Background Effective school-based HIV and STD prevention improves health education, access to health services, parent engagement, and increases school connectedness (SC). SC – the degree to which students believe that adults and peers in the school care about them and their success – has long term-implications for sexual behavior, experience of sexual violence, and STD acquisition into adulthood. The current analyses examine the associations of activities to increase school connectedness and health-related experiences and behaviors among high school students in 347 schools from 17 school districts funded by CDC’s Division of Adolescent and School Health (DASH) from 2013 to 2018 to implement HIV and STD prevention.

Methods We used data from DASH’s Program Evaluation Reporting System (PERS) and School Health Profiles survey (Profiles) to assess implementation of four school connectedness activities and data from the Youth Risk Behavior Survey (YRBS) to assess youth behaviors and experiences. We examine whether level of implementation of SC in Year 3 of the program was related to STD risk at the end of Year 4.

Results SC, as measured by PERS, was significantly related to decreased forced sex (OR=0.99, CI=0.99–1.0, p<0.001), sexual initiation (OR=0.99, CI=0.98-0.99, p<0.001), current sexual activity (OR=0.99, CI=0.98-0.99, p<0.001), and increased dual protection (OR=1.02, CI=1.00–1.04, p<0.05). SC as assessed by Profiles was related to lower levels of sexual dating violence (OR=0.98, CI=0.97-0.99, p<0.001), initiation (OR=0.98, CI=0.98-0.99, p<0.001), current sexual activity (OR=0.99, CI=0.98-0.99, p<0.001), and increased condom use (OR=1.01, CI=1.00–1.02, p<0.01).

Conclusion The DASH approach to primary prevention of HIV and STD is effective in improving sexual risk behaviors at a population level in schools. The current analyses demonstrate that increased implementation of school-connectedness specific activities are associated with reduced behaviors and experiences tied to STD acquisition, with significant implications for those experiences into adulthood.

Disclosure No significant relationships.