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Despite national guidelines advocating a comprehensive, age-appropriate, and sequential approach to sexual health education in schools, many young people in the USA do not receive sexual health information until high school. To date, there has been little research on the need for a supplemental round of sexual health education -- a 'booster' -- later in adolescence to reinforce and expand upon information and skills previously provided. In rural California, we conducted six focus groups with young people (N = 22, ages 14-20) and key informant interviews with youth-serving professionals (N = 10) to examine the sexual health education needs of youth as they complete high school. Five themes were identified, indicating a need for booster education that 1) reinforces existing sexual health knowledge; 2) expands beyond traditional areas of sexual health education; 3) addresses community stigma about adolescent health; and 4) prepares young people for the transition to adulthood. In addition, booster education should 5) be established within the school system to promote an environment that addresses and normalises health issues throughout the school year. Providing booster sexual health education may meet critical gaps in efforts to support the healthy sexual development of young people, especially those living in rural communities.

Objective: Although Hispanic adolescents in the USA are often the focus of sexual health interventions, their response to survey measures has rarely been assessed within evaluation studies. This study documents the test-retest reliability of a wide range of self-reported sexual health values, attitudes, knowledge and behaviours among Hispanic adolescents from low-income, urban communities. Method: Intraclass correlation coefficients were calculated for sexual health scales (knowledge, values about condom use, parent communication, protection self-efficacy and condom-use intentions) in a 2-week sample (N = 86). Cohen's kappa and intraclass correlation coefficients were calculated for behaviours (romantic and sexual behaviours, and sexual health services history) in two separate 2-week samples (N = 86, N = 202). Selected behaviours were also examined for retractions in both 2-week samples and in a 1-year sample (N = 291). Results: Among sexual health scales, test-retest reliability ranged from 0.37 for condom-use intentions to 0.93 for parent communication. Among behaviours, reliability ranged from .27 for use of sexual health services to 1.00 for use of birth control at first sex. Retractions ranged from below 10% for ever having had a steady partner to 50% or more for sexual health services and testing. Conclusion: Test-retest reliability differed greatly across self-reported sexual health values, attitudes, knowledge and behaviours for the three samples of Hispanic adolescents. Overall, however, most items and scales showed good to excellent reliability (i.e. a coefficient greater than 0.60), suggesting that Hispanic adolescents are moderately to highly stable reporters in response to sexual health measures.

Numerous classroom-based interventions have aimed to improve sexual health outcomes for young people, yet few have shown strong, lasting effects. Ecological approaches that address multiple levels of a young person's environment offer largely untapped potential to positively change sexual behaviour. This paper presents results of a cluster-randomised trial of a multicomponent sexuality education intervention that integrated a classroom curriculum, parent education workshops and materials, peer advocate programme, and sexual health services at 10 urban high schools. An implementation evaluation, employing quantitative and qualitative instruments, was conducted to examine whether the individual components of the intervention were delivered as planned and how they were received by the target populations. Multilevel modelling was used to evaluate the effect of the multicomponent intervention on outcomes at one-year follow-up. Results showed that the intervention components were successfully implemented with and well received by target populations. Students receiving the multicomponent intervention reported greater increases in the use of sexual health services (odds ratio [OR] = 1.73, 95% CI = 1.09-2.75) and the likelihood of carrying a condom (OR = 2.71, 95% CI = 1.44-5.09) relative to those receiving a control condition. No effects were found for other behaviours, possibly due to low prevalence of sexual activity in the sample and the small number of schools randomised.

