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- Morbidity and Mortality Weekly Report
- Thursday June 14, 1990
-
- Current Trends
-
- HIV-Related Knowledge and Behaviors Among High School Students --
- Selected U.S. Sites, 1989
-
- Since 1987, state, territorial, and local departments of education
- have periodically assessed human immunodeficiency virus (HIV)-related
- knowledge and behaviors among high school students (13-18 years of age)
- in their jurisdictions (1). This report presents selected data from
- surveys conducted by departments of education in 30 states, 10 cities,
- and two territories during February-May 1989.
-
- A questionnaire for anonymous self-administration was developed by
- representatives from 71 state, territorial, and local departments of
- education, with technical assistance from CDC. The questionnaire
- contained 39 questions: five for assessing demographic characteristics
- of respondents, 26 for HIV-related knowledge and beliefs, and eight for
- intravenous (IV)-drug use and sexual behaviors. Each department of
- education chose which of the 39 questions to administer: all sites
- administered questions that assessed demographic characteristics and
- HIV-related knowledge and beliefs; 25 sites, questions that assessed
- IV-drug-use behaviors; and 19 sites, questions that assessed sexual
- behaviors.
-
- Sampling schemes varied among the 42 sites. Eleven sites* drew
- probability samples from well-defined sampling frames of schools and
- students, which allowed weighted results of known precision to be
- computed. Ten sites** also drew probability samples of both schools and
- students. However, documentation necessary to weight the data or to
- estimate precision was not available. In general, the 21 other sites***
- drew nonprobability samples of either schools or students.
-
- School response rates ranged from 27% to 100%; student response
- rates ranged from 41% to 92%. Sample sizes ranged from 303 to 10,279
- students (Table 1). From 33% to 86% (median: 62%) of students from all
- sites reported having been taught about acquired immunodeficiency
- syndrome (AIDS) or HIV infection in school. The percentage of students
- from all sites who reported having discussed AIDS or HIV infection with
- their parents or other adults in their families ranged from 43% to 69%
- (median: 56%).
-
- Varying proportions of students knew that AIDS or HIV infection
- cannot be transmitted by blood donation (32%-75% (median: 58%)),
- mosquito or other insect bites (22%-67% (median: 48%)), use of public
- toilets (44%-85% (median: 73%)), or blood tests (59%-82% (median:
- 73%)). Most students knew that AIDS or HIV infection can be transmitted
- by sharing needles used to inject drugs (93%-100% (median: 98%)) or
- from having sexual intercourse without using a condom (74%-98% (median:
- 88%)) (Table 2).
-
- Rates of reported IV-drug use varied: 2%-5% of students (median:
- 3%) reported ever injecting cocaine, heroin, or other illegal drugs,
- and 0.2%-3% (median: 0.9%) reported sharing needles used to inject any
- drugs. In all but one site, more male than female students reported
- these behaviors (Table 3).
-
- Rates of reported sexual intercourse also varied: 27%-76% of
- students (median: 56%) reported having had sexual intercourse at least
- once. In addition, 7%-40% (median: 21%) reported ever having had four
- or more sex partners. At each site, more male than female students
- reported having had sexual intercourse at least once and ever having
- had four or more sex partners (Table 4).
-
- Reported by: S Adams, Alabama State Dept of Education. M Towery,
- Arkansas Dept of Education. R Rich, Los Angeles Unified School Dist; J
- Campana, San Diego Unified School Dist; M Lam, San Francisco Unified
- School Dist; W White, California State Dept of Education. D
- Sandau-Christopher, State of Colorado Dept of Education. J Arns,
- Delaware State Dept of Public Instruction. J Sadler, District of
- Columbia Public Schools. G Davis, Georgia Dept of Education. A
- Horiuchi, Hawaii Dept of Education. J Hummer, Idaho Dept of Education.
