Healthy Students of Duval County Program Plan 1

Healthy Students of Duval County Program Plan

Healthy People 2020 Objective: HIV

Elizabeth Rose
Healthy Students of Duval County Program Plan 2

Needs Assessment

As of June 2020, there are around 1.1 million people who have been diagnosed with HIV

in the United States (amfAR [APA], 2020). In 2015, around 4,849 people (adults and teens) in

Florida were diagnosed with HIV, making Florida the number one state in the country with the

most people with HIV in 2015 (CDC [APA], n.d.). As of 2017 around 6,174 people in Duval

County were confirmed to have HIV (AIDSVU [APA], n.d.), and of the people diagnosed with

HIV in Area 4 (Duval, Baker, St. Johns, Clay, and Nassau county), 70% of the people in Duval

are men, 64% of the people in Duval are black, 36% of the people in Duval are aged 30-39, and

40% of the men in Duval who were diagnosed were exposed during MSM (men who have sex

with men) (Florida Health [APA], March 2017). The CDC also reports data explaining that the

southern states make up 52%, over half, of all new HIV diagnoses in the whole country in 2017

(CDC [APA], n.d.). Right now in Jacksonville, Florida there are many intervention programs

including the Area 4 AIDS Program (APO), HIV Care Now, as well as Dental Services for

HIV/AIDS patient, the Northeast Florida AIDS Network, the UF Center for HIV/AIDS

Research, Education and Service, along with many treatment centers and counselors who offer

services to those with HIV/AIDS. But Duval County missing a whole demographic when it

comes to educating and providing resources and services for HIV/AIDS in Jacksonville.

According to the CDC, in 2018 young adults ages 13-24 made up 21% of new diagnoses for

HIV/AIDS in the United States. The CDC also explains that the younger generation is the least

likely to receive care or have a low viral load. Of the 21%, 90% of the young men’s exposure to

male-to-male sexual contact, which is about 6,284 individuals, and based on the 2017 YRBS

data 25.9% of teens in Duval County reported identifying as gay, lesbian, or bisexual while only

19% reported identifying as straight (the rest reported they were not sure). Among the teens who
Healthy Students of Duval County Program Plan 3

filled out the survey in Duval County, 28.2% of them reported having sex with the same or both

sexes, while only 22.2% reported only have opposite sex partners (the rest had not had any

sexual contact) (323). Eighty-five percent of young women’s exposure was from heterosexual

contact, 51% of all young people ages 13-24 are African American as of 2018. According to the

2017 YRBS data black high school students in Florida reported testing for HIV at a higher rate

than other students, with 15.2% of them saying they had been tested. (70). In Jacksonville 30.6%

of our population are black individuals (Census [APA], July 1, 2019), and among that percentage

38% of our children ages 10-14 are black along with 37.7% of teens 15-17 years old, 35.6% of

teens 18-19 years old, and 33.5% of young adults ages 20-24 years old (Statistical Atlas [APA],

n.d.). That means a lot of our county’s teens and young adults are at risk of contracting HIV,

which could lead to AIDS, if they engage in risky sexual behaviors. Our goal will be to

implement a sexual health curriculum program, including HIV/AIDS education and prevention,

as well as LGBTQ sex education, into our high school’s health classes.

While Duval County currently teaches comprehensive sex education in their schools, it

appears they only do this from a heterosexual standpoint. According to the 2017 YRBS data

5.5% of teens in Duval identify as Gay or Lesbian, 10.9% of teens in Florida identify as bisexual,

and 5.1% are not sure (126). Of the students who have chosen to have sex in Duval County,

5.9% report having sex with the same sex only and 9.8% report having sex with both sexes

(128). The 2017 YRBS data also shows that 52.5% of teens in Duval who have had sexual

intercourse identify as gay, lesbian, or bisexual (323), and 36.7% of those students reported

being currently sexually active at that time (332). That means a large amount of Floridian high

school students are not receiving the sex education they need to make the safest choices based of

their sexual identity and preference. Also based on the 2017 YRBS data, 25.4% of students in
Healthy Students of Duval County Program Plan 4

Duval identifying as heterosexual claim to have had sex with someone who is the same sex as

them or have had sex with both sexes, so they also should be taught safe sex practices for

homosexual sex as well as heterosexual sex (131). The good news is that Florida is not one of

the few states that prohibit any promotion of homosexuality in their sex education so we do have

the ability to offer a program to those students (Leins, 2019).

