***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Although there are now several  adolescent HIV and STD preventive interventions of demonstrated efficacy in the literature , little is understood about the portability of these interventions . This study replicated Stanton 's Focus on Kids intervention , developed for inner city African American adolescents , in a different population , transferring it to a multicultural city . Despite careful replication of the original study 's procedures , youth in the preventive intervention condition of the replication study did not improve in attitudes , perceived norms , self-efficacy , or intentions toward sexual initiation , condom use , or abstinence compared with a carefully matched control condition . We discuss several possible reasons for this failure to replicate , concluding that the most likely reason is the lower rates of sexual activity  among youth in the replication city The purpose of this study was to document the effectiveness of small group condom motivation education in reducing new and reinfection rates of sexually transmitted diseases ( STD ) among female teenagers . Two hundred and five ( 205 ) female adolescents ( age 13 - 20 ) with a current STD were studied at two sites of a Teen Health Clinic . There were 86 teens in the Study Group and 119 in the Comparison Group . Patients were sample d from December 1992 to July 1993 . The patients in the Study Group received a condom motivation class given by the clinic STD educator in small groups of four or more adolescents . The Comparison Group , comparable in age and ethnicity , received treatment for their STD but did not participate in condom motivation classes . All teens were given treatment and condoms . The sample was followed for 6 months . The total number of patients returning with new infections was 21 ( 14.7 % ) . The total number of patients with reinfections was 14 ( 9.8 % ) . There were no significant differences between the Study and Comparison Group on return rates , new and reinfection rates or on any socio-demographic variables . The comparison of these groups suggests that a specific condom motivation class has minimal effectiveness in urban teens . However , almost 70 % of the teens returned to the clinic for their scheduled visits . It is suggested that adolescent clinics which combine family planning and STD treatment services maintain high client enrollment and therefore may be ideal locations to initiate new and continuous interventions for condom use especially for high risk teens Young Black men ( YBM ) , aged 13 to 24 years , face a disproportionate burden of sexually transmitted infections ( STIs ) . STI acquisition among YBM is due to incorrect and inconsistent condom use and is exacerbated by multiple sexual partners . Sexual and reproductive health is influenced by a complex interaction of biological , psychological , and social determinants that contribute to increased risk for STI acquisition . However , there are key social determinants of sexual health that play a major role in adolescent sexual risk – taking behaviors : gender norms , environment , peers , and families as well as a desire to impregnate a woman . Associations between context ual factors ( risky environmental context , desire to impregnate a woman , and peer norms supportive of unsafe sex ) and sexual risk behaviors were examined among a sample of YBM attending adolescent health clinics . This study used baseline data from a r and omized controlled trial ( N = 702 ) .  Parental monitoring was also examined as an effect modifier of those associations . Sexual risk behaviors were the frequency of condomless vaginal sex , number of sexual partners within the previous 2 months , and lifetime number of sexual partners . Mean age was 19.7 . In the adjusted model , peer norms was the only significant predictor for all sexual risk outcomes ( p < .05 ) .  