Research Summary

Introduction

The YWCA of the Mid-Peninsula’s AIDS Prevention Program conducts HIV/STD prevention education workshops for young people in middle and high school, colleges, juvenile hall, and community-based programs. Our program uses an innovative curriculum that addresses the gender ideologies and sexual scripts that regulate adolescent sexual behavior. We developed this curriculum based on several years of experience working in the classroom and on the street where young people would tell us stories that indicated the significant role that stereotyped beliefs about sex and gender roles seemed to play in their sexual decision-making. In the 1997-98 school year, we conducted an evaluation of our program as part of a community-based research collaboration between UCSF’s Center for AIDS Prevention Studies and Northern California Grantmakers.

Key Questions:

  • What relationship, if any, exists between students’ belief in gender ideologies and their sexual behavior, particularly unprotected sexual intercourse?
  • What impact does our 5-day workshop have on students’ sexual and drug behavior and gender-related attitudes?

Intervention and Research Design:

The intervention we designed consisted of a 5-day curriculum which covered the following: statistics; transmission and prevention information and skills; resources and HIV testing referrrals; an activity, “The Game,” which helps youth think critically about gender role ideologies and society’s messages about sexuality; and gender-separated discussion groups dealing with how to resist the gender role ideologies. For more detailed information on this Project see the Complete Research Protocol.

We conducted our evaluation research with ninth graders in Integrated Science courses, a required course for all freshman, at Santa Clara High School and Wilcox High School in Santa Clara Unified School District. We used a delayed intervention timeline, administering our survey at three different points in the year: October, January, and May with a 3 – month interval between each survey point. For the intervention component, half of the classes (Group A) at each school received our workshop in the fall while the other half (Group B) received the workshop in the spring. Group B functioned as the control group for Group A. In addition to comparing control and experimental groups, we were interested in looking at maintenance effects and changes over the entire year.

We were unable to do a randomized design, namely because randomly assigning classes to either Group A or B would have resulted in individual teachers having classes split between the two groups. This would have disrupted their teaching schedule for the entire year. Instead, we opted to randomly assign which teachers would have their set of classes be in Group A or B.

The survey we designed included knowledge questions and behavioral questions, including sexual behavior, sexual behavior under the influence of drugs and alcohol, and forced or coerced sexual behavior. For attitude questions, we constructed new measures that specifically address gender roles and sexual scripts. For example, one measure asked about how important students felt certain reasons would be in choosing to have sex or not. We created three categories of reasons: self-determined, other-determined, and gender ideology-based. For the gender related reasons, we had different reasons for guys and girls. This was one of the most important outcomes of our two years with the CAPS/NCG collaborative because it allowed us to measure something for which no previous tools existed.

Population Overview:

Our total population size was 503 youth, average age 14. It was a racially and socio-economically diverse population. An equal percentage of guys and girls, 26%, indicated that they had engaged in sexual intercourse at some point in their lifetime. In the last three months, 19% of the girls and 14% of the boys had been sexually active. Of the sexually active guys and girls, 84% had had unprotected vaginal intercourse in the last 3 months. Much of the sexual activity youth engaged took place in a risky context, either under the influence of alcohol or drugs, or in an unwanted or forced situation.

Results:

  • Our workshop significantly increased students’ knowledge about HIV/STD transmission and prevention compared to the control group.
  • While we were not able to measure any significant decreases in sexual behavior or increases in use of protection, we did see some promising trends among the girls who were not sexually active at wave 1. Namely, we found that fewer of the sexually inactive girls in our experimental group became sexually active in the following 3 months than the sexually inactive girls in the control group. This indicates that our program may be successful in delaying the onset of sexual intercourse for sexually inactive girls in our population.
  • The majority of students responded that they not only liked the workshop but also found it useful in helping them become more aware of gender-based pressures and what they can do when they are feeling pressured around sex and how to protect themselves from HIV.
  • Overall, we found a significant correlation between the level of risky sexual behavior and the level of agreement with the stereotypical belief about sex and gender, particularly for guys. Guys tended to agree more strongly than girls with the stereotypical beliefs about gender roles. Guys also agreed more strongly with the stereotyped beliefs about sex, such as “sex just happens and can’t be planned” or “in the heat of the moment, people lose control and just can’t think.”
  • We found that sexually active males, particularly those who had inconsistently used protection, were more likely to score higher on a scale that measured their proneness to coerce a girl into having sex.
  • When we looked at how the “non-sexually active”, “sexually active students using protection”, and “sexually active not using protection” rated the importance they attach to the gender-based motivations for having sex, we found a correlation between level of sexual risk and the importance of the gender-based motivations.

Conclusion:

In terms of measuring the impact of our program on students’ sexual behavior, we found that our study was limited because (1) it is difficult to measure change in 3 months- a very short time period (2) there was a low amount of risky sexual behavior to begin with and (3) while we were hoping to change students’ beliefs about gender and sexuality, our workshop only spent 1-1/2 hours discussing gender ideologies as compared to the nearly 14 years of gender role socialization that students have already experienced. We were not discouraged by this, however, because students responded positively to our program and indicated in their self-reports that the program had helped them think more critically about gender in the context of sexual pressure situations.

Our findings confirmed our hypothesis that the gender ideologies, which set up very narrow expectations about how a “real man” or “good girl” should act, are correlated with risky sexual behavior. This data helps us recognize the role that gender ideologies play in regulating teens beliefs about sexuality and gender roles, especially for guys and indicates that HIV prevention educators need to develop activities that address gender ideologies. Given the stricter adherence to stereotypic gender-role beliefs among boys and the correlation for boys between risky behavior and likelihood of coercion, HIV prevention education must target boys specifically. Furthermore, we need HIV prevention education to be integrated with efforts to prevent sexual assaults by addressing the culturally enforced beliefs about girls that perpetuate a climate in which sexual assaults are allowed to occur.

Last modified: February 7, 2011