SEXUAL RISK TAKING, ALCOHOL, AND HIV PREVENTION IN YOUTH

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APPLICANT'S ABSTRACT: The proposed research is aimed at increasing understanding of the relationships among sensation seeking and decision- making processes, alcohol use, and risky sexual behaviors in adolescents. Drawing upon previous research into these processes, we propose to develop and test more effective mass media and school-based interventions. The proposed research will examine the joint relationship of sensation-seeking (i.e., seeking out high arousal situations) and impulsive decision-making (i.e., making quick decisions once in a situation, based on factors that may not be "rational") with sexual risk-taking, in particular, alcohol and other drug use before or during a sexual encounter. Based, on our previous research, we expect that high school-age students who are high on sensation-seeking and impulsive decision-makers (HSS/IDM) will be particularly difficult to reach using conventional skills-based classroom curricula. These curricula are based on models of rational decision-making and do not sufficiently focus on the role of alcohol in sexual activities, or on alternate high-sensation activities to replace those to be reduced or eliminated. The curricula may also not be sufficiently fast-paced and novel to hold the high sensation seeker's attention. Thus, we propose to develop a radio-based media campaign with messages targeted to HSS/IDM individuals to increase their interest in the school-based program before the beginning of and during the implementation of the curriculum. We also propose to enhance the school-based curriculum to meet the special sensation-seeking and decision-making needs of the HSS/IDM individuals, both in terms of their likely behaviors as HSS/IDM individuals and in the method of presentation itself. The enhanced version will include greater novelty, more involvement, and a faster pace. The intervention will occur within an experimental design over a three-year period in school systems in Louisville, Kentucky and Cleveland, Ohio. It will consist of the main intervention in the first year and booster interventions within the second and third years, to augment the impact of the intervention during the period of entry into sexual activity of many of the high school-aged participants. Multiple follow-up assessments will occur during the three-year time interval in order to measure the impact of media and classroom-based interventions both independently and jointly. Specific aims of the proposed project are to: delineate more precisely how alcohol use, sensation-seeking, impulsive decision-making, and risky sexual behaviors are related among high school-aged adolescents, and assess the importance of relevant social and psychological mediating variables; develop, via focus and reaction groups, radio public service announcements (PSAs) and an enhanced version of a skills-based classroom intervention that will attract the attention of and increase the salience of HIV for HSS/IDM adolescents; and to assess the joint impact of a radio campaign and an enhanced skill-focused classroom-based HIV intervention on perceived risk of HIV, behavioral intentions, and alcohol use with sex and other sexual risk-taking behaviors.