National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention 

Division of Adolescent and School Health 

CS218336-A

Effective HIV and STD Prevention Programs for Youth: 

A Summary of Scientific Evidence 

Just as schools are critical settings for preparing students academically, they are 

also vital partners in helping young people take responsibility for their own health. 

School health programs can help youth adopt lifelong attitudes and behaviors that 

support overall health and well-being—including behaviors that can reduce their 

risk for HIV and other sexually transmitted diseases (STDs). 

HIV/STD prevention programs implemented by schools include prevention 

education programs designed specifically to reduce sexual risk behaviors and youth 

asset-development programs, which provide adolescents with more general skills 

that help them engage in healthy behaviors and solve problems. 

Effective HIV/STD Prevention Education Programs 

Research shows that well-designed and well-implemented HIV/STD prevention 

programs can decrease sexual risk behaviors among students, including— 

 Delaying first sexual intercourse.1-4 

 Reducing the number of sex partners.4-7 

 Decreasing the number of times students have unprotected sex.8-9 

 Increasing condom use.8,10-11 

A review of 48 research studies found that about two-thirds of the HIV/STD 

prevention programs studied had a significant impact on reducing sexual risk 

behaviors, including a delay in first sexual intercourse, a decline in the number of 

sex partners, and an increase in condom or contraceptive use. Notably, the HIV 

prevention programs were not shown to hasten initiation of sexual intercourse 

among adolescents, even when those curricula encouraged sexually active young 

people to use condoms.12-13 

In addition to determining programs that are most effective in reducing sexual 

health risk behaviors among youth, scientists also have identified key common 

attributes among these programs. Effective HIV/STD prevention programs tend to 

be those that 

 Are delivered by trained instructors. 

 Are age-appropriate. 

 Include components on skill-building, support of healthy behaviors in school 

environments, and involvement of parents, youth-serving organizations, and health 

organizations. 12 

These common traits should guide curriculum development and integration of 

program activities for HIV/STD prevention programs in schools and communities. 

Youth Asset-Development Programs 

A promising approach to HIV prevention seeks to increase the skills of children and 

adolescents to avoid health risks, including sexual risk behaviors.14-17 Youth assetdevelopment programs, including those conducted in schools, teach youth how to 

solve problems, communicate with others, and plan for the future. They also help 

youth develop positive connections with their parents, schools, and communities. 

Youth asset-development programs typically address multiple health risk behaviors 

and are commonly provided to children and adolescents over a number of 

years. Evidence indicates that these programs can be associated with long-term 

reductions in sexual risk behaviors.22 
October 1, 2010 

CDC’s Ongoing Efforts To Identify and Implement Effective 

HIV/STD Prevention Programs for Youth 

CDC’s Division of Adolescent and School Health (DASH) 

supports rigorous evaluation research and other projects to 

identify the types of programs and practices that can reduce 

sexual risk behaviors among youth: 

 DASH has supported the development and evaluation of 

– All About Youth, a randomized, controlled trial testing 

two HIV/STD education programs for middle school 

students: one that emphasizes sexual abstinence until 

marriage, and one that emphasizes abstinence in 

conjunction with skill-building 

activities for condom and contraceptive use. 

– Linking Lives, a program designed to build parents’ skills to help them reduce 

sexual health risks among their middle school children. 

 DASH and CDC’s Division of Reproductive Health collaborated with partners to 

publish a systematic review of the growing body of evidence on positive youth 

development approaches for reducing HIV, sexually transmitted infections, and 

unintended pregnancy.22 

 DASH scientists 

– Analyze research on program effectiveness. 

– Develop guidelines for best practices in schoolbased HIV prevention. 

– Create tools to help schools implement the 

guidelines, such as the Health Education 

Curriculum Analysis Tool (www.cdc.gov/HECAT), 

which integrates research findings and national 

health education standards to help school 

districts select or develop health education 

curricula that are most likely to reduce sexual 

risk behaviors among the youth they serve. 

Reducing Risk Behaviors and Saving Money 

Effective HIV/STD prevention programs are cost-effective. 

An economic analysis of one school-based sexual risk 

reduction program found that for every dollar invested 

in the program, $2.65 was saved in medical costs and lost 

productivity.18 Other studies have found similar savings 

for HIV prevention programs focusing on youth who are 

at disproportionate risk for HIV, including young gay 

and bisexual men19-20 and urban African American male 

adolescents.21 

For More Information 

For more information about DASH and its programs, 

surveillance, and research, please contact: 

www.cdc.gov/HealthyYouth 

1-800-CDC-INFO (1-800-232-4636) 

nccddashinfo@cdc.gov 

References 

1. Tortolero S, Markham C, Peskin M, Shegog R, Addy R, Escobar-Chavez L, et al. It’s your game: 

keep it real: delaying sexual behavior with an effective middle school program. Journal of 

Adolescent Health 2010;46(2):169–179. 

2. Coyle K, Kirby D, Marín B, Gómez C, Gregorich S. Draw the line/respect the line: a randomized 

trial of a middle school intervention to reduce sexual risk behaviors. American Journal of 

Public Health 2004;94(5):843–851. 