According to [Link], the majority of teens who are diagnosed with HIV

contract it from sexual behaviors. Also the 2017 YRBS data reports that only 39.4% of teens in

Duval who identify as gay, lesbian, or bisexual used a condom during their last sexual

intercourse, as opposed to the 61.5% of straight teens who reported they had used a condom

during their last sexual intercourse (334). Condoms are one of the only forms of prevention for

STIs, including HIV and with the amount of LGBTQ teens contracting HIV, specifically teens

engaging in MSM, this statistic should be alarming. Because of the stigma behind HIV, and any

other STI, adolescents may be hesitant to share their diagnoses which leads to them not being

adequately treated. They also may not be receiving treatment because they are unaware that they

acquired the disease, the 2017 YRBS data also reports only 24% of gay, lesbian, or bisexual

teens in Florida have been tested for HIV (358). The American Academy of Pediatrics’

publication Condom Use in Adolescents in their textbook Reaching Teens, explain that 60% of

the male teens who tested positive for HIV due to MSM did not know they were infected (974).

It is important to a teens health that they are given the proper education to know when to be

tested and, if they choose to have sex, engage in it safely. Along with this, the American

Academy of Pediatrics also states that 90% of individuals who contracted HIV perinatally have

now reached their teens and young adulthood, so we have a whole new generation who now have

to experience their newly independent lives learning how to navigate them with HIV (974).
Healthy Students of Duval County Program Plan 5

There is a need for HIV resources to be available at the high school level so these individuals can

go into their adulthood prepared and with the ability to live their highest quality of life.

Behavioral interventions have started to gain popularity in schools and it seems the

interventions with the highest success rates were “curriculum-based, adult-led, and followed

specific guidelines,” (Pettifor, et al, 2013), while also merging them with biomedical

interventions to encourage preventing the spread of HIV/AIDS. It is important that the

interventions take into account the risks for their adolescents and young adults to contract

HIV/AIDS including discrimination, stigma, non-youth friendly environments, ctc…. Because of

the high rates of rape in sub-Saharan Africa, where this study took place, it was important to

consider that when thinking of risks their children face for contracting HIV/AIDS (Pettifor, et al,

2013). Some of the steps the community took included providing money to the young female

teens and young adults, which created a positive shift in their choice of sex partners and how

often they had sex by giving them financial freedom, they also used the media to promote change

in the social norms by creating campaigns to advocate for HIV preventative measure that a

young person can take and they did this through social media since the adolescents and young

adults in the community were the biggest users. Adolescents need to be given the tools and

influences to change their behavior and encourage taking precautions or holding off on having

sex. It is also important to consider the environment the teen or young adult is living in when

providing the tools and knowledge to prevent the spread of HIV/AIDS. Despite there being an

estimated 78,949 young adults and teens infected with HIV/AIDS, only about 40% of that

amount have been diagnosed. This is seems to be especially true for young adults ages 18-24,

which are the ages right after high school. The rate of undiagnosed adults is 20% and the rate of

undiagnosed young adults is about 60%, yet data showed that young adults were able to receive
Healthy Students of Duval County Program Plan 6

more accurate test results than older adults (Zanoni & Mayer, 2014). That is too much of a

difference for us to not want to be shifting a lot of our focus to young adults and teens. We need

to be preparing our youth with the abilities and knowledge to take care of themselves and

encourage testing once they are on their own. The first few years after high school can be

confusing and scary for many as they begin to navigate life without the constant help from their

parents. Zanoni and Mayer also explain in their writings that the highest incidence rate of teens

and young adults with HIV ages 14-29 were in black males engaging in MSM in urban areas,

just like Duval County (Zanoni & Mayer, 2014).

