The Body of Power Dr. Kimberly Brodie Health Behavior Theory MPH 515 Sara Quale Dec. 16, 2013 Combatting the Spread of Sexually Transmitted Disease in Adolescents

1.3 million cases of chlamydia in ,341 cases of gonorrhea in ,774 cases of syphilis in 2010 HIV has much higher case rate among young, black males (Stoner and Rother, 2012) The problem Twenty million infections of sexually transmitted diseases (STDs) occur annually, half in people ages (CDC Fact Sheet, 2011). Most common infections are: Chlamydia Gonorrhea Syphilis HIV Young women have higher rates of chlamydia. HIV case rates higher in young, black males.

Why teens need help Individuals who are infected with STDs are 2 to 5 times more likely than people who aren’t infected to acquire HIV if they are exposed to HIV during sex. STDs can cause pelvic inflammatory disease and ectopic pregnancy in women and health complications including infertility in men (CDC Fact Sheet, 2013). STDs also can spread from mothers to newborns during birth. STDs can be treated and sometimes cured if caught early. Younger people are at a greater risk because they aren’t diagnosed early due to lack of symptoms or they don’t get screened (CDC Fact Sheet, 2013). Prevent lifelong health complications Teens avoid screening because of fears of confidentiality or discussing issue with parents.

Focuses in TPB on STDs Teen’s attitude toward sex Teen’s attitude toward infections/disease risk Teen’s attitude toward condom use Parents’ attitude toward teen sex Peer norms Peer beliefs about safe sex Facilitating factors and inhibitors to abstinence/safe sexual behaviors and condom use Theory of Planned Behavior Value-expectancy theory Weighs a person’s attitude, subjective norms and beliefs about efficacy and self-efficacy toward a behavior to form intention of adopting a health behavior (DiClemente, Salazar and Crosby, 2103).

Approaches to Sexual Education in Teens Use of Social Cognitive Theory, Theory of Reasoned Action and Theory of Planned Behavior in combined abstinence and prevention program, “Making Proud Choices” Emphasizes self-efficacy, goal setting, strong attitudes and support for prevention, peer attitudes and partner belief/support. Favorable results toward more consistent condom use, less unprotected sex Less sexual intercourse among active teens Drawback –opposition from supporters of abstinence only education (Resources Center for Adolescent Pregnancy Prevention, 2007). “Promoting Health Among Teens! Abstinence only Version” Follows similar model, but omits discussion of safe sex options and condoms Reported reduction in incidence of recent sexual intercourse Criticized as being moralistic and including incorrect information on condom use May be ineffective in teens who are already sexually active (Jemmott, Jemmott, & Font, 2009). AIDS prevention for Adolescents in School (Health Belief Model) Focused on skills to reduce risk including condom use Successful in increasing monogamy, reduction of multiple drug-using partners and increased condom use (Walter and Vaughan, n.d.). Existing programs

Following the TPB The Body of Power uses the three constructs of the Theory of Planned Behavior to help teens adopt healthy behaviors and prevent the spread of STDs. The Body of Power Program will impact rate of STDs in adolescents by influencing attitudes toward teen sex, consequences of sex and skills needed to get out of tough situations. Personal attitude: Evaluate beliefs toward sex Visualize what it means to be a teen (goals, dreams) Discuss how or if sex fits into those goals and dreams Discuss long-term consequences of STDs Subjective norms: Parents attitudes toward sex Impacts of STDs on future relationships

The Body of Power Individual access, achievability and self-efficacy Increase screening availability, health services, medical insurance Improve negotiating skills to say no Increase knowledge of and access to condoms Implementation channels: Small groups Classroom education Electronic media Testimonials Media spots continued