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Say It With Research: 4 Ways to Deliver Effective STD Messaging for Youth
By Cody Sigel, MPH, CHES | May 19, 2016
The history of sex education in the United States is fraught with horror stories, from fear-based tactics to blatant misinformation. Sadly, ineffective sex education is not a thing of the past. A recent CDC report shows that most middle and high schools around the country are not implementing effective approaches to sexuality education. It’s no surprise that statistics about the impact of STDs on young people are discouraging.
What’s more discouraging perhaps is that we have answers and proven effective programs and strategies that we could use to bring about positive change. When it comes to framing our messaging around STD prevention with youth, we should be using research to guide us to results!
Let’s take a look at four educational strategies educators can easily apply. Trust the science and the behavior change theories of public health and we will see a difference!
STD & Youth
- There will be 20 million new cases of STD in the coming year, and half will occur in young people aged 15 to 24.
- Youth aged 13 to 24 account for 1 in 5 new HIV diagnoses—about 10,000 cases a year.
- Four in 10 sexually active teen girls have had an STD that can result in infertility and even death.
1. Focus on Key Concepts. Repeat.
Knowledge alone doesn’t change sexual risk behaviors among youth. To do this, we need to influence risk and protective factors. That includes having an impact on attitudes, beliefs, perceived susceptibility and severity, and self-efficacy.
Teaching every clinical detail about chlamydia will not lead to a change in condom use behavior among youth. Focusing on key concepts that can shape beliefs and attitudes about condoms will.
The human brain does not finish maturing until about age 25. The prefrontal cortex, the part of the brain that is responsible for complex and abstract thinking, is not fully developed in adolescents. This is why key concepts and concrete lessons need to be central in sexual health education for youth. And it’s why we need to repeat those key concepts—that helps them make a true imprint on the developing brain.
Examples of Key Concepts About STDs
- “Having unprotected sex of any kind puts you at risk for STDs and HIV.”
- “HIV is a serious disease that can lead to death.”
- “Anyone can get an STD or HIV if they engage in risky behavior.”
- “You can prevent HIV and other STDs by choosing not to have sex. If you choose to have sex, you can reduce your risk by using a barrier method (such as condoms) every time you have sex.”
- “Many teens successfully use condoms.”
- “The only way to know if you have HIV or other STDs is to get tested for them.”
Use and Repeat Key Concepts About STDs
- Focus on the clear goal of preventing STDs.
- Focus on specific behaviors leading to this goal.
- Use key concepts to respond to or reframe student questions that may be overly detailed or “in the weeds.”
- Spend more time teaching, emphasizing and repeating key concepts, and less time introducing and reviewing facts.
2. Focus on Testing, Not Symptoms
Many educators, when introducing STDs, review signs and symptoms in detail. However, many STDs have no signs or symptoms at all. Without symptoms, sexually active teens often do not realize they might have STD.
One of the most effective ways educators can help young people prevent STDs and HIV is to focus on the importance of testing. Research shows that educating young people about STDs and HIV can encourage them to seek testing. Programs are especially helpful when they include information on locations for obtaining free or low-cost teen-friendly STD testing.
Emphasize the Importance of STD Testing
- Reinforce the concept that many STDs have no symptoms.
- Integrate information into your lesson about where to receive free or low-cost STD testing services.
- Emphasize that STD testing is an additional responsibility that comes with the choice to become sexually active.
- Repeat the key concept about STD testing: “The only way to know if you have HIV or other STDs is to get tested for them.”
3. Avoid STD Pictures and Fear-Based Tactics
Sometimes sexual health teachers show students graphic pictures of genitals showing lesions or other symptoms of STDs. This is an ineffective strategy for several reasons.
Inducing fear is not an effective way to promote sexual health risk reduction. Showing images of symptomatic genitals might lead some youth to believe that if their own genitals do not look like those shown in the image, they and their partner must not be infected with an STD.
For some students, these graphic and disturbing pictures are the first realistic images they have seen of genitals. This negative approach pathologizes sexual activity instead of promoting positive sexual health and personal responsibility.
Teach Information About STDs Effectively, Without Showing Pictures
- Avoid fear- and shame-based activities.
- Emphasize that most STDs will not present any symptoms.
- Emphasize correct and consistent condom use and routine STD testing as specific behaviors to reduce risk.
- Repeat key concepts related to STD prevention.
4. Encourage Positive Attitudes Toward Condoms
One of the most effective actions sexually active youth can take to reduce their risk for STD infection is to correctly and consistently use condoms. Research shows that positive attitudes toward condoms are a protective factor that leads to reduced sexual activity and increased condom use. Further, condom use self-efficacy, or the confidence that one can use condoms correctly and consistently, is a protective factor that can encourage condom use.
Encourage Condom Use Among Youth
- Reinforce that condoms are the most effective form of STD prevention among sexually active youth. Promote condoms as a method that also protects against unintended pregnancy.
- Use gain-framed messages (“What’s in it for me?”). Young people are more likely to report intention to use condoms when they receive the message that condom use reduces STD risk, rather than the message that not using condoms increases STD risk.
- Don’t forget oral sex! Only 20% of young people consider oral sex to be sex. Emphasize that any type of sex, be it vaginal, anal or oral, comes with risks for STDs, and it is important to use a barrier method every time to reduce the risk of transmission.
- Repeat the key concepts related to condom use: “Condoms are safe and effective” and “Many youth successfully use condoms.”
Emphasizing these key concepts and messages can help all of us have a genuine impact with youth. Let’s use the research to make sure the classes we teach don’t end up in a sex ed horror story!
I’d love to hear what you do to communicate key concepts to youth in your classes and programs.
Cody Sigel, MPH, CHES, is a Professional Development Consultant with ETR.
