HIV Prevention in Youth

A Framework for Research and Action
  • Richard A. Winett
  • Eileen S. Anderson
Part of the Advances in Clinical Child Psychology book series (ACCP, volume 16)


With increasing urgency, attention is turning to preventing HIV infection in youth. There are several reasons for this perceptible shift in policy (and allocation of program resources) from a more exclusive focus on adult homosexual and bisexual men, adult intravenous drug users and their sexual partners, female prostitutes, and women of lower socioeconomic status (Miller, Turner, & Moses, 1990). These reasons include: (1) The long incubation period required for the HIV infection to develop into AIDS. This period often lasts 8 to 10 years, indicating that many of the approximately 45,000 people with AIDS in the United States who were diagnosed in their 20s contracted HIV in their teenage years (Miller et al., 1990). (2) Epidemiological data from other countries showing the primary mode of HIV transmission is heterosexual contact. Recent reports show that 71% of AIDS cases worldwide are contracted through heterosexual transmission (Eckholm, 1992) in contrast to homosexual contact that accounted for 58% of AIDS cases in the United States (Eckholm, 1992). (3) Evidence indicating teens have not appreciably altered high-risk behaviors in this era of HIV and AIDS. For example, 80% of teens are reported to be sexually active before age 19, yet only a quarter to a third use condoms, and still fewer use condoms consistently (Pleck, Sonenstein, & Ku, 1991).


Human Immunodeficiency Virus Human Immunodeficiency Virus Infection Acquire Immune Deficiency Syndrome Social Marketing Homeless Youth 
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  1. Baldwin, J. D., & Baldwin, J. I. (1988). Factors affecting AIDS-related sexual risk-taking behaviors among college students. The Journal of Sex Research, 25, 181–196.CrossRefGoogle Scholar
  2. Bandura, A. J. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliff, NJ: Prentice-Hall.Google Scholar
  3. Biglan, A., Metzler, C. W., Wirt, R., Ary, D., Noell, J., Ochs, L., French, C., & Hood, D. (1990). Social and behavioral factors associated with high-risk sexual behavior among adolescents. Journal of Behavioral Medicine, 13, 245–261.PubMedCrossRefGoogle Scholar
  4. Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.Google Scholar
  5. Brown, L. K., Barone, V. J., Fritz, G. K., Cebollero, P., & Nassau, J. H. (1991). AIDS education: The Rhode Island experience. Health Education Quarterly, 18, 195–206.PubMedCrossRefGoogle Scholar
  6. Brownell, K. D., Marlatt, A., Lichtenstein, E., & Wilson, G. T. (1986). Understanding and preventing relapse. American Psychologist, 41, 765–782.PubMedCrossRefGoogle Scholar
  7. Bry, B. H., Conboy, C., & Bisgay, K. (1986). Decreasing adolescent drug use and school failure: Long-term effects of targeted family problem-solving training. Child and Family Behavior Therapy, 8, 43–59.CrossRefGoogle Scholar
  8. Caplan, M., Weissberg, R. P., Grober, J. H., Sivo, P. J., Grady, K., & Jacoby, C. (1992). Social-competence promotion with inner-city and suburban young adolescents: Effects on social adjustment and alcohol use. Journal of Consulting and Clinical Psychology, 60, 56–63.PubMedCrossRefGoogle Scholar
  9. Catania, J. A., Kegeles, S. H., & Coates, T. J. (1990). Toward an understanding of risk behavior: An AIDS risk reduction model (ARRM). Health Education Quarterly, 17, 53–72.PubMedCrossRefGoogle Scholar
  10. Centers for Disease Control (1992, July). Human immunodeficiency virus infection in the United States: Monthly reporting. Atlanta: Author.Google Scholar
  11. Crawford, I., Jason, L. A., Riordan, N., Kaufman, J., Salena, D., Sawalski, L., & Chu Ho, F. (1990). A multimedia-based approach to increasing communication and the level of AIDS knowledge within families. Journal of Community Psychology, 18, 361–373.CrossRefGoogle Scholar
  12. Department of Health and Human Services (1991). Healthy people 2000: National health promotion and disease prevention objectives. Washington, DC: U.S. Government Printing Office.Google Scholar
  13. DiClemente, R. J. (1990). The emergence of adolescents as a risk group for human immunodeficiency virus infection. Journal of Adolescent Research, 5, 7–17.CrossRefGoogle Scholar
  14. DiClemente, R. J., Lanier, M. M., Horan, P. F., & Lodico, M. (1991). Comparison of AIDS knowledge, attitudes, and behaviors among incarcerated adolescents and a public school sample in San Francisco. American Journal of Public Health, 81, 628–630.CrossRefGoogle Scholar
  15. Donovan, J. E., Jessor, R., & Costa, F. (1988). The syndrome of problem behavior in adolescence: A replication. Journal of Consulting and Clinical Psychology, 56, 762–765.PubMedCrossRefGoogle Scholar
  16. Dryfoos, J. G. (1990). Adolescents at risk: Prevalence and prevention. New York: Oxford University Press.Google Scholar
  17. Eckholm, E. (1992, June 26). AIDS, fatally steady in U.S., accelerates worldwide. New York Times, p. E5.Google Scholar
  18. Erikson, E. (1968). Identity: Youth and crisis. New York: W. W. Norton & Co.Google Scholar
  19. Evans, R. I., Rozelle, R. M., Maxwell, S. E., Raines, B. E., Dill, C. A., Gutherie, T. J., Henderson, A. H., & Hill, P. C. (1981). Social modeling films to deter smoking in adolescents: Results of a three-year field investigation. Journal of Applied Psychology, 66, 399–414.CrossRefGoogle Scholar
  20. Fairweather, G. W., & Toronatsky, L. G. (1977). Experimental methods for social policy research. Elmsford, NY: Pergamon Press.Google Scholar
  21. Farquhar, J. W., Fortmann, S. P., Flora, J. A., Taylor, C. B., Haskell, W. L., Williams, P. T., Maccoby, N., & Wood, P. D. (1990). Effects of community-wide education on cardiovascular risk factors. Journal of the American Medical Association, 264, 359–365.PubMedCrossRefGoogle Scholar
  22. Fishbein, M. Y., & Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.Google Scholar
  23. Fisher, J. D., & Fisher, W. A. (1992). Changing AIDS risk behavior. Psychological Bulletin, 111, 455–474.PubMedCrossRefGoogle Scholar
  24. Flavell, J. (1984, November). Cognitive development of adolescents. Paper presented at the Stanford University Conference on Understanding Risk-taking Behaviors in Adolescents. Palo Alto, CA.Google Scholar
  25. Gardner, W., & Herman, J. (1990). Adolescents’ AIDS risk-taking: A rational choice perspective. In W. Gardner, S. G. Millster, & B. Wilcox (Eds.), New Directions for Child Development, Vol. 50: Adolescents in the AIDS Epidemic (pp. 17–34). San Francisco: Jossey-Bass, Inc.Google Scholar
  26. Hanlon, J. J., & Pickett, G. E. (1984). Public health: Administration and practice (8th Ed.). St. Louis: Mosby.Google Scholar
  27. Hingson, R. W., Strunin, L., Berlin, B. M., & Heeren, T. (1990). Beliefs about AIDS, use of alcohol and drugs, and unprotected sex among Massachusetts adolescents. American Journal of Public Health, 3, 295–299.CrossRefGoogle Scholar
  28. Jeffrey, R. W. (1989). Risk behavior and health: Contrasting individual and population perspectives. American Psychologist, 44, 1194–1202.CrossRefGoogle Scholar
  29. Jemmott, J. B. III, Jemmott, L. S., & Fong, G. T. (1992). Reducing the risk of sexually transmitted HIV infection: Attitudes, knowledge, and behavior. American Journal of Public Health, 82, 372–377.PubMedCrossRefGoogle Scholar
