Objectives. This study evaluated the long-term effectiveness of Sofer Cholces, a theory-based, multi-component educational program designed to reduce sexual risk behaviors and increase protective behaviors in preventing HlV, other STDs, and pregnancy among high school students.Methods. The study used a randomized controlled trial involving 20 high schools in California and Texas. A cohort of 3869 ninth-grade students was tracked for 3 | months from fall semester 1993 (baseline) to spring semester 1996 (3 l-month follow-up). Data were collected using self-report surveys administered by trained data collectors. Response rate at 3l-month follow-up was 79%.Results. Sofer Chorces had its greatest effect on measures involving condom use. The program reduced the frequency of intercourse without a condom during the three months prior to the survey, reduced the number of sexual partners with whom students had intercourse without a condom, and increased use of condoms and other protection against pregnancy at last intercourse. Sofer Choices also improved 7 of l3 psychosocial variables, many related to condom use, but did not have a significant effect upon rates of sexual initiation.Conclusions. The Safer Cholces program was effective in reducing important risk behaviors for HlV, other STDs, and pregnancy and in enhancing most psychosocial determinants of such behavior.

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The hypotheses were supported. Bicultural stress appears to be an important underlying factor for health disparities among US adolescents. Future research may consider promoting well-being in majority, as well as minority adolescents, through targeting sources of bicultural stressors or examining ways to moderate their effects on adolescent risk behaviors.

This investigation predicted adolescents' delay of intercourse onset from attitudes, social norms, and self-efficacy about refraining from sexual intercourse. Age, gender, ethnicity, and parental education were also examined as predictors and moderators of the relationships among the 3 psychosocial determinants and onset. The participants (N = 827), part of a cohort initially surveyed in the 9th grade, reported at baseline that they had never engaged in intercourse. The multivariable proportional hazards regression model suggested that adolescents with more positive attitudinal and normative beliefs, as well as those with a parent who graduated from college, were less likely to engage in intercourse in the follow-up period (up to approximately 2 years). Interventions that include an objective to delay onset may benefit from addressing psychosocial determinants, especially attitudes and norms about sexual intercourse.

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