- J Harris, Iowa Dept of Education. J Grosko, Kansas State Dept of
- Education. I Mudd, Kentucky Dept of Education. D Frost, Louisiana State
- Dept of Education. J Cohen, Massachusetts Dept of Education. W Jubb,
- Michigan Dept of Education. C Hungerford, Missouri Dept of Elementary
- and Secondary Education. D Chioda, Jersey City Board of Education; D
- Cole, New Jersey State Dept of Education. K Gaylord, New Mexico State
- Dept of Education. G Abelson, New York City Board of Education; A
- Sheffield, New York State Education Dept. R Frye, North Carolina Dept
- of Public Instruction. C DeRemer, North Dakota Dept of Public
- Instruction. K Stofsick, Ohio Dept of Education. J Richter, Oklahoma
- State Dept of Education. J Warren, Oregon Dept of Education. M Sutter,
- Pennsylvania Dept of Education. E Rosado, Puerto Rico Dept of
- Education. A Ferreira, Rhode Island Dept of Education. M Carr, South
- Dakota Dept of Education and Cultural Affairs. E Word, Tennessee State
- Dept of Education. M Peterson, Utah State Board of Education. S Tye,
- Dept of Education, Government of the Virgin Islands. P Hillard, Seattle
- Public Schools; P Baldwin, Washington State Education Dept. B Johnson
- Biehr, Chicago Public Schools, Illinois. D Scalise, The School Board of
- Broward County; AN Gay, The School Board of Dade County, Florida. P
- Simpson, Dallas Independent School Dist, Texas. Div of Adolescent and
- School Health, Center for Chronic Disease Prevention and Health
- Promotion, CDC.
-
- Editorial Note: From 1988 to 1989, the number of state, territorial,
- and local departments of education that conducted surveys about
- HIV-related knowledge and behaviors among high school students nearly
- tripled (from 15 to 42). This increase represents a notable step toward
- establishment of state, territorial, and local school-based
- surveillance systems for monitoring priority health-risk behaviors
- among high school students.
-
- HIV-related knowledge and behaviors among high school students are
- cause for concern throughout the United States. Most importantly, these
- surveys indicate that many students are at risk for HIV infection
- because they use IV drugs and share needles or because they have sexual
- intercourse with multiple partners. Many of these findings are similar
- to those from surveys conducted in 1988 (1).
-
- Although the findings in this report are based on a combination of
- probability and nonprobability samples and comparisons of data among
- sites should be made with caution, these results have assisted in
- planning and evaluating broad programs in individual cities and states.
- For example, the Michigan Department of Education used results from its
- 1988 and 1989 surveys to assist the State Board of Education in
- supporting school-based HIV education programs that help students avoid
- behaviors that result in HIV infection.
-
- In addition to determining the prevalence of HIV-related risk
- behaviors among high school students, surveys of this type should be
- used to measure the prevalence of other priority health-risk behaviors,
- such as drug, alcohol, and tobacco use; imprudent dietary patterns;
- inadequate physical activity; behaviors that result in intentional and
- unintentional injuries; and sexual intercourse that can result in
- sexually transmitted diseases or unintended pregnancies. State,
- territorial, and local departments of education have worked with CDC
- and other federal agencies to develop the Youth Risk Behavior
- Surveillance System. This system, implemented in 1990, will be used to
- periodically measure changes in these priority health-risk behaviors.
- To increase the number of sites with probability samples of ninth-
- through 12th-grade students and the comparability of data among sites,
- CDC is providing intensive technical assistance to interested
- departments of education. Departments of education can use the results
- from these surveys to plan and evaluate comprehensive school health
- education programs that help students avoid these priority health-risk
- behaviors.
-
- Reference
-
- 1. CDC. HIV-related beliefs, knowledge, and behaviors among high school
- students. MMWR 1988;37:717-21.
-
- * Delaware, District of Columbia, Hawaii, Iowa, Kentucky,
- Massachusetts, Pennsylvania, and South Dakota; Dallas, Jersey City, and
- Miami.
- ** Alabama, Arkansas, California, Louisiana, Michigan, Missouri,
- Oregon, and Rhode Island; Chicago and Seattle.
- *** Colorado, Georgia, Idaho, Kansas, New Jersey, New Mexico, New
- York, North Carolina, North Dakota, Ohio, Oklahoma, Puerto Rico,
- Tennessee, Utah, Virgin Islands, and Washington; Fort Lauderdale, Los
- Angeles, New York City, San Diego, and San Francisco.
-
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