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"Efficacy of an HIV Prevention Intervention for African American Adolescent Girls"
  CDC HIV/STD/TB Prevention News Update
Monday, August 02, 2004
Journal of the American Medical Association
(07.14.04) Vol. 292; No. 2: P. 171-179::Ralph J. DiClemente, PhD; Gina M. Wingwood, ScD, MPH; Kathy F. Harrington, MPH, MAEd; Delia L. Lang, PhD, MPH; Susan L. Davies, PhD, MEd; Edward W. Hook III, MD; M. Kim Oh, MD; Richard A. Crosby, PhD; Vicki Stover Hertzberg, PhD; Angelita B. Gordon, MS; James W. Hardin, PhD; Shan Parker, PhD, MPH; Alyssa Robillard, PhD, MSPH
Adolescents are at increased risk of HIV, and among this population, African-American girls are at particularly high risk. In the US South, African-American female adolescents had the highest HIV prevalence (6.4 per 1,000) relative to adolescents from other regions. In the current study, researchers evaluated the efficacy of an intervention in reducing risky sexual behaviors and STDs and enhancing mediators of HIV-preventive behaviors among sexually experienced African-American adolescent females in the South.
The researchers conducted a randomized controlled trial of 522 sexually experienced African-American girls ages 14-18 screened from December 1996 to April 1999 at four community health agencies. The participants completed a self-administered questionnaire and an interview, demonstrated condom application skills, and provided specimens for STD testing. Outcomes were assessed at six- and 12-month follow-up.
All participants took part in four four-hour sessions. The intervention emphasized ethnic and gender pride, HIV knowledge, communication, condom-use skills, and healthy relationships. Exercise and nutrition were emphasized in the comparison condition.
In comparing outcomes for the intervention vs. the comparison groups, intervention participants were more likely to report consistent condom use in the 30 days prior to the six-month assessment (unadjusted analysis: 75.3 percent vs. 58.2 percent) and the 12-month assessment (unadjusted analysis: 73.3 percent vs. 56.5 percent) and over the entire 12-month period. Using generalized estimating equation analyses over the 12-month follow-up period, intervention participants were more likely to use a condom at last intercourse, less likely to have had a new vaginal sex partner in the past 30 days, more likely to apply condoms to sex partners, and had better condom applications skills, a higher percentage of condom-protected sex acts, fewer unprotected vaginal sex acts, and higher scores on measures of mediators. Researchers also observed promising effects for chlamydia infections and self-reported pregnancy.
The theme of the intervention, "Stay Safe for Yourself and Your Community," was designed, the researchers wrote, "to promote a sense of solidarity and ethnic pride among participants and may have inspired them to modify risk behaviors for altruistic motives: by enhancing their health, they were also enhancing the health of the African American community."
"Interventions for African American adolescent girls that are gender-tailored and culturally congruent can enhance HIV- preventive behaviors, skills, and mediators and may reduce pregnancy and chlamydia infection," the researchers concluded.
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