3. Sikkema K, Anderson E, Kelly J, Winett R, Gore-Felton C, Roffman R, et al. Outcomes of a 

randomized, controlled community-level HIV prevention intervention for adolescents in lowincome housing developments. AIDS 2005;19(14):1509–1516. 

4. Jemmott J, Jemmott L, Fong G. Efficacy of a theory-based abstinence-only intervention over 

24 months: a randomized controlled trial with young adolescents. Archives of Pediatrics & 

Adolescent Medicine 2010;164(2):152–159. 

5. Villarruel A, Jemmott J , Jemmott L. A randomized controlled trial testing an HIV prevention 

intervention for Latino youth. Archives of Pediatrics & Adolescent Medicine 2006;160(8):772– 

777. 

6. Koniak-Griffin D, Lesser J, Nyamathi A, Uman G, Stein J, Cumberland W. Project CHARM: an HIV 

prevention program for adolescent mothers. Family & Community Health 2003; 26(2):94–107. 

7. Shrier L, Ancheta R, Goodman E, Chiou V, Lyden M, Emans J. Randomized controlled trial 

of a safer sex intervention for high-risk adolescent girls. Archives of Pediatrics & Adolescent 

Medicine 2001;155:73–79. 

8. Coyle K, Kirby D, Robin L, Banspach S, Baumler E, Glassman J. All4You! A randomized trial of 

an HIV, other STDs, and pregnancy prevention intervention for alternative school students. 

AIDS Education and Prevention 2006;18(3):187–203. 

9. Jemmott J, Jemmott L, Braverman P, Fong G. HIV/STD risk reduction interventions for 

African American and Latino adolescent girls at an adolescent medicine clinic: a randomized 

controlled trial. Archives of Pediatrics & Adolescent Medicine 2005;159:440–449. 

10. DiClemente R, Wingood G, Rose E, Sales E, Lang D, Caliendo A, et al. Efficacy of sexually 

transmitted disease/human immunodeficiency virus sexual risk-reduction intervention for 

African American adolescent females seeking sexual health services: a randomized controlled 

trial. Archives of Pediatric & Adolescent Medicine 2009;163(12):1112–1121. 

11. DiClemente R, Wingood G, Harrington K, Lang D, Davies S, Hook E III, et al. Efficacy of an HIV 

prevention intervention for African American adolescent girls: a randomized controlled trial. 

Journal of the American Medical Association 2004;292:171–179. 

12. Kirby D. Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy 

and Sexually Transmitted Diseases. Washington, DC: National Campaign to Prevent Teen 

Pregnancy; 2007. 

13. Kirby D. The impact of abstinence and comprehensive sex and STD/HIV education programs 

on adolescent sexual behavior. Sexuality Research & Social Policy 2008;5(3):18–27. 

14. Philliber S, Kaye J, Herrling S, West E. Preventing pregnancy and improving health care access 

among teenagers: an evaluation of the Children’s Aid Society-Carrera Program. Perspectives 

on Sexual and Reproductive Health 2002;34(5):244–251. 

15. Lonczak H, Abbott R, Hawkins D, Kosterman R, Catalano R. Effects of the Seattle Social 

Development Project on sexual behavior, pregnancy, birth, and sexually transmitted disease 

outcomes by age 21 years. Archives of Pediatrics & Adolescent Medicine 2002;156:438–447. 

16. Hawkins J , Catalano R, Kosterman R, Abbott R, Hill K. Preventing adolescent health-risk 

behaviors by strengthening protection during childhood. Archives of Pediatrics & Adolescent 

Medicine 1999;153:226–234. 

17. Hawkins J, Kosterman R, Catalano R, Hill K, Abbott R. Effects of social development 

intervention in childhood 15 years later. Archives of Pediatrics & Adolescent Medicine 

2008;162(12):1133–1141. 

18. Wang L, Davis M, Robin L, Collins J, Coyle K. Economic evaluation of Safer Choices: a schoolbased HIV/STD and pregnancy prevention program. Archives of Pediatrics & Adolescent 

Medicine 2000;154(10):1017–1024. 

19. Tao G, Remafedi G. Economic evaluation of an HIV prevention intervention for gay and 

biseuxal male adolescents. Journal of Acquired Immune Deficiency Syndromes and Human 

Retrovirology 1998;83-90. 

20. Kahn J, Kegeles S, Hays R, Beltzer N. Cost-effectiveness of the Mpowerment project, a 

community-level intervention for young gay men. Journal of Acquired Immune Deficiency 

Syndrome 2001;27(5): 482–491. 

21. Pinkerton S, Holtgrave D, Jemmott J. Economic evaluation of HIV risk reduction intervention 

in African-American male adolescents. Journal of Acquired Immune Deficiency Syndrome 

2000;25(2):164–172. 

22. Gavin L, Catalano R, David-Ferdon C, Gloppen K, Markham C. A review of positive youth 

development programs that promote adolescent sexual and reproductive health. Journal of 

Adolescent Health 2010;46:S75–S91. 

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