STD risk assessment and education tools administered in a single office visit facilitated STD/HIV prevention education. Any impact on sexual activity and condom use was short-lived. Further research is needed to develop brief, office-based sexual risk reduction for young adolescents.

A harm-reduction focus that acknowledges and builds on existing protective strategies may be a promising avenue for alcohol interventions.

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Evidence-based interventions (EBIs) are used in public health to prevent HIV infection among youth and other groups. EBIs include core elements, features that are thought to be responsible for the efficacy of interventions. The authors evaluate experiences of organizations that adopted an HIV-prevention EBI, Focus on Kids (FOK), and their fidelity to the intervention's eight core elements. A cross-sectional telephone survey was administered to 34 staff members from organizations that had previously implemented FOK. Questions assessed how the organization adhered to, adapted, dropped, or altered the intervention. None of the organizations implemented all eight core elements. This study underscores the importance for HIV intervention researchers to clearly identify and describe core elements. More effort is needed to reflect the constraints practitioners face in nonresearch settings. To ensure intervention effectiveness, additional research and technical assistance are needed to help organizations implement HIV prevention EBIs with fidelity.

IntodudionBecause of recent increases in the number and incidence of sexually transmitted diseases (STDs) and the lethality of human immunodeficiency virus (H1V) infection, improved physician STD/HIV prevention practice is urgent.1'2 The US Preventive Services Task Force recommends that all primary care clinicians obtain a complete sexual practice and druguse history from all adolescent and adult patients.1 Primary care physicians report however, that they infrequently assess the sexual practices of their patients.3Recent studies indicate that discomfort with homosexuality is a barrier to HIV-related care.3-5 Non-internist, older, male, solo-practice physicians and physicians having no AIDS patients are all reported to have less HIV-related competence.-5 Although manybarriers to STD/HIVrisk assessment cannot be overcome through continuing medical education (CME) (i.e., physician's age or type of practice), CME can potentially decrease barriers caused by lackofknowledge, predisposing attitudes, and skills. In this study, current levels of self-reported primary care physician STD/H1V risk questioning are measured and educationally mutable factors associated with this questioning are identified.Melos cialties (internal medicine, fmily practice, general practice, and obstetrics/ gynecology), and (2) they delivered at least 1 hour of primary care each week. The overall survey response rate was 60% (N = 961).All telephone survey questions were closed-ended, with trained interviewers recording responses on precoded forms. In data analysis, variable associations were measured using Pearson productmoment correlation coefficients and forward stepwise multiple linear regression (PROC REG).7 Independt VaniablesStudy physicians were asked about their personal and practice characteristics. Theywere also asked to rate the magnitude of the STDIHIV problem in their practice. A battery ofseven 5-point Likert scale questions (available from the authors) was used to measure physicians' confidence in their ability to assess risk and successfully counsel patients in the prevention ofHIV infection (Cronbach alpha = 0.68, range = 7-35, mean = 25.0, SD = 5.00, median = 25). Physicians were also asked about their comfort level when discussing sexual practices with five different types of patients: single women, homosexual women, long-time married patients, homosexual men, and single men. The cronbach A among these items was 0.78. These 3-point item scores were Baseline data foradenstration project ofphysiian office-based STD/HV prevention proms usng simulated patients6 were obtained thrgh telephone interview.The samplingframewas the 1988 American Medical Association (AMA) list of officebased p physicians whose mailiUg addresses were in the Washhigton DC metropolitan statistical area.Physicians were eligible for participation in the study if (1) they identified themselves at the time of the interview as being in one offour designated primary care speAll authors are with Georgetown University

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Objective The current study examined the dimensionality of a protective behavioral strategies (PBS) measure among undergraduate, predominantly freshmen (92.5%) college students reporting recent alcohol use (r = 320). Method Participants completed a web-based survey assessing 22 PBS items. Factor analyses determined the underlying factor structure of the items. Congruence of the factor structure among gender and racial sub-groups was examined by rotating the sub-groups’ matrices via the Procrustes rotation method. Reliability analyses determined internal consistency. Results A 2-factor solution was retained utilizing 17 of the original items. Both PBS sub-scales (Limits and Avoidance) had acceptable internal consistency across all samples. Conclusions This PBS Scale was determined to be bi-dimensional and reliable. The dimensions suggest two underlying foci: ways to limit alcohol intake and ways to avoid alcohol intake while socializing. Practical implications of these findings are discussed.