After implementing a school-based HIV/AIDS prevention program and health education

course in secondary schools throughout Wuhan China, the data reported before and after the

program shows a switch between negative attitudes towards HIV/AIDS before the program and

an increase in knowledge and positive attitude towards HIV/AIDS after the program (Gao, et al,

2012). The curriculum of the classes included two 30 minute lectures along with a short

advocational video that explained the biology, epidemiology, modes of transmission, high risk

sexual and non-sexual behaviors, and preventative skills and steps they can take to protect

themselves from HIV/AIDS. All the classes were instructed by those with medical degrees and

the courses lasted a week (Gao, et al, 2012). Based on the surveys given, before the program

students in middle school reported a low knowledge rate on all the questions except the two

asking if AIDS was an infectious disease and if it can be prevented. There was a slightly higher

level of knowledge in high school students before the program, and the post-intervention survey

showed a substantial increase in knowledge on all topics regarding HIV/AIDS (Gao, et al, 2012).

A program similar to this was also conducted in secondary schools in Nigeria in 1999. The data

also showed that before their program, 20% of the students involved said they did not feel AIDS
Healthy Students of Duval County Program Plan 7

was a medical issue in Nigeria and over 82% of students said they would dislike if someone

infected with AIDS was close to them. The students also reported that over 35% of them had

sexual intercourse in the past and over 26% of them had sex within the past month and only

about 19% of those students reported using a condom. Over 67% of the male students and over

32% of the female students reported having sex with multiple partners (Fawole, et al, 1999).

Although this research was conducted over 20 years ago, the data supports a positive shift in

attitudes and sexual behaviors regarding education on HIV/AIDS.

The affect of HIV/AIDS can have on the growth and development of adolescents is

substantial and can be detrimental to some. About 90% of teens infected with HIV live in areas

with little to no resources available to help treat and maintain low levels of HIV, which puts

them at a high risk of developing AIDS. HIV/AIDS can lead to stunted growth in teens, along

with the possibility of being underweight and wasting. Without treatment HIV/AIDS can also put

a teen at risk for chronic swelling and soreness, GI illnesses, and hormonal defects. But with

treatment, there is a greater chance at a normal life and improvements to their health. (Williams

& Jesson, 2018). These reasons indicate that it is vital to teens health to educate them on the risks

of HIV/AIDS and encourage testing, while removing the stigma for HIV/AIDS. Based on these

findings, the goal of my program will be to decrease HIV/AIDS in our Jacksonville teens,

specifically male and LGBTQ individuals by targeting risky sexual behavior, negative attitudes

towards LGBTQ sexual health and HIV/AIDS and increasing preventative skills and sexual

health knowledge in our high school students.

Healthy Students of Duval County Program Plan 8

Goals and Objectives

Goal: Lowering HIV rates in High School Students in Duval County

Process Objective:

• By the end of the program, freshmen student’s at Atlantic Coast High School in Duval

County will have been taught an HIV/AIDS preventative curriculum consisting of 18

classes (1 class a week for 1 school semester).

• During program implementation, program facilitators, which will be trained health

professionals, will receive a “very good” from at least 80% of the student participants.

Impact Learner Objective: Six months after the program, 90% of participants will be able to

identify how HIV can be prevented.

Impact Behavioral Objective:

• Six months after the program, there will be a 10% increase in participants that report

using a condom during last sexual intercourse.

• Six months after the program, there will be a 10% increase in participants that report

getting tested after having sexual intercourse with a new partner.

Outcome- Program Objectives

• Two years after the program there will be a 10% decrease in HIV cases in Duval County

among young adults.

