Table of Contents
Christine Markham, Ph.D.
assistant professor of health promotion and behavioral sciences, SPH
Research Work: Adolescent Sexual and Reproductive Health

Christine Markham, Ph.D.
The U.S. has the highest teen pregnancy rate of all developed countries and more than four million young people contracting a sexually transmitted infection every year, Christine Markham, Ph.D., takes on the task of guiding America’s youth toward more responsible sexual behavior.
Markham, assistant professor of health promotion and behavioral sciences, is the principal investigator (PI) on four federally funded studies totaling more than $7.7 million in research funds and the co-investigator on two additional studies that all focus on sexual and reproductive health among adolescents, including HIV, sexually transmitted infections (STIs) and pregnancy prevention. She also serves as deputy director of The University of Texas Prevention Research Center.
“Teen pregnancy and HIV/STIs represent serious public health issues,” said Markham, who uses theory-based, interactive programs to educate students about sexual and reproductive health issues. “One of our most recent studies headed by Dr. Susan Tortolero – It’s Your Game, Keep It Real – developed a multi-media HIV, STI and pregnancy prevention program for 7th and 8th graders, which included classroom lessons and interactive computer activities to help teens learn how to resist pressures to have sex and how to have healthy dating relationships. The project was funded by the National Institute for Mental Health and showed significant delay in sexual initiation when the students entered 9th grade, relative to students in a comparison group.”
Markham uses computer-assisted surveys to gauge students’ opinions about oral, anal and vaginal sex because this survey method has been shown to yield more honest answers from young people.
“The computers also are programmed with automatic skip patterns, so that we do not over-expose young middle school students to explicit questions about sex when they are not yet sexually active,” she added.
Markham’s recent surveys with 7th graders in Houston revealed several startling statistics about the students’ sexual behavior.
“We found that 12 percent of students have had vaginal sex, 8 percent oral sex and 7 percent anal sex,” she said. “Some of the youth who are sexually experienced also have had multiple partners, four or more, which puts them at very high risk for unintended pregnancy or for contracting an STI.”
Funded by the Baylor-UT Houston Center for AIDS Research, Markham also is working on a collaborative pilot study with Ross Shegog, Ph.D., at the UT Center for Health Promotion and Prevention Research, and Amy Leonard and Mary Paul, M.D., at Baylor College of Medicine, to develop a computerbased, self-management program for youth with HIV.
“In the United States, it’s estimated that half of all new HIV cases occur among youth under the age of 25,” Markham said. “With advances in antiretroviral therapy, mortality and morbidity related to HIV infection have dramatically declined, and HIV infection has become a chronic disease requiring lifetime management. Our project focuses on medication adherence and sexual risk reduction to give HIV-positive youth the skills to take their medications correctly and to navigate dating and intimate relationships more safely.”
Markham’s educational programs aim to promote sensible sexual health for American teen-agers, but they also are being expanded for use internationally.
“We’re beginning collaborations with colleagues in Puerto Rico, the Caribbean and Australia to adapt effective programs for youth in their countries, and I’m hopeful that our work with HIV-positive youth also will lead to international collaborations down the road.”

