Adaptation of an effective school-based sexual health promotion program for youth in Colombia

Rationale: Given the disproportionate impact of HIV and STIs among youth in Latin America, there is a compelling need for effective sex education programs. In particular, Colombia lacks a nationally standardized youth sex education program, despite the fact that 15 to 24-year-olds accounted for the highest incidence and prevalence rates of HIV and STIs in the nation. In an attempt to fill this void, our team adapted COMPAS, a Spanish school-based sexual health promotion intervention, for Colombian adolescents. Objective: This study describes the adaptation process that resulted in a modified version of COMPAS for youth in Colombia. Method: We employed a systematic cultural adaptation process utilizing a mixed methods approach, including intervention adaptation sessions with 100 young adolescents aged 15–19. The process included six steps: 1) consulting international researchers and community stakeholders; 2) capturing the lived experiences of a diverse sample of colombian youth; 3) identifying priorities and areas in need of improvement; 4) integrating the social cognitive theory, information-motivation-behavioral skills model, and an ecological framework for colombian youth; 5) adapting intervention content, activities, and materials; and 6) quantitative evaluation of COMPAS by Colombian youth. Results: The adapted intervention incorporates elements common to effective youth sex education interventions, including: a solid theoretical foundation, sexual communication skills and social support for protection, and guidance on how to utilize available cultural- and linguistic-appropriate services. In addition, the adapted intervention incorporates cultural and linguistic appropriate content, including an emphasis on tackling machismo to promote risk reduction behaviors. Conclusions: The systematic adaptation approach to sexual health intervention for youth can be employed by researchers and community stakeholders in low-resource settings for the promotion of health wellness, linkage to care, and STI and unplanned pregnancy prevention for youth.