Healthy Students of Duval County Program Plan 9

Health Belief Model Worksheet

Concept Definition Application Specify what activity will address these concepts
for your project and give an example of what
you’ll present

Perceived One’s opinion Define Begin first lesson of school-based comprehensive

Susceptibility of chances of population(s) at HIV/AIDS course with a lesson that defined the
getting risk, risk levels. populations at risk and what behaviors are high-risk
condition Personalize risk when it comes to contracting HIV/AIDS, with a fill-in-
based on a the-blank worksheet to follow along with the lesson
person’s so the students are paying attention to the key points.
features or The students will keep their notes. Also show an
behavior. Make educational video about HIV from
perceived [Link] It
susceptibility is also important to inform the students of HIV/AIDS
consistent w/ contraction through injection drug use. After I would
actual risk. give a post-test with the same questions and scale for
the students to fill out. Time will be left at the end of
the lesson for questions from the students and open
discussion if the instructor feels it would be
appropriate for the class.
Perceived One’s opinion Specify Provide a handout with information on what happens
Severity of how consequences of when HIV/AIDS goes left untreated and give students
serious a the risk and the lesson on benefits of wearing a condom. A group
condition and condition. activity that can be done to prove how little condoms
its interfere with the sensations during sex, provide
consequences every student with a latex glove and allow them to go
are around the room shaking everyone’s hands, then ask
them if they were able to feel the other person’s hand.
After they answer, tell the students how a condom is
thinner than a latex glove. Towards the end of the
lesson ask the student if their perceptions on the
severity of contracting HIV/AIDS has changed from
the beginning of the lesson.
Perceived One’s opinion Define action to Begin lesson by having an open discussion with the
Benefits of the take how, students about their knowledge on condoms and what
efficacy of where, when; condoms are used for. Then have a conversation
the advised clarify the about the benefits of limited sexual partners. Then
action to positive effects have the same conversation about abstinence. Then
reduce risk or to be expected. have the same conversation on HIV testing. Explain
to the students the benefits of using the safe sex
practices; condoms, abstinence, and a limiting the
Healthy Students of Duval County Program Plan 10

seriousness of amount of sexual partners are all ways to prevent the

impact spread of HIV, and knowing your status allows you to
take the precautionary steps you need to prevent
spreading it to others and keeping yourself as healthy
as possible.

Perceived One’s opinion Identify & Throughout the lessons during the open
Barriers of the reduce barriers conversations at the beginning of class encourage the
tangible and through students to share what they believe to know. If they
psychological reassurance, believe something not to be true, gently debunk their
costs of the correction of statement and provide them with the correct
advised misinformation, information. It is important to make the conversation
action incentives & light and open so the students feel comfortable and
assistance. safe to share their beliefs. Some barriers that may
prevent the student from reducing their risk of HIV
could be:
• Believing that a condom will ruin sex by
making it not feel as good
• Students feeling they will be judged by their
peers or adults if they were tested for HIV
• Feeling constrained from having sex with as
many people as they would like
Cues to Strategies to Provide how-to Providing students with open dialogue scenarios to
Action activate information, act out with their peers can empower them and give
“readiness” promote them the knowledge to speak up for themselves when
awareness, it comes to using condoms, remaining abstinent,
reminders. limiting their number of sexual partners, and being
getting tested for HIV. It is also important to inform
students to where they can find condoms and where
testing sites near them are located. Presenting videos
on how to correctly use condoms and dental dams
educates the students so they are prepared if they are
in a situation where they need to use them. Delay
tactics should also be taught to the students so that
they are able to delay the initiation of sex without
feeling uncomfortable.
Self-Efficacy Confidence in Provide training, During this time students can act out any dialogue
one’s ability guidance in that they created in groups. You can also pass out
to take action performing beh., both male and female condoms and allow the students
progressive goal to practice putting them on with their hands. Students
setting, should be given condoms and scissors to make their
Healthy Students of Duval County Program Plan 11

reinforcement, own dental dams as well. Brochures can be passed

demonstrate out with information on nearest testing sites. Any
behaviors, other questions should be answered during this time.
reduce anxiety.