  30. Jessor, R., & Jessor, S. L. (1977). Problem behavior and psychosocial development. New York: Academic Press.Google Scholar
  31. Jones, E. F. (1989). Pregnancy, contraception, and family planning services in industrialized countries: A study of the Alan Guttmacher Institute. New Haven: Yale University Press.Google Scholar
  32. Kazdin, A. E. (1989). Behavior modification in applied settings (4th ed.). Belmont, CA: Brooks/Cole.Google Scholar
  33. Kegeles, S. M., Adler, N. E., & Irwin, C.E. (1990). Sexually active adolescents and condoms: Changes over one year in knowledge, attitudes, and use. American Journal of Public Health, 78, 460–461.CrossRefGoogle Scholar
  34. Kelly, J. A., & St. Lawrence, J. S. (1988). The AIDS health crisis: Psychological and social intervention. New York: Plenum Press.CrossRefGoogle Scholar
  35. Kelly, J. A., St. Lawrence, J. S., Diaz, Y. E., Stevenson, L. Y, Hauth, A. C., Brasfield, T. L., Kalichman, S. C., Smith, J. E., & Andrew, M. E. (1991). HIV risk behavior redirection following intervention with key opinion leaders of population: An experimental analysis. American journal of Public Health, 81, 168–171.PubMedCrossRefGoogle Scholar
  36. Kotier, P., & Roberts, E. L. (1989). Social marketing: Strategies for changing public behavior. New York: Free Press.Google Scholar
  37. Lewis, C., Battistick, V., & Schaps, E. (1990). School-based primary prevention: What is an effective program? In W. Gardner, S. G. Millster, & B. Wilcox (Eds.), New Directions for Child Development, Vol. 50: Adolescents in the AIDS Epidemic (pp. 35–60). San Francisco: Jossey-Bass, Inc.Google Scholar
  38. Manoff, R. K. (1985). Social marketing: Imperative for public health. New York: Praeger.Google Scholar
  39. Marlatt, G. A., & Gordon, J. R. (1985). Relapse prevention: Maintenance strategies in addictive behavior change. New York: Guilford.Google Scholar
  40. Mays, V. M., & Cochran, S. E. (1988). Issues in the perception of AIDS risk and risk reduction activities by Black and Hispanic/Latino women. American Psychologist, 14, 949–957.CrossRefGoogle Scholar
  41. Miller, H. G., Turner, C. F., & Moses, L. E. (Eds.). (1990). AIDS: The second decade. Washington, DC: National Academy Press.Google Scholar
  42. Morbidity and Mortality Weekly Report (MMWR) (1989). Results from the national adolescent student health survey. Journal of the American Medical Association, 261, 2025–2030.CrossRefGoogle Scholar
  43. Perry, C. L., & Jessor, R. (1985). The concept of health promotion and the prevention of adolescent drug abuse. Health Education Quarterly, 12, 169–184.PubMedCrossRefGoogle Scholar
  44. Piaget, J., & Inhelder, B. (1969). The psychology of the child. New York: Basic Books.Google Scholar
  45. Pleck, J. H., Sonenstein, F. L., & Ku, L. C. (1991). Adolescent males’ condom use: Relationships between perceived cost benefits and consistency. Journal of Marriage and the Family, 53, 733–745.CrossRefGoogle Scholar
  46. Prochaska, J. O. (1992, March). A transtheoretical model of behavior change: Implications for diet interventions. Proceedings of the conference on promoting dietary change in communities: Applying existing models of dietary change to population-based interventions (pp. 37–52). Seattle: Fred Hutchinson Cancer Research Center.Google Scholar
  47. Prochaska, J. O., & DiClemente, C. C. (1983). Stage process of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390–395.PubMedCrossRefGoogle Scholar
  48. Reppucci, N. D. (1987). Prevention and ecology: Teenage pregnancy, child sexual abuse, and organized youth sports. Journal of the American Geriatric Society, 34, 854–859.Google Scholar
  49. Rogers, E. M. (1983). Diffusion of innovation. New York: The Free Press.Google Scholar
