Skip to main content


Log in

Adaptation of an Alcohol and HIV School-Based Prevention Program for Teens

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript


Given the current status of HIV infection in youth in India, developing and implementing HIV education and prevention interventions is critical. The goal for School-based Teenage Education Program (STEP) was to demonstrate that a HIV/AIDS and alcohol abuse educational program built with specific cultural, linguistic, and community-specific characteristics could be effective. Utilizing the Train-the-Trainer model, the instructors (17–21 years) were trained to present the 10 session manualized program to primarily rural and tribal youth aged 13–16 years in 23 schools (N = 1,421) in the northern state of Himachal Pradesh in India. The intervention had a greater impact on girls; girls evidenced greater communication skills and a trend towards greater self efficacy and reduced risk taking behavior. The STEP has been successfully adapted by the community organizations that were involved in coordinating the program at the local level. Their intention to continue STEP beyond extra funding shows that utilizing the local community in designing, implementing and evaluating programs promotes ownership and sustainability.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Pallikadavath S, Jayachandran AA, Stones RW. Women’s reproductive health, sociocultural context and AIDS knowledge in northern India. J Health Manag. 2005;7:109–28.

    Article  Google Scholar 

  2. NACO. Youth and HIV/AIDS. National AIDS Control Organization. (1999). Accessed 19 April 2009.

  3. NACO. HIV sentinel surveillance and HIV estimation 2007—a technical brief. (2009). Accessed 19 April 2009.

  4. ActionAid. The sound of silence: difficulties in communicating on HIV/AIDS in schools (experiences from India and Kenya). (2010). Accessed 31 January 2010.

  5. Gupta N, Mathur AK, Singh MP, Saxena NC. Reproductive health awareness of school-going, unmarried, rural adolescents. Indian J Pediatr. 2004;71:797–801.

    Article  PubMed  Google Scholar 

  6. Andrew G, Patel V, Ramakrishna J. Sex, studies or strife? What to integrate in adolescent health services. Reprod Health Matters. 2003;11(21):120–9.

    Article  PubMed  Google Scholar 

  7. Peltzer K, Nzewi E, Mohan K. Attitudes towards HIV-antibody testing and people with aids among university students in India, South Africa and United States. Indian J Med Sci. 2004;58:95–108.

    PubMed  Google Scholar 

  8. Saxena S. Country profile on alcohol in India. In: Riley L, Marshall M, editors. Alcohol and public health in eight developing countries. Geneva: World Health Organization; 1999. p. 37–60.

    Google Scholar 

  9. Das SK, Balakrishnan V, Vasudevan DM. Alcohol: its health and social impact in India. Med Soc. 2006;19:94–9.

    Google Scholar 

  10. Reddy KS, Arora M, Kohli A, et al. Tobacco and alcohol use outcomes of a school-based intervention in New Delhi. Am J Health Behav. 2002;26(3):173–81.

    PubMed  Google Scholar 

  11. Sharma AK, Chaubey D. Risk factors in sexually transmitted diseases. Indian J Sex Transm Dis. 1996;17:8–10.

    Google Scholar 

  12. Mahal A. What works in alcohol policy? Evidence from rural India. Econ Polit Wkly. 2000;35(45):3959–68.

    Google Scholar 

  13. Ambwani PN, Gilada IS. Dry alcohol days during festivals to prevent HIV/AIDS. XII international conference on AIDS, Geneva [abstract AIDSLINE ICA 12/98410386].

  14. Chandra PS, Bengal V, Ramkrishna J, Krishna VAS. Development and evaluation of a module for HIV/AIDS related risk reduction among patients with alcohol dependence (Project report). Bangalore: National Institute of Mental Health and Neurosciences; 1999.

  15. Weekly MMWR. Alcohol policy and sexually transmitted disease rates—United States, 1981–1995. MMWR Wkly. 2000;49:346–9.

    Google Scholar 

  16. Chhabra R, Springer C, Rapkin B, Merchant Y. Differences among male/female adolescents participating in a School-Based Teenage Education Program (STEP) focusing on HIV prevention in India. Ethn Dis. 2008;18(2–2):123–7.

    Google Scholar 

  17. Chhabra R, Ghosh SN, Sharma SK. Need assessment of an alcohol and HIV prevention education program for youth in North Western Himalayas. J Indian Acad Appl Psychol. 2007;33(1):5–14.

    Google Scholar 

  18. Chhabra R, Ghosh SN, Sharma S, Merchant Y. Adaptation of an HIV prevention program (STEP) for youth in north western Himalayas. Poster presentation at NIMH fifth Indo-U.S. Collaborative Workshop on HIV/STD behavioral prevention research, February 12–15, 2006, Bangalore, India.

  19. Census of India. Govt. site with detailed data from 2001 census. (2010). Accessed 31 January 2010.

  20. Javed MI. NACO and HIV/AIDS in India. Mainstream. 2007;XLV(50).

  21. Javed MI. AIDS and the state: a comparison of Brazil, India and South Africa. South Asian Surv. 2009;16:119–35.

    Article  Google Scholar 

  22. Himachal at a Glance. (2009). Accessed 13 October 2009.

  23. State AIDS Control Society (SACS), Himachal Pradesh. Voluntary Counseling and Testing Center (VCTC) report, June 2006.

  24. Centers for Disease Control and Prevention. The handbook of evaluating HIV education—booklet 6, assessment instruments for measuring student outcomes grades 7–12. (2010). Accessed 31 January 2010.

  25. Bandura A. Self-efficacy. In: Ramachandran VS, editor. Encyclopedia of human behavior. New York: Academic Press; 1994.

    Google Scholar 

  26. Bandura A. Guide for constructing self-efficacy scales. In: Pajares F, Urdan T, editors. Self-efficacy beliefs of adolescents. Greenwich: Information Age Publishing; 2006.

    Google Scholar 

  27. Card JJ, editor. Handbook of adolescent sexuality and pregnancy: research and evaluation instruments. Newbury Park: Sage Publications; 1993.

    Google Scholar 

Download references


The current paper is part of a larger study called “A School-based Teenage Education Program (STEP II) for Alcohol Abuse and HIV Prevention” which was funded by National Institute on Alcohol Abuse and Alcoholism (R21AA014826; PI: Chhabra).

Author information

Authors and Affiliations


Corresponding author

Correspondence to Rosy Chhabra.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chhabra, R., Springer, C., Leu, CS. et al. Adaptation of an Alcohol and HIV School-Based Prevention Program for Teens. AIDS Behav 14 (Suppl 1), 177–184 (2010).

Download citation

  • Published:

  • Issue Date:

  • DOI: