Young people in Control, Doing if Safe!

Young people from ethnic minorities in The Netherlands are a group with high risk sexual behavior. As a consequence the HIV/STD-prevalence among young people and migrant populations from sub-Sahara Africa, Latin-America and the Caribbean is relatively high among the heterosexual population and teenage pregnancies are more common among these migrant populations. Because of their high level of sexual risk behavior, higher teenage pregnancy rates, relatively high HIV/STD prevalence, and the attendant increased risk of HIV/STD transmission, migrant populations and, in particular, young adolescents, are recognized as important target groups for HIV/STD prevention programs. However, prevention programs which target young people in the age groups which are most sexually active (young adolescents >15 years) are rare. This is especially the case with regard to young people outside the school-age population. Moreover, traditional prevention programs tend to deliver their safe sex message in cognitive formats which do not appeal to the norms and cultural values of migrant groups. In recent years innovative prevention activities aiming to communicate educational messages to ethnic groups have been implemented using a variety of E&E activities (theatre plays, songs, music, cabaret, and dance, for example). These programs seem to have the potential to be successful both because they appeal to cultural values of particular ethnic groups and because they present messages in an attractive and entertaining way. However, the effectiveness of these prevention activities has not been subject to robust or rigorous evaluation. Therefore, this paper proposes an effect-evaluation of a promising prevention project, called: “Young people in Control, Doing it Safe” (JIC DIS). The project focuses on sexual development and behavior among people in the urban scene; a group from a multicultural background, aged between 15 and 30 years old, the majority of whom are from The Dutch Antilles, Aruba, Surinam, Africa (Ghana), Morocco and The Netherlands. These young people are targeted via an Education & Entertainment (E&E)-strategy implemented through a Safe Sex Comedy Show (SSCS). This show lasts about two and a half hours and provides a full evening of entertainment comprising about 25 acts involving a variety of modes of communication including rap, song, the spoken word, comedy, R&B music and dance. The project is unique as an E&E as prevention strategy because of the high degree of participation of young people from the target group in the development and delivery of the show including taking responsibility for the stage design, the scripts and the performance. The objectives of this study are to examine i) whether the target group is reached ii) to what extent this SSCS is an effective way of addressing young people;; and, iii) the effects of JIC DIS on behavioral determinants of sexual risk behavior. The study will be quasi-experimental in design. An experimental group drawn from the Amsterdam urban scene will visit the SSCS (n =225) and a control group of young people who wish to see the show will be drawn from young people living in the other G4-cities (n=450). Recruitment of both groups will be through popular websites, flyers and posters. The intervention draws on the ASE-model and the ARRM-model of health-related behavior change and the study will examine relevant (intermediate) determinants of behavioral change among young people in study sample including knowledge, risk perception, attitude, social influence and intention. We will also evaluate perceptions of the show. Findings will be used both to improve the JIC DIC prevention program, the development of innovative prevention activities, and the development of the E&E-strategy. They will also represent a contribution to evidence-base for assessing the effectiveness of prevention programs.