Substance Use and Intention for Future Use in Adolescents After an HIV and Alcohol Prevention Education Program

Increasing substance use/abuse among adolescents in India is of concern to the general and academic community as well as policy makers. We looked at this pattern in our collaborative community and academic based initiative a School-based Teenage Education Program (STEP) focusing on alcohol abuse and HIV prevention with youth. The program was aimed at educating youth in public schools in three states of India. Utilizing Train-the-Trainer model, we trained over 70 undergraduate students (17-21 years) from local undergraduate colleges to provide the 10 session program to over 6000 8^th and 9^th grade students (13-16 years) in 100 schools in India.  Program effectiveness was measured by a series of self-reported knowledge, behavior-related questions, as well as history of alcohol use, risk taking behavior, self–efficacy, communication skills & future intentions of substance use.  

Close to eight percent (n=476) of the students reported using some kind of illicit drugs; 64.5% were boys and about 61% were ninth graders. The range of illicit substance use ranged  from 70.4% reporting using only one kind of substance to about 3.8% reported using up to five different illicit substances in their life time. There were significant gender differences in using one or more kind of illicit substances.  The majority of girls reported using one or two types of illicit substance but boys reported use of more than two; this difference was more pronounced for youth in the control group.  Youth in the intervention group were significantly more likely to report that they did not intend to use alcohol, drugs, inject drugs/steroids or tobacco in the next three months.  In addition, girls were significantly more likely than boys to report they did not intend to use alcohol, drugs, or tobacco in the next three months.  Greater knowledge, higher self-efficacy and low risk taking were also significantly associated with lower levels of substance use.   

The community based initiative though focusing on HIV and alcohol prevention only, also supported less future intention to use other substances like IV drug use, steroid and tobacco use. Participants in intervention group were less likely to indicate they intended to use controlled substances and there were significant differences by gender. In general, this cost and time effective program shows promise in building efficacy by increasing knowledge and skills  and as a result tends to reduce risk for adolescent in multiple aspects by focusing on building youth assets even by focusing on related variables.