title: Traditional Balinese youth groups as a venue for prevention of AIDS and other sexually transmitted diseases.
abstract: OBJECTIVE
  Our aims were to assess the feasibility of conducting peer-led educational interventions against AIDS and other sexually transmitted diseases (STDs) through traditional Balinese youth groups and to gather information on sexual risk-taking and its correlates among Balinese youth.
  
  
  METHODS
  A cross-sectional survey was conducted, with follow-up questionnaires for pilot intervention participants.
  
  
  METHODS
  A self-administered questionnaire was given to 375 subjects (aged 16-25 years) from 12 youth groups representing four main resort areas in Bali. Post-intervention data were collected from 97 of these subjects who had taken part in pilot educational programs. Focus groups supplemented survey data in evaluating the intervention and understanding risk behaviors.
  
  
  RESULTS
  In a cross-sectional survey, one-quarter of males and few females reported sexual activity; subsequent focus groups suggested under-reporting by females. While knowledge and worries about HIV/AIDS were high, only 10% of sexually active males and no females reported consistent condom use. The mean age of first sexual intercourse was highly correlated with first alcohol consumption (P = 0.0003). Peer educators from selected youth groups planned and implemented interventions for their own groups. Post-intervention data indicated significant increases in communication about sexual issues with friends and parents. Condom attitudes became less negative and efficacy increased. Participants reported this as a first experience with peer-led health education, preferred interactive activities to adult-led lectures and recommended follow-up educational sessions.
  
  
  CONCLUSIONS
  Peer educators from traditional youth groups can plan and conduct prevention programs for HIV/STDs that are well-received by their group memberships. Using such venues may be an efficient way to reach a wide range of pre-sexual Balinese youth, as well as those already at risk for HIV/STD due to unprotected sex, alcohol consumption and multiple sexual partners.
authors.affiliation: Udayana University AIDS Working Group and Citra Usadha Indonesia Foundation, Bali, Indonesia.
authors.forename: T P
authors.initials: TP
authors.lastname: Merati
authors.forename: M L
authors.initials: ML
authors.lastname: Ekstrand
authors.forename: E S
authors.initials: ES
authors.lastname: Hudes
authors.forename: E
authors.initials: E
authors.lastname: Suarmiartha
authors.forename: J S
authors.initials: JS
authors.lastname: Mandel
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008297:Male; D012309:Risk-Taking; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission