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Description:Safe on the Outs is a group-level intervention delivered in a single session to typically 3-5 adolescents of the same sex. It combines a group psychosocial intervention (GPI) for sexual risk reduction with group motivational enhancement therapy (GMET). The GPI portion uses group activities, videos, condom demonstrations, a videogame, general HIV transmission information, and local information and health services resources to increase HIV knowledge, and develop self-efficacy, normative perceptions, and positive attitudes toward condoms. A movie depicting ethnically representative young people emphasizes and explicitly models being prepared for safer sex and the importance of good communication skills with current and potential sex partners. In a videogame participants make a series of choices related to sexual activity to consider how negative consequences of unprotected sex would impact life goals. Participants then pick a safer sex goal they want to accomplish in the next 3 months to increase positive intentions. The GMET portion focuses on alcohol use, including feedback on drinking behaviors, and uses the FRAMES (Feedback, Responsibility, Advice, Menu, Empathy, and Self-Efficacy) to organize its structure. It uses motivational interviewing (MI) and empathetic, open, and non-confrontational motivationalenhancement-therapy style group discussion to address awareness about alcohol consumption level, consequences of alcohol use, strategies to develop self-efficacy to reduce alcohol use risk, and motivation to change alcohol use behavior during sexual activity. Participants watch an additional video depicting ethnically representative young people at a party with alcohol to provide an example of the negative consequences from alcohol use in sexual situations and provide options for positive decisions. The emphasis is on specific alcohol-related sexual risk reduction skills (e.g., understanding one’s limits, avoiding situations in which a risky sexual encounter may happen, having a “buddy system”).
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