To effectively combat the AIDS health crisis among adolescents, future research must address three key issues: (a) the risk of disease for culturally differing adolescent populations, particularly African-American adolescents; (b) the need for empirical investigations to identify and understand the variables influencing adolescents 'adoption of HIV-preventive sexual practices; and (c) the development of more effective prevention programs to reduce adolescents' existing HIV-associated risk behaviors. This article reviews the relevance of these issues for prevention research and suggests policy recommendations. These recommendations argue for: (a) expanded funding for basic behavioral surveys to identify the prevalence of risk-taking behavior among adolescents in general, and among high-risk adolescent subgroups, for example, incarcerated and homeless adolescents; (b) encouraging more epidemiologic and ethnographic research to understand the psychosocial and cultural variables associated with high and low-risk behavior among understudied and underserved racial/ethnic populations such as African-American adolescents; and (c) urging that evaluation of HIV prevention programs include multisite trials and larger samples in ethnically and geographically diverse populations.
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References
1.
Airhihenbuwa, C. O.
, DiClemente, R. J., Wingood, G., & Lowe, A. (1992). HIV/AIDS education and prevention among African-Americans: A focus on culture. Journal of AIDS Education & Prevention, 4, 251-260.
2.
Ajzen, I.
, & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall.
3.
Anderson, J. E.
, Kann, L., Holtzman, D., Arday, S., Truman, B., & Kolbe, L. (1990). HIV/AIDS knowledge and sexual behavior among high school students. Family Planning Perspectives, 22, 252-255.
4.
Becker, M. H.
, & Joseph, J. G. (1988). AIDS and behavioral change to reduce risk: A review. American Journal of Public Health, 78, 394-410.
5.
Botvin, G.
(1986). Substance abuse prevention research: Recent developments and future directions. Journal of School Health, 56, 369-373.
6.
Brown, L.
, DiClemente, R. J., & Reynolds, L. A. (1991). HIV prevention for adolescents: Utility of the Health Belief Model. Journal of AIDS Education & Prevention, 3, 50-59.
7.
Burke, D. S.
, Brundage, J. F., Goldenbaum, M., Gardner, L. I., Peterson, M., Visintine, R., & Redfield, R. R. (1990). Human immunodeficiency virus infections in teenagers. Journal of the American Medical Association, 263, 2074-2077.
8.
Cates, W.
(1990). The epidemiology and control of sexually transmitted diseases in adolescents. In M. Schydlower & M. A. Shafer (Eds.), AIDS and other sexually transmitted diseases (pp. 409-427). Philadelphia, PA: Hanley & Belfus.
9.
Conant, M.
, Hardy, D., Sematinger, J., Spicer, D., & Levy, J. A. (1986). Condoms prevent transmission of AIDS-associated retrovirus. Journal of the American Medical Association, 255, 1706-1706.
10.
Curran, J. W.
(1992, January). [Untitled testimony before the National Commission on Acquired Immune Deficiency Syndrome]. Washington, DC.
11.
Curran, J. W
, Morgan., W M., Hardy, A. M., Jaffe, H. W, Darrow, W. W., & Dowale, W. R. (1985). The epidemiology of AIDS: Current status and future prospects. Science, 229, 1352-1357.
12.
DiClemente, R. J.
(1990a). The emergence of adolescents as a risk group for human immunodeficiency virus infection. Journal of Adolescent Research, 5, 7-17.
13.
DiClemente, R. J.
(1990b). Adolescents and AIDS: Current research, prevention strategies and public policy. In L. Temoshok & A. Baum (Eds.), Psychosocial perspectives on AIDS: Etiology, prevention, and treatment (pp. 51-64). Hillsdale, NJ: Lawrence Erlbaum.
14.
DiClemente, R. J.
(1992a). Epidemiology of AIDS, HIV seroprevalence and HIV incidence among adolescents. Journal of School Health, 62, 325-330.
15.
DiClemente, R. J.
(1992b). Psychosocial determinants of condom use among adolescents. In R. J. DiClemente (Ed.), Adolescents and AIDS: A generation in jeopardy (pp. 34-51). Newbury Park, CA: Sage.
16.
DiClemente, R. J.
, Boyer, C. B., & Mills, S. (1987). Prevention of AIDS among adolescents: Strategies for the development of comprehensive risk-reduction health education programs. Health Education Research, 2, 287-291.
17.
DiClemente, R. J.
, Forrest, K. & Mickler, S. (1990). College students' knowledge and attitudes about HIV and changes in HIV-preventive behaviors. Journal of AIDS Education & Prevention, 2, 201-212.
18.
DuRant, R. H.
, Sanders, J. M., Jay, S., & Levinson, R. (1988). Analysis of contraceptive behavior of sexually active female adolescents in the United States. Journal of Pediatrics, 113, 930-936.
19.
Emans, S. J.
, Grace, E., Woods, E. R., Smith, D. E., Klein, K., & Merola, J. (1987). Adolescents' compliance with the use of oral contraceptives. Journal of the American Medical Association, 257, 3377-3381.
20.
Fineberg, H. V.
(1988). Education to prevent AIDS: Prospects and obstacles. Science, 239, 592-596.
21.
Flora, J. A.
, & Thoresen, C. E. (1989). Components of a comprehensive strategy for reducing the risk of AIDS in adolescents. In V. M. Mays, G. W. Albee, & S. F. Schneider (Eds.), Primary prevention of AIDS (pp. 374-389). Newbury Park, CA: Sage.
