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Overview of Demonstration Sites

Smiling WomanYoung people accounted for approximately 4 percent of AIDS diagnoses through 2003, and evidence suggests diagnoses are increasing in this population. About half of the nearly 19 million new sexually transmitted infections (STIs) diagnosed each year occur among youth aged 15–24 years. At highest risk for HIV and STIs are young women of color who are exposed through heterosexual contact, young men who have sex with men (YMSM), youth who engage in substance abuse, and runaways and other homeless young people who are exchanging sex for drugs or money.

The National Association of County and City Health Officials (NACCHO), in cooperation with the Division of Adolescent and School Health (DASH) of the Centers for Disease Control and Prevention (CDC), is developing and monitoring capacity building mechanisms for local health department (LHD) program and partnership development.

In 2005–2006, NACCHO awarded $12,000 to two LHDs to:

  • Plan and implement a means by which to reach adolescents at highest risk of STIs and HIV, and
  • Collect preliminary performance and evaluation data on the intervention.

Description of Programs

Collier County Health Department

Relatively few programs in the Collier County Health Department (CCHD) specifically target youth for HIV prevention. There are no programs or social or supportive institutions for young men who have sex with men (YMSM), aside from two local gay bars that exclude those under age 21. Collier County's lack of visible HIV prevention programs for youth may have created a false perception of safety for these individuals, similar to what is seen in rural areas.

CCHD adapted the Popular Opinion Leader (POL) HIV/STI Prevention Program, which is effective in working with MSM, minority women, and MSM sex workers. The project targets YMSM and includes a community assessment to further define the target population, estimate population size, and tailor the program and some of its content to address concerns specific to YMSM in Collier County. Rapid ethnographic and formative research methods were used to assess the at-risk community and to adapt the program to meet the needs of the community.

Washoe County District Health Department

The Washoe County District Health Department (WCDHD) serves one of the fastest growing communities in the nation. Adolescents are most affected by rising STI rates; 13- to 24-year-olds comprised 13 percent of all new HIV/AIDS cases in Washoe County in 2004. Hispanics in Washoe County are also overrepresented in the STI burden, and the county has one of the highest teen pregnancy rates in Nevada. Few sexual health interventions in the county are aimed at parents of adolescents, and none are conducted in Spanish. The lack of parenting groups was recently identified as a priority for the county in the Nevada HIV Prevention Plan, a community-driven document that guides all HIV activities.

WCDHD, in partnership with local youth-serving organizations (YSOs), implemented the Positive Choices Positive Futures (PCPF) curriculum, an evidence-based parent-child communication enhancement intervention. The PCPF classes are targeted to Spanish-speaking parents with the goal of providing increased knowledge and resources to address the topics of adolescent development, sexuality, family morals and values, and safer sexual practices with their adolescent children. Because of the data linking parental involvement and communication with a decrease in sexual risk taking among adolescents, PCPF complemented ongoing intervention strategies directly targeting youth.