  50. Rolf, J., Nanda, J., Baldwin, J., Chandra, A., & Thompson, L. (1991). Substance misuse and HIV/AIDS risks among delinquents: A prevention challenge. The International Journal of the Addictions, 25, 533–539.Google Scholar
  51. Rotheram-Borus, M. J., Koopman, C., & Ehrhardt, A. A. (1991). Homeless youths and HIV infection. American Psychologist, 46, 1188–1197.PubMedCrossRefGoogle Scholar
  52. Shure, M. B., & Spivack, G. (1988). Interpersonal cognitive problem solving. In R. H. Price, E. L. Cowen, R. P. Lorion, & J. Ramos-McKay (Eds.), 14 ounces of prevention: A casebook for practitioners (pp. 69–82). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  53. Sonenstein, F. L., Pleck, J. H., & Ku, L. C. (1989). Sexual activity, condom use, and AIDS awareness among adolescent males. Family Planning Perspectives, 22(4), 152–158.CrossRefGoogle Scholar
  54. Weissberg, R. P., Caplan, M., & Harwood, R. L. (1991). Promoting competent young people in competency-enhancing environments: A systems-based perspective on primary prevention. Journal of Consulting and Clinical Psychology, 59, 830–841.PubMedCrossRefGoogle Scholar
  55. Wendell, D. A., Onorato, I. M., McCray, E., Allen, D., & Sweeny, P. A. (1992). Youth at risk: Sex, drugs, and human immunodeficiency virus. American journal of Diseases in Children, 146, 76–81.Google Scholar
  56. Winett, R. A. (1986). Information and behavior: Systems of influence. Englewood Cliffs, NJ: Lawrence Erlbaum Associates, Inc.Google Scholar
  57. Winett, R. A. (in press). Media-based behavior change approach for prevention in the community: Behavioral systems framework. In D. Glenwick & L. A. Jason (Eds.), Prevention in the community: Behavioral approaches to intervention. New York: Springer.Google Scholar
  58. Winett, R. A., King, A. C., & Altman, D. G. (1989). Health psychology and public health: An integrative approach. New York: Pergamon Press.Google Scholar
  59. Winett, R. A., Altman, D. G., & King, A. C. (1990). Conceptual and strategic foundations for effective media campaigns for preventing the spread of HIV infection. Evaluation and Program Planning, 13, 91–104.CrossRefGoogle Scholar
  60. Winett, R. A., Moore, J. F., & Anderson, E. S. (1991). Extending the concept of social validity: Behavior analysis for disease prevention and health promotion, journal of Applied Behavior Analysis, 24, 215–230.PubMedCrossRefGoogle Scholar
  61. Winett, R. A., Anderson, E. S., Moore, J. F., Sikkema, K. J., Hook, R. J., Webster, D. A., Taylor, C. D., Dalton, J. E., Ollendick, T. H., & Eisler, R. M. (1992). Family/media approach to HIV prevention: results with a home-based parent-teen video program. Health Psychology, 11, 203–206.PubMedCrossRefGoogle Scholar
  62. Winett, R. A., Anderson, E. S., Moore, J. F., Taylor, C. D., Hook, R. J., Webster, D. A., Neubauer, T. E., Harden, M. C., & Mundy, L. L. (1992). The efficacy of an HIV prevention video program for teens and parents promoted through primary care physicians. Manuscript submitted for publication.Google Scholar
  63. Winett, R. A., Southard, D. R., & Walberg-Rankin, J. (1993). Nutrition promotion and dietary change. Medicine, Exercise, Nutrition, and Health, 2, 2–24.Google Scholar
  64. Zierler, S., Feingold, L., Laufer, D., Velentgas, I., Krantrowitz-Gordon, I., & Mayer, K. (1991). Adult survivors of childhood sexual abuse and subsequent risk of HIV infection. American Journal of Public Health, 81, 572–616.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Richard A. Winett
    • 1
  • Eileen S. Anderson
    • 1
  1. 1.Center for Research in Health BehaviorVirginia Polytechnic Institute, and State UniversityBlacksburgUSA

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