To understand the diverse reasons why some young women choose contraceptive methods that are less effective at preventing pregnancy, including condoms, withdrawal, and emergency contraception pills, even when more effective contraceptive methods are made available to them. In-depth interviews with young women at family planning clinics in July-November 2016. Interview data were thematically coded and analyzed using an iterative approach. Two youth-serving family planning clinics serving predominantly Latinx and African American communities in the San Francisco Bay Area, California. Twenty-two young women ages 15-25 years who recently accessed emergency contraception to prevent pregnancy. None. Young women's experiences using different methods of contraception, with specific attention to methods that are less effective at preventing pregnancy. Young women reported having previously used a range of higher- and lower-efficacy contraceptive methods. In interviews, they described affirmative values that drive their decision to use lower-efficacy methods, including: a preference for flexibility and spontaneity over continual contraceptive use, an emphasis on protecting one's body, and satisfaction with the method's effectiveness at preventing pregnancy. Some young women described using a combination of lower-efficacy methods to reduce their pregnancy risk. Young women make contraceptive decisions on the basis of preferences and values that include, but are not limited to, effectiveness at preventing pregnancy. These reasons are salient in their lives and need to be recognized as valid by sexual health care providers to ensure that young women receive ongoing high-quality care. [ABSTRACT FROM AUTHOR]

Background: An emerging model for sexuality education is the rights-based approach, which unifies discussions of sexuality, gender norms, and sexual rights to promote the healthy sexual development of adolescents. A rigorous evaluation of a rights-based intervention for a broad population of adolescents in the U.S. has not previously been published. This paper evaluates the immediate effects of the Sexuality Education Initiative (SEI) on hypothesized psychosocial determinants of sexual behavior. Methods: A cluster-randomized trial was conducted with ninth-grade students at 10 high schools in Los Angeles. Classrooms at each school were randomized to receive either a rights-based curriculum or basic sex education (control) curriculum. Surveys were completed by 1,750 students (N = 934 intervention, N = 816 control) at pretest and immediate posttest. Multilevel regression models examined the short-term effects of the intervention on nine psychosocial outcomes, which were hypothesized to be mediators of students' sexual behaviors. Results: Compared with students who received the control curriculum, students receiving the rights-based curriculum demonstrated significantly greater knowledge about sexual health and sexual health services, more positive attitudes about sexual relationship rights, greater communication about sex and relationships with parents, and greater self-efficacy to manage risky situations at immediate posttest. There were no significant differences between the two groups for two outcomes, communication with sexual partners and intentions to use condoms. Conclusions: Participation in the rights-based classroom curriculum resulted in positive, statistically significant effects on seven of nine psychosocial outcomes, relative to a basic sex education curriculum. Longer-term effects on students' sexual behaviors will be tested in subsequent analyses. [ABSTRACT FROM AUTHOR]

Objective The number of persons living with HIV/AIDS, the number of new infections and the number of persons at risk for HIV infection are the foundations of evidence-based prevention, treatment and care planning. However, few jurisdictions have complete and accurate estimates of these indicators. HIV/AIDS case reporting, which includes only persons diagnosed with infection and reported to health departments, does not reflect all HIV/AIDS cases, thus underestimating the true size of the epidemic. Obtaining direct measures of HIV incidence is methodologically challenging. Moreover, no censuses exist for the number of persons at highest risk for infection, including men who have sex with men (MSM). Method We present an approach of triangulation that draws upon multiple empirical and overlapping sources of information through different methods to synthesise data-based estimates of the prevalence, incidence and denominator of MSM at risk for infection in San Francisco. We further use existing data to establish plausible upper and lower bounds for each estimate. Result We arrived at an overall population size of 66 487 of MSM in San Francisco as of 31 December 2010. The number of MSM living with HIV/AIDS was 15 873, corresponding to an HIV prevalence of 23.9%. We projected 806 new cases in 2010, translating to an incidence rate of 1.59% per year. Conclusions While not without limitations, our estimates provide useful information for the purpose of HIV/AIDS prevention and care planning, drawing from diverse sources that may be available in local health jurisdictions. We believe that our approach enhances the credibility of such estimates by mitigating bias from only one source of data or one methodological approach. [ABSTRACT FROM AUTHOR]

The article reports on a study regarding the potential for utilizing social networking sites (SNS) particularly MySpace Inc. to connect youth to sexual health services in California. The study is designed to explore emerging efforts and understand the potential as a model for other youth-serving programs. It concludes that SNS and other technologies have strong potential for reaching diverse youth with critical health information when implemented as part of a comprehensive outreach strategy.