22.
Goldsmith, M.
(1987). Sex in the age of AIDS calls for common sense and "condom sense."Journal of the American Medical Association, 257, 2261-2266.
23.
Gottlieb, M. S.
, Schroff, R., Schanker, H. M., Weisman, J. D., Fan, P. T., Wolf, R. A., & Saxon, A. (1981). Pneumocystis carinii pneumonia and muscosal candidiasis in previously healthy homosexual men: Evidence of a new acquired cellular immunodeficiency. New England Journal of Medicine, 305, 1425-1431.
24.
Hansen, W. B.
, & Graham, J. W. (1991). Preventing alcohol, marijuana and cigarette use among adolescents: Peer pressure resistance training versus establishing conservative norms. Preventive Medicine, 20, 414-430.
25.
Hein, K.
(1991). Risky business: Adolescents and human immunodeficiency virus. Pediatrics, 88, 1052-1054.
26.
Hein, K.
(1992). Adolescents at risk for HIV infection. In R. J. DiClemente (Ed.), Adolescents and AIDS: A generation in jeopardy (pp. 3-16). Newbury Park, CA: Sage.
27.
Hingson, R.
, Strunin, L., & Berlin, B. (1990). Acquired immunodeficiency syndrome transmission: Changes in knowledge and behaviors among teenagers. Massachusetts Statewide Surveys, 1986 to 1988. Pediatrics, 85, 24-29.
28.
Kann, L.
, Anderson, J. E., Holtzman, D., Ross, J., Truman, B. I., Collins, J., & Kolbe, L. J. (1991). HIV-related knowledge, beliefs, and behaviors among high school students in the United States: Results from a national survey. Journal of School Health, 61, 397-401.
29.
Kegeles, S. M.
, Adler, N. E., & Irwin, C. E. (1988). Sexually active adolescents and condoms: Changes over the year in knowledge, attitudes and use. American Journal of Public Health, 78, 460-461.
30.
Klepp, K. I.
, Halper, A., & Perry, C. L. (1986). The efficacy of peer leaders in drug abuse prevention. Journal of School Health, 56, 407-411.
31.
Masur, H.
, Michelis, M. A., Greene, J. B., Onorato, I., Vande Stouwe, R. A., Holzman, R. S., Wormser, G., Brettman, L., Lange, M., Murray, H. W., & Cunningham-Rundles, S. (1981). An outbreak of community-acquired pneumocystis carinii pneumonia: Initial manifestation of cellular immune dysfunction. New England Journal of Medicine, 305, 1431-1438.
32.
Memon, A.
(1990). Young people's knowledge, beliefs, and attitudes about HIV/AIDS: A review of the research. Health Education Research, 5, 327-335.
33.
Miller, H. G.
, Turner, C. F., & Moses, L. E. (1990). AIDS. The second decade. Washington, DC: National Academy Press.
34.
Perry, C. L.
, & Grant, M. (1988). Comparing peer-led to teacher-led youth alcohol education in four countries. Alcohol Health Research World, 12, 322-326.
35.
Robinson, T. N.
, Killen, J. D., Taylor, B., Telch, M. J., Bryson, S. W., Saylor, K. E., Maron, D. J., Maccoby, N., & Farquhar, J. W. (1987). Perspectives on adolescent substance abuse. Journal of the American Medical Association, 258, 2072-2076.
36.
Siegal, F. P.
, Lopez, C., Hammer, G. S., Brown, A. E., Kornfeld, S. J., Gold, J., Hassett, J., Hirschman, S. Z., Cunningham-Rundles, C., Adelsberg, B. R., Parham, D. M., Siegal, M., Cunningham-Rundles, S., & Armstrong, D. (1981). Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions. New England Journal of Medicine, 305, 1439-1444.
37.
Sonenstein, F.
, Pleck, J., & Ku, L. (1989). Sexual activity, condom use and AIDS awareness among adolescent males. Family Planning Perspectives, 21, 152-158.
38.
St. Louis, M. E.
, Conway, G. A., Hayman, C. R., Miller, C., Petersen, L. R., & Dondero, T. J. (1991). Human immunodeficiency virus infection in disadvantaged adolescents. Journal of the American Medical Association, 266, 2387-2391.
39.
Stone, K. M.
, Grimes, D. A., Magder, L. S. (1986). Primary prevention of sexually transmitted diseases. Journal of the American Medical Association, 255, 1763-1766.
40.
Stone, E. J.
, & Perry, C. L. (1990). United States: Perspectives in school health. Journal of School Health, 60, 363-369.
41.
Telch, M. J.
, Miller, L. M., Killen, J. D., Cooke, S., & Maccoby, N. (1990). Social influences approach to smoking prevention: The effects of videotape delivery with and without same-age peer leader participation. Addictive Behavior, 15, 21-28.
42.
Van de Perre, P.
, Jacobs, D., & Sprecher-Goldberger, S. (1987). The latex condom, an efficient barrier against sexual transmission of AIDS-related viruses. AIDS, 1, 49-52.
43.
Wingood, G. M.
, & DiClemente, R. J. (1992). Cultural, gender and psychosocial influences on HIV-related behavior of African-American female adolescents: Implications for the development of targeted prevention programs. Ethnicity & Disease, 2, 381-388.