Right now Duval County schools teach an abstinence-plus sex education curriculum that

teaches the students the importance of abstinence to prevent HIV and other STIs, as well as

informing students how to correctly protect themselves if they do decided to have sex. They do

this through their “Reducing the Risk,” curriculum. The curriculum puts an emphasis on the

effects of becoming infected, according to Duval County Public School’s website, as well as

teaching the students that the most successful way to prevent HIV/AIDS is by using proper

protection and abstaining from having sex. The curriculum also provides students with factual

and scientific data on HIV/AIDS. Duval County teaches the students different ways to

communicate with their partners on abstaining from having sex as well as how to advocate for

the use of protection in their sexual relationships. According to the CDC, Duval County is also

working towards increasing their on-site resources in the high schools to be more accessible to

students who may need help. They offer group sexual health education, HIV tests, condoms,

pregnancy tests, individual education sessions, domestic violence, and trafficking education. As

of 2017 these sites are in 7 of the high schools in Duval County according to the CDC, but

according to Duval County’s Florida Health Department’s website there are 9 currently. These

schools include Andrew Jackson High School, Englewood High School, Jean Ribault High

School, Robert E. Lee High School, Sandalwood High School, Terry Parker High School,

Westside High School, Ed White High School, Fletcher High School, and First Coast High

School. Outside of the public school system, Planned Parenthood offers their own sex education
Healthy Students of Duval County Program Plan 12

programs at their locations in Duval County, including one called LIGHT. LIGHT is a program

aimed towards the youth to prevent HIV, along with other STIs and unintended pregnancies.

Duval County’s sex education curriculum and programs offered in the schools and

around the county towards the youth have proven successful throughout the recent years, but a

big part that is missing is the full inclusion of LGBTQ students, which holds a large population

of those infected with HIV. My program will be intended for all ninth grade students in the

Duval County public high schools but will also focus on homosexual sex practices including anal

and oral sex. The program will also include correct terminology regarding gender and anatomy.

Students will be provided with tools to use protection or abstain from having sex, such as role-

playing activities where students will read scripts to each other where they decline having sex

with a partner or person respectfully but clearly, make it understandable that they want to use

protection and will not have any form of sex without using protection, and what to do in

situations where the other person is being persistent. Students will be taught that abstinence and

condom, both male and female, as well as dental dams, are the most effective forms in

preventing HIV. Students will be given factual data from credible sources, such as the YRBS,

that include data on HIV relating to LGBTQ youth in Duval County and the rest of Florida.

Students will be shown educational, but age-appropriate videos that are engaging to the students.

Instructors will lead and guide open discussions at the beginning of class about the days topic

and also leave time at the end of class for any questions the students may have. It will be

imperative that the classes are inclusive and comfortable for the students so that they are able to

ask any questions they may have and they will get the most education out of the class to prepare

them to make thoughtful and knowledgeable decisions on their sexual health. It will be

imperative that this program is accessible to all students so that students will receive a full sex
Healthy Students of Duval County Program Plan 13

education in case they decide to experiment with their sexuality later in life or ultimately identify

with any term on the LGBTQ spectrum. Another reason it is important to include all students is

so all students can understand what it means to be LGBTQ and encourage their peers to take the

safety precautions needed to prevent the spread of HIV in their sexual relationships. A pre-test

and post-test will be given during the program to determine the success of the program. The

program will provide resources on where to find local testing sites, including free testing

locations in some of the schools already. The students will also be informed on the different tests

that are given to detect HIV and how to decide, alongside their parents, what the best test is for

them. Students will also be given free condoms on the first day of the course and will also be

given resources on where to find condoms in the community. A panel of individuals with HIV in

the community will be asked to come in to answer questions about getting tested. Students will

be taught the consequences of have HIV and what happens if it develops into AIDS. A large

focus of the program will be to reduce the stigma of being test for HIV through peer acceptance.

