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Comprehensive Risk Reduction for Adolescents

Comprehensive risk reduction (CRR) for adolescents is recommended by the Guide to Community Preventive Services, which reports that both CRR interventions and interventions which integrate community service have been effective in reducing sexual risk behaviors among adolescents 10-19 years old. CRR interventions promote behaviors that have been shown to prevent or reduce the risk of HIV infection. Interventions are group-based, aim to build skills and increase knowledge for youth, and can be implemented in school or community settings.

Examples of Rural Comprehensive Risk Reduction Programs for Adolescents:

  • Native STAND is an example of an adapted CRR program to target and improve decision-making for American Indian/Alaska Native youth in several rural states. STAND, or Students Together Against Negative Decisions, is a curriculum developed to train peer educators in rural Georgia to work with other adolescents to improve knowledge and decision-making related to HIV, pregnancy, and sexually transmitted infections (STIs). An evaluation of STAND found that the program was effective in improving specific sexual knowledge and behaviors among participants in the school group.
  • Strong African American Families-Teen (SAAF-T) is a risk reduction intervention included in the Centers for Disease Control and Prevention Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention. This model was designed to target African American adolescents and their families living in the rural South. The intervention aims to reduce unprotected sex and increase condom use through group-level skills training. An evaluation of program implementation in Georgia public high schools from 2007 to 2010 demonstrated that participants reported significantly lower frequency of unprotected sex after completion of the program.

Considerations for Implementation

Programs targeted at adolescents must consider the most appropriate setting for the intervention, including location, gender composition of the group, transportation issues, and group leadership. Comprehensive risk reduction interventions implemented in public schools in particular must be aware of state laws that could prohibit discussion of sexual risk behaviors. Some states may mandate or encourage abstinence-only education, which may not be compatible with the curricula of some interventions or with condom distribution programs. State laws also vary about whether parental consent is required or can be revoked (through “opt-out” policies) for sexual education or HIV education in the schools. For more implementation considerations for programs working with adolescents, please see: Implementation Considerations/Adolescents.

Resources to Learn More

HIV Risk Reduction Tool (Beta version)
Customizable profile that allows individuals to gauge their HIV risk information based on gender and lifestyle habits. Once users specify this information, they can read additional information about different successful methods of preventing HIV.
Organization(s): Centers for Disease Control and Prevention

HIV/AIDS, STIs and Pregnancy
Provides information about different types of evidence-based HIV prevention interventions, categorized by the target population. Focuses on the prevention of HIV and sexually transmitted infections in adolescents aged 10-19 years. Includes Task Force findings and the level of evidence for each intervention type.
Organization(s): Community Preventive Services Task Force, The Community Guide