Prevention and intervention of sexually transmitted diseases in adolescents

Adolescents are the age group at greatest risk for acquiring sexually transmitted diseases. Sexually transmitted disease intervention programs based on behavioral change theories that emphasize self-efficacy and motivational enhancement may provide adolescents with skills to change risk behavior patterns. School-based sexually transmitted disease programs can reach the majority of the at-risk adolescent population. Community-based programs attempt to change community norms for a targeted high-risk population and are particularly helpful in reaching adolescents who are not in school. Finally, clinic-based interventions serve adolescents seeking health care, not only encouraging abstinence and safer sex practices for prevention of sexually transmitted disease but also providing opportunities for early detection and treatment. All three have their advantages, but each may neglect a significant portion of the population at risk. Development of structured sexually transmitted disease intervention programs utilizing school, community, and clinic settings merits further study.