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Such efforts should be part of a broad and comprehensive array of prevention approaches that integrate both supply and demand reduction strategies in the family and community, as well as the individual, domains. Science-Based Practices in Substance Abuse Prevention: A Guide. Rockville, MD: Center for Substance Abuse Prevention. The presence of other sexually transmitted infections (STIs) can also facilitate HIV transmission.

See also: Drug and Alcohol Abuse; Guidance and Counseling, School; Family Composition and Circumstance, subentry on Alcohol, Tobacco, and Other Drugs; Out-of-School Influences and Academic Success; Risk Behaviors, subentry on Smoking and Its Effect on Children's Health. Washington, DC: Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention, Division of Knowledge Development and Evaluation. Adolescents and young adults are physiologically and behaviorally at higher risk for acquiring STIs.

In the family domain, ATOD use has been associated with familial substance use, poor parenting practices including harsh or inconsistent discipline, poor intrafamilial communication, and inadequate supervision and monitoring of children's behaviors and peer associations.

In the peer domain, substance use has been linked to social isolation and association with ATOD-using and otherwise deviant peer networks.

Mass media campaigns are of dubious value, especially if they are brief, aired in contexts that are unlikely to reach their target audience, and uncoordinated with a comprehensive, community-wide strategy. Strategies to Reduce Underage Alcohol Use: Typology and Brief Overview. Many adolescents are sexually experienced, but the extent of experience and risk varies for different groups of adolescents.

Unfortunately, relatively little is also known about prevention on college campuses. "Risk and Protective Factors for Alcohol and Other Drug Problems in Adolescence and Early Adulthood: Implications for Substance Abuse Prevention." Psychological Bulletin 1105. Youth Risk Behavior Survey (YRBS) data indicate that about half of all high school students report having engaged in intercourse at least once.

Many college campuses have cultures that are at least covertly supportive of alcohol consumption, and many administrators treat the issue with benign neglect. Eggert, Leona L.; Thompson, Elaine A.; Herting, Jerald R.; Nicholas, Liela J.; and Dicker, Barbara G. "Preventing Adolescent Drug Abuse and High School Dropout through an Intensive School-Based Social Network Development Program." American Journal of Health Promotion 2861. Almost 10 percent of youth were younger than age thirteen at first sexual intercourse, and by twelfth grade, 65 percent of students have become sexually active.

While most drinking on college campuses occurs in neighborhood bars and residential contexts such as fraternities, relatively little has been done to develop and implement demonstration programs that increase enforcement of, and penalties for, selling or otherwise supplying liquor to underage students. Ennett, Susan; Tobler, Nancy S.; Ringwalt, Christopher L.; and Flewelling, Robert L.1994. A Meta-Analysis of Project DARE Outcome Evaluations." American Journal of Public Health 941401. Sexual risk increases with the number of partners and the failure to use condoms.

Project Alert, described by Phyllis Ellickson and colleagues in a 1993 article, and Life Skills Training Program, described by Gill Botvin and colleagues in 1995, are the two most-prevalent effective classroom-based-curricula.

The "Reconnecting Youth" Program, described by Leona Eggert and colleagues in 1994, is designed for high school students who manifest poor academic achievement or who are at high risk for dropping out and other problem behaviors.

In the family domain, the Iowa Strengthening Families Program, described by Richard Spoth and colleagues in 1999, has received considerable attention.

Botvin, Gilbert J.; Baker, Eli; Dusenburg, Linda; Botvin, Elizabeth M.; and Diaz, Tracy. "Long-Term Followup Results of a Randomized Drug Abuse Prevention Trial in a White Middle-Class Population." Journal of the American Medical Association 2061112. An estimated three million cases of STIs other than HIV are acquired each year among persons between ten and nineteen years old.

Youth under the age of twenty-five account for two-thirds of the total number of cases of STIs diagnosed annually.

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