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.

In Latin America, unplanned pregnancies and sexually transmitted infections (STIs) in youth are two main public health problems. Colombia accounts for one of the highest prevalence rate of HIV and STIs in this population; however, a national standardized sex education program for adolescents is still not available. Competences for adolescents with a Healthy Sexuality (COMPAS for its acronym in Spanish)-a school-based sexual health promotion intervention for Spanish adolescents-was adapted for Colombian youth. We hypothesized that COMPAS key elements would be translated and its effectiveness would be retained. This research describes the adaptation process that resulted in an adapted version for youth in Colombia