Parent engagement will also be a large focus of the program to encourage healthy

communicative relationships between the students and their parents.

Healthy Students of Duval County Program Plan 14

Evaluation

The Learner Objective will be at the end of the semester, at least 90% of the students will

be able to list three ways to prevent the spread of HIV (answers: wear a condom/use dental dam,

remain abstinent, be tested for HIV after every new sexual partner). We will look at pre- and

post-test results to see if at least 90% of the students were able to correctly list three ways to

prevent the spread of HIV. The Behavior Objective will be six months after the program there

will be a 10% increase in the number of student’s who claim to have used a condom/dental dam

during their last sexual intercourse. The question will be “did you or your partner use a

condom/dental dam during your last sexual intercourse,” with the answer choices being yes, no, I

did not have sexual intercourse. For the Evaluation Method we will compare pre- and post-test

results to see if there was an at least 10% increase in the number of sexually active students who

reported using a condom/dental dam during their last sexual intercourse. The Outcome Objective

will be three years after the program there will be a 10% decrease in the number of students with

HIV in the school the program is located at (Atlantic Coast High School). The Evaluation

Method will be to look at data and statistics provided by the DCPS and YRBS for the

corresponding year.

The program will initially be implemented in Atlantic Coast High School and the control

group data will be collected from students of the same grade-level (ninth grade) from Mandarin

High School. Students at Mandarin High School will be given the same pre-and post-test but

student’s at Mandarin High School will just be given the sex education curriculum provided at

all the Duval County high schools. Both Atlantic Coast High School and Mandarin High School

do not have Teen Health Centers provided from the CDC at 12 of Duval County’s high schools.

The data will be collected through a pre- and post-test to compare the student’s knowledge
Healthy Students of Duval County Program Plan 15

before and after the program, as well as the activities and worksheets given out for the students

to do throughout the program. The activities and worksheets will be used to track the student’s

progress and to see where students may be having difficulty understanding a topic. Data will also

be collected from future YRBS surveys to track program progress. After the first 6 months after

the program student’s shift in knowledge will be shared with school board and CDC, and every 4

years after the first implementation of the program student’s changes in behavior will be shared

with the school board and CDC. The means of evaluation will be internal evaluation by the

medical professionals leading the curriculum in the classrooms; who will be collecting the data

from the students and the data will be collected anonymously. Students will have the option of

keeping a copy of any worksheets or activities that they do during the duration of the program

but an anonymous copy will be kept for data and statistics.

Healthy Students of Duval County Program Plan 16

Program Budget

Program Director- $4,000 a month (7 months)……………………………………..$28,000 total

5 Medical Professionals- $2,000 a month per Med. Prof. (7 months)……………………..$14,000

per medical professional → $70,000 total

• Work with Program Director to create:

o PowerPoints

o Brochures on where to find local testing clinics and free condoms

o Posters for the classroom and to refer to

o The pre- and post-test

o Worksheets and activities

Program Materials……………………………………………………………………………$1500

• Activity Worksheets

• Posters

• Brochures

• Male and Female Condoms (latex free)

• Disposable Gloves (latex free)

• Pre- and Post-tests

• Crayola Wide Stroke Markers

• Scissors

Miscellaneous………………………………………………………………………………..$500

Total Cost $100,000

Healthy Students of Duval County Program Plan 17

Healthy Students of Duval County Program provides up to $100,000 for up to one year of

the program to Atlantic Coast High School. DCPS will give the program $50,000 a year for 2

years, giving the program $100,000 total. Since the program will only last the first semester of

each school year, the programs staff will only be receiving pay for 7 months total (3.5 months’

worth of pay per school year). The first lesson will begin with the pre-test that is put together by

the program’s staff. It will then cover basic knowledge on how HIV is spread and who is most

susceptible to contracting HIV. The only materials need for this lesson will be the computer and

internet found in the classroom already and worksheets that the program’s staff created

beforehand. The classes will continue and then students will be able to do an activity with