Parental monitoring  was an effect modifier for the perceived peer norms and lifetime sexual partners association ( p = .053 ) where the effect of peer norms on lifetime sexual partners was lower for participants with higher levels of perceived parental monitoring OBJECTIVE : To compare the efficacy of a r and omized controlled trial of the Sexual Awareness For Everyone ( SAFE ) behavioral intervention on teenagers ( aged 14 to 18 years ) compared with adult rates of reinfection with Neiserria gonorrhea or Chlamydia trachomatis cervicitis , and to identify behaviors associated with recurrent infection . METHODS : Mexican-American and African-American females with a nonviral sexually transmitted disease ( STD ) were enrolled in SAFE or assigned to the control group . All participants were interviewed and examined at baseline , 6 , and 12 months . The primary outcome variable was reinfection with N. gonorrhea or C. trachomatis . Secondary outcomes were changes in risky sexual behavior . RESULTS : Teens r and omized to participation in SAFE had a statistically lower incidence of recurrent N. gonorrhea and C. trachomatis at 0 to 6 months ( 52 % , P=.04 ) and cumulatively ( 39 % , P=.04 ) compared with teens in the control group . Cumulatively , teens as a group had higher rates of reinfection ( 33.1 % ) than adults ( 14.4 % ) ( P<.001 ) . Adolescent reinfection was explained by unprotected sex with untreated partners ( adjusted odds ratio [ OR ] 5.58 ) , nonmonogamy ( adjusted OR 5.14 ) , and rapid partner turnover ( adjusted OR 2.02 ) . In adults , reinfection was predicted by unprotected sex with untreated partners ( adjusted OR 4.90 ) , unsafe sex ( adjusted OR 2.18 ) , rapid partner turnover ( adjusted OR 3.13 ) , and douching after sex ( adjusted OR 2.14 ) . CONCLUSION : Sexual Awareness for Everyone significantly reduced recurrent STDs in teenagers . Adults and teens r and omized to the SAFE intervention had significant decreases in high-risk sexual behaviors as compared with those in the control group . Although not specifically design ed for teens , the SAFE intervention worked very well in this high-risk population . CLINICAL TRIAL REGISTRATION : www . clinical trials.gov , Clinical Trials.gov , HSC2004415H LEVEL OF EVIDENCE : OBJECTIVE To evaluate the efficacy of an abstinence-only intervention in preventing sexual involvement in young adolescents . DESIGN R and omized controlled trial . SETTING Urban public schools . PARTICIPANTS A total of 662 African American students in grade s 6 and 7 . INTERVENTIONS An 8-hour abstinence-only intervention targeted reduced sexual intercourse ; an 8-hour safer sex-only intervention targeted increased condom use ; 8-hour and 12-hour comprehensive interventions targeted sexual intercourse and condom use ; and an 8-hour health-promotion control intervention targeted health issues unrelated to sexual behavior . Participants also were r and omized to receive or not receive an intervention maintenance program to extend intervention efficacy . OUTCOME MEASURES The primary outcome was self-report of ever having sexual intercourse by the 24-month follow-up . Secondary outcomes were other sexual behaviors . RESULTS The participants ' mean age was 12.2 years ; 53.5 % were girls ; and 84.4 % were still enrolled at 24 months .  Abstinence-only intervention  reduced sexual initiation ( risk ratio [ RR ] , 0.67 ; 95 % confidence interval [ CI ] , 0.48 - 0.96 ) . The model-estimated probability of ever having sexual intercourse by the 24-month follow-up was 33.5 % in the abstinence-only intervention and 48.5 % in the control group . Fewer abstinence-only intervention participants ( 20.6 % ) than control participants ( 29.0 % ) reported having coitus in the previous 3 months during the follow-up period ( RR , 0.94 ; 95 % CI , 0.90 - 0.99 ) . Abstinence-only intervention did not affect condom use . The 8-hour ( RR , 0.96 ; 95 % CI , 0.92 - 1.00 ) and 12-hour comprehensive ( RR , 0.95 ; 95 % CI , 0.91 - 0.99 ) interventions reduced reports of having multiple partners compared with the control group . No other differences between interventions and controls were significant . CONCLUSION Theory-based abstinence-only interventions may have an important role in preventing adolescent sexual involvement . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00640653 BACKGROUND Although numerous interventions have been demonstrated to reduce targeted adolescent risk behaviors for brief periods , sustained behavior changes covering multiple risk behaviors have been elusive . OBJECTIVE To determine whether a parental monitoring intervention ( Informed Parents and Children Together [ ImPACT ] ) with and without boosters can further reduce adolescent truancy , substance abuse , and sexual risk behaviors and can alter related perceptions 24 months after intervention among youth who have all received an adolescent risk-reduction intervention ,  Focus on Kids ( FOK ) . DESIGN R and omized , controlled , 3-celled longitudinal trial . SETTING Thirty-five low-income , urban community sites . PARTICIPANTS Eight hundred seventeen African American youth aged 13 to 16 at baseline . Intervention All youth participated in FOK , an 8-session , theory-based , small group , face-to-face risk-reduction intervention , 496 youth and parents received the  1-session ImPACT intervention ( a videotape and discussion ) , 238 of the ImPACT youth also received four 90-minute FOK boosters delivered in small groups . MAIN OUTCOME MEASURES Responses at baseline and 24 months after intervention to a question naire assessing risk and protective behaviors and perceptions . Analyses used General Linear Modeling , intraclass correlation coefficient , analysis of covariance , and multiple comparisons with least significant difference test adjustment . RESULTS After adjusting for the intraclass correlation coefficient , 6 of 16 risk behaviors were significantly reduced ( P < or = .05 ) among youth receiving ImPACT compared with youth who only received FOK ( respectively , mean number of days suspended , 0.65 vs 1.17 ; carry a bat as a weapon , 4.1 % vs 9.6 % ; smoked cigarettes , 12.5 % vs 22.7 % ; used marijuana , 18.3 % vs 26.8 % ; used other illicit drugs , 1.4 % vs 5.6 % ; and , asked sexual partner if condom always used , 77.9 % vs 64.9 % ) . Four of the 7 theory-based subscales reflected significant protective changes among youth who received ImPACT . ImPACT did not produce any significant adverse effects on behaviors or perceptions . CONCLUSION A parent monitoring intervention can significantly broaden and sustain protection beyond that conferred through an adolescent risk-reduction intervention CONTEXT African American adolescents are at high risk of contracting sexually transmitted infection with human immunodeficiency virus ( HIV ) , but which behavioral interventions to reduce risk are most effective and who should conduct them is not known . OBJECTIVE To evaluate the effects of abstinence and safer-sex HIV risk-reduction interventions on young inner-city African American adolescents ' HIV sexual risk behaviors when implemented by adult facilitators as compared with peer cofacilitators . DESIGN R and omized controlled trial with 3- , 6- , and 12-month follow-up . SETTING Three middle schools serving low-income African American communities in Philadelphia , Pa. PARTICIPANTS A total of 659 African American adolescents recruited for a Saturday program . INTERVENTIONS Based on cognitive-behavioral theories and elicitation research , interventions involved 8 1-hour modules implemented by adult facilitators or peer cofacilitators . Abstinence intervention stressed delaying sexual intercourse or reducing its frequency ; safer-sex intervention stressed condom use ; control intervention concerned health issues unrelated to sexual behavior . MAIN OUTCOME MEASURES Self-reported sexual intercourse , condom use , and unprotected sexual intercourse . RESULTS Mean age of the enrollees was 11.8 years ; 53 % were female and 92.6 % were still enrolled at 12 months .  Abstinence intervention participants were less likely to report having sexual intercourse in the 3 months after intervention than were control group participants ( 12.5 % vs 21.5 % , P=.02 ) , but not at 6- or 12-month follow-up ( 17.2 % vs 22.7 % , P=.14 ; 20.0 % vs 23.1 % , P=.42 , respectively ) . Safer-sex intervention participants reported significantly more consistent condom use than did control group participants at 3 months ( odds ratio [OR]=3.38 ; 95 % confidence interval [ CI ] , 1.25 - 9.16 ) and higher frequency of condom use at all follow-ups . Among adolescents who reported sexual experience at baseline , the safer-sex intervention group reported less sexual intercourse in the previous 3 months at 6- and 12-month follow-up than did control and abstinence intervention ( adjusted mean days over prior 3 months , 1.34 vs 3.77 and 3.03 , respectively ; P < or = .01 at 12- month follow-up ) and less unprotected intercourse at all follow-ups than did control group ( adjusted mean days , 0.04 vs 1.85 , respectively , P<.001 , at 12-month follow-up ) . There were no differences in intervention effects with adult facilitators as compared with peer cofacilitators . CONCLUSION Both abstinence and safer-sex interventions can 
    Output:
    
Conclusions and Relevance The findings suggest that sexual health interventions are associated with improvements in sexual well-being  among black adolescents .