Youth United Through Health Education: Community-Level, Peer-Led Outreach to Increase Awareness and Improve Noninvasive Sexually Transmitted Infection Screening in Urban African American Youth

Abstract

Purpose To evaluate the effectiveness of the Youth United Through Health Education (YUTHE) program, a community-level, peer-led outreach program to increase awareness and improve noninvasive sexually transmitted infection (STI) screening in youth residing in the targeted community. Methods Sexually experienced youth, aged 12–22 years, anonymously participated in the YUTHE program (a 15-minute encounter, including a risk assessment with feedback and prevention messages). A street- and venue-based intercept approach using a nonequivalent control group design was implemented to evaluate the YUTHE program. Results YUTHE community respondents were more likely to know that STIs could be asymptomatic (odds ratios [OR] 1.36, 95% confidence interval [CI] 1.08–1.72), know about urine-based STI screening tests (OR 1.34, 95% CI 1.04–1.72), perceive themselves to be at risk for STIs (OR 1.71, 95% CI 1.11–2.62), and worried about acquiring an STI (OR 1.50, 95% CI 1.04–2.18). No other community differences were identified. However, respondents who reported a single contact (OR = 2.12, 95% CI = 1.11–4.03) or multiple contacts (OR 2.78, 95% CI 1.81–4.26) with the YUTHE program were more likely to have been tested for STIs in the previous six months. Conclusions We did not accomplish our overall goal of increasing STI screening in our outreach community relative to the comparison community; our findings suggest that a peer-led, street- and venue-based community outreach approach is a feasible means for reaching large numbers of adolescents for STI prevention.