condoms (male and female) teaching them how to properly put them on using their hands and

fingers. They will also spend this class learning how to create dental dams out of condoms using

scissors. Another lesson will involve using latex-free disposable gloves that the students will put

on and shake hands to show them that using condoms does not involving loss of sensation during

sex. All lessons will involve note taking and worksheets. Some worksheets will have diagrams

on them for the students to color code. Posters will be used during lessons to emphasize key

points of each lesson and brochures will be handed out to every student that tells them where

they can be tested for HIV/AIDS, as well as where they can find free condoms in the school and

community. One lesson will involves students acting out dialogue they created that helps them

practice tactics meant to delay initiation of sex with current or future partners and empower them

to use the tactics in real situations without making them feel uncomfortable or confused.
Healthy Students of Duval County Program Plan 18

References

Adolescence, C. O. (2013, November 1). Condom Use by Adolescents. Retrieved from

[Link]

Brieger, & R., W. (1999, October 1). school-based AIDS education program for secondary

school students in Nigeria: a review of effectiveness. Retrieved from

[Link]

Centers for Disease Control and Prevention. (2015). Florida- State Health Profile.

[Link]

Centers for Disease Control and Prevention. (2018). Youth Risk Behavior Surveillance- United

States, 2017. [Link]

COVID-19 Call Center available 24/7: 1 (866) 779-6121 or email COVID-19@[Link].

(n.d.). Retrieved from [Link]

disease-services/hiv-aids-program/[Link]

District of Columbia FY17 State Profile. (n.d.). Retrieved from

[Link]

Duval County. (2020, April 14). Retrieved from [Link]

states/south/florida/duval-county/

Gao, X., Wu, Y., Zhang, Y., Zhang, N., Tang, J., Qiu, J., … Du, Y. (2012). Effectiveness of

school-based education on HIV/AIDS knowledge, attitude, and behavior among

secondary school students in Wuhan, China. Retrieved from

[Link]
Healthy Students of Duval County Program Plan 19

Geographic Distribution. (2019, October 30). Retrieved from

[Link]

HIV/AIDS Surveillance Office. (2017). Aids Surveillance Report Duval, St. Johns, Clay, Nassau,

& Baker- Area 4 (Vol. xxxll, pp. 1–1). Jacksonville, Fl.

HIV Among Youth. (2020, May 18). Retrieved from

[Link]

HIV and Children and Adolescents Understanding HIV/AIDS. (2020, March 27). Retrieved from

[Link]

adolescents

HIV. (n.d.). Retrieved from [Link]

objectives/topic/hiv/objectives

Pettifor, A., Bekker, L.-G., Hosek, S., DiClemente, R., Rosenberg, M., Bull, S. S., … HIV

Prevention Trials Network (HPTN) Adolescent Scientific Committee. (2013, July).

Preventing HIV among young people: research priorities for the future. Retrieved from

[Link]

Race and Ethnicity in Duval County School District, Florida (Unified School District). (n.d.).

Retrieved from [Link]

District/Race-and-Ethnicity

Results. (2018, June 14). Retrieved from [Link]

Statistics: United States. (2020, June). Retrieved from [Link]

aids/facts-and-stats/statistics--united-states/
Healthy Students of Duval County Program Plan 20

Stratford, B. (2020, April 09). The majority of schools in 15 states and DC offer LGBTQ-

inclusive sex-ed curricula. Retrieved from [Link]

schools-in-15-states-and-dc-offer-lgbtq-inclusive-sex-ed-curricula

U.S. Census Bureau QuickFacts: Duval County, Florida. (n.d.). Retrieved from

[Link]

Williams, P. L., & Jesson, J. (2018, May). Growth and pubertal development in HIV-infected

adolescents. Retrieved from [Link]

Zanoni, B. C., & Mayer, K. H. (2014, March). The adolescent and young adult HIV cascade of

care in the United States: exaggerated health disparities. Retrieved from

[Link]