Preventive Effects of a Relational Skill-Based Intervention on Risky Sexual Behaviors Among at-Risk Girls

INTRODUCTION: Girls involved in the juvenile justice system and those exposed to early adversity have elevated rates of involvement in risky sexual behaviors (RSB) and subsequent negative health outcomes including sexually transmitted infections and unintended pregnancies. Few preventive intervention programs exist that are both evidence based and available to this at-risk population. The present study sought to address this gap by examining the effects of a relational and social-skill based intervention on RSB outcomes for at-risk teen girls. The intervention included one-on-one skill-building sessions for girls (12 sessions) and a group-based parenting component delivered to the primary caregivers in weekly parenting groups (14 sessions).

METHODS: Data from 122 girls (Baseline/T1 age= 15.4±1.48 years), who were recruited from the Department of Youth Services (63%; n=76) and community agencies serving at-risk girls (37%; n=46) and randomly assigned to the intervention or a services-as-usual control condition, were analyzed to assess effects of the intervention on RSB outcomes at 6-months (T2), and 12 months post-baseline (T3). Participants self-identified into the following racial-ethnic groups: 62% non-Hispanic White, 7% non-Hispanic Black, 12% Hispanic, 11% more than one race, and 8% other racial-ethnic backgrounds including Native American, Asian American, and Pacific Islander. RSB was assessed (T1-T3) using a composite of 8 items including number of romantic partners, frequency of kissing, frequency of touching above the waist, frequency of touching below the waist, frequency of pressure to go further sexually, any sexual activity, number of sexual partners, and use of safe sex practices (0.89).

RESULTS: Controlling for the effects of age, race-ethnicity, and personality risk indicators of impulsivity and sensation seeking, girls assigned to the intervention condition reported significant reductions in RSB immediately post-intervention (from T1-T2) as compared to the control group, B(SE) = -0.22 (0.10), p <0.05. The effect was not significant at T3, B(SE) = -0.13(0.09), p=0.15. However, significant intervention effects were observed at T3 for condom use, with girls in the intervention group reporting more consistent condom use as compared to girls in the control group, B(SE) = -0.59 (0.31), p <0.05.

CONCLUSION: Findings provide preliminary evidence regarding the efficacy of a skill-based intervention with parent and teen components in reducing RSB and promoting safe sex practices in a high-risk sample of teen girls. Next steps include exploring proximal mediators of intervention effects such as knowledge of safe sex practices, comfort in discussing safe sex options with partners, and parenting behaviors.