Efficacy of an HIV Prevention Intervention for African American Adolescent Girls: A Randomized Controlled Trial

• Published in: JAMA : the journal of the American Medical Association 2004-07, Vol.292 (2), p.171-179
• Main Authors: DiClemente, Ralph J, Wingood, Gina M, Harrington, Kathy F, Lang, Delia L, Davies, Susan L, Hook III, Edward W, Oh, M. Kim, Crosby, Richard A, Hertzberg, Vicki Stover, Gordon, Angelita B, Hardin, James W, Parker, Shan, Robillard, Alyssa
• Format: Article
• Language: English
• Subjects: Adolescent; African Americans; African Americans - ethnology; African Americans - psychology; Biological and medical sciences; Chlamydia; Female; Girls; Harm Reduction; Health Education; Health Knowledge, Attitudes, Practice; Health Promotion; HIV Infections - ethnology; HIV Infections - prevention & control; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Medical sciences; Medical screening; Miscellaneous; Prevention and actions; Preventive medicine; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sexual behavior; Sexual Behavior - ethnology; Sexual Behavior - psychology; Sexually transmitted diseases; STD; United States; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Wellness programs
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.292.2.171

CONTEXT African American adolescent girls are at high risk for human immunodeficiency virus (HIV) infection, but interventions specifically designed for this population have not reduced HIV risk behaviors. OBJECTIVE To evaluate the efficacy of an intervention to reduce sexual risk behaviors, sexually transmitted diseases (STDs), and pregnancy and enhance mediators of HIV-preventive behaviors. DESIGN, SETTING, AND PARTICIPANTS Randomized controlled trial of 522 sexually experienced African American girls aged 14 to 18 years screened from December 1996 through April 1999 at 4 community health agencies. Participants completed a self-administered questionnaire and an interview, demonstrated condom application skills, and provided specimens for STD testing. Outcome assessments were made at 6- and 12-month follow-up. INTERVENTION All participants received four 4-hour group sessions. The intervention emphasized ethnic and gender pride, HIV knowledge, communication, condom use skills, and healthy relationships. The comparison condition emphasized exercise and nutrition. MAIN OUTCOME MEASURES The primary outcome measure was consistent condom use, defined as condom use during every episode of vaginal intercourse; other outcome measures were sexual behaviors, observed condom application skills, incident STD infection, self-reported pregnancy, and mediators of HIV-preventive behaviors. RESULTS Relative to the comparison condition, participants in the intervention reported using condoms more consistently in the 30 days preceding the 6-month assessment (unadjusted analysis, intervention, 75.3% vs comparison, 58.2%) and the 12-month assessment (unadjusted analysis, intervention, 73.3% vs comparison, 56.5%) and over the entire 12-month period (adjusted odds ratio, 2.01; 95% confidence interval [CI], 1.28-3.17; P = .003). Participants in the intervention reported using condoms more consistently in the 6 months preceding the 6-month assessment (unadjusted analysis, intervention, 61.3% vs comparison, 42.6%), at the 12-month assessment (unadjusted analysis, intervention, 58.1% vs comparison, 45.3%), and over the entire 12-month period (adjusted odds ratio, 2.30; 95% CI, 1.51-3.50; P