection, HIV and other sexually transmissible infections is essential for responsible sexual behavior.

3) Effective abstinence and refusal communication skills contribute to responsible sexual behavior.

The major objectives are to enable students to:

1) Evaluate the risks and consequences of becoming an adolescent parent or infected with HIV or another sexually transmissible infection.

2) Recognize that abstaining from sexual activity or using contraception are the only ways to avoid pregnancy, HIV and other sexually transmissible infections.

3) Conclude that factual information about conception and protection is essential for avoiding pregnancy and infection with HIV or other sexually transmissible infections.

4) Demonstrate effective communication skills for remaining abstinent or avoiding unprotected sexual intercourse.

ETR also offers a Program Development Workshop and Educator Training Program for school districts and teachers interested in implementing the curriculum.

Candy Gutierrez, a teacher at the Yerba Buena High School in San Jose, California, is a true believer in the "Reducing the Risk" curriculum and has been using it as the sex education unit in her ninth grade freshmen orientation class. She does not have the time to complete all 17 lessons in the curriculum and has made some modifications to meet the needs of her students. Nevertheless, she tries to adhere as closely as possible to its basic philosophy. While neither the state nor the school district restricts the teaching of sex education, parents who do not wish to have their children participate in these classes may ask to have them excused. Ms. Guttierez has found that most parents allow their children to attend.

Many of the students attending Yerba Buena are from homes supported by welfare. They are largely Latino and Asian and have a high rate of teen pregnancy. Ms. Gutierrez estimates that 50% of them are sexually active. She says that their attitude toward pregnancy and AIDS can be summed up in one short sentence: "It won't happen to me." For six weeks, the students in her "Reducing the Risk" class participate in individual and group activities, written and oral exercises, class discussions, and role-playing situations that help them recognize and resist social pressure. They also learn about anatomy, birth control, and sexually transmissible infections, and that having unprotected intercourse just once can lead to unwanted pregnancy and disease. For homework, they are required to go to a local pharmacy to do research on contraceptives, and to discuss their "Reducing the Risk" lessons on abstinence and protection with their parents.

Ms. Gutierrez thinks that the curriculum has great value because it teaches young people to say "no", to make decisions and take control of their lives, and to care about themselves and others.

Implementation:

Evaluations have found the "Reducing the Risk" curriculum to have a measurable impact in delaying the initiation of sexual intercourse (short-term), reducing unprotected sex among some students, increasing knowledge about pregnancy risk and prevention of sexually transmissible infections, and increasing communication with parents about abstinence and birth control. It is one of only five curricula identified as a "program that works" by the United States Centers for Disease Control. Data is not currently available on the number of schools or teachers using it.

Web Links:

Submitted by:

Ms. Nancy Shanfeld
ETR Associates
P.O. Box 1830
Santa Cruz, CA 95061-1830
T: 831-438-4060
F: 831-438-3618
Email: nancy@etr-associates.org
Web: http://www.etr-associates.org

Ms. Candy Gutierrez
Yerba Buena High School
1855 Lucretia Avenue
San Jose, CA 95122
Tel: 408-279-1500
Fax: 408-279-0675