Timing of HIV interventions on reductions in sexual risk among adolescents
Rotheram-Borus, M.J.; Gwadz, M.; Fernandez, M.I.; Srinivasan, S.
American Journal of Community Psychology 26(1): 73-96
1998
ISSN/ISBN: 0091-0562 PMID: 9574499 DOI: 10.1023/a:1021834224454Document Number: 282204
The effectiveness of a small-group HIV/AIDS prevention intervention was assessed in 151 US adolescents 13-24 years of age who were randomly assigned to seven 1.5-hour sessions, three 3.5-hour sessions, or no intervention. The study participants were recruited from a community-based agency in New York, New York, that serves high-risk Black and Hispanic youth from neighborhoods with high HIV seroprevalence rates. The cognitive-behavioral intervention emphasized role-playing for social skills development and HIV-related beliefs, perceptions, and norms. Regression analysis indicated that over the 3-month study period, the numbers of sexual partners and sex acts unprotected by condoms were significantly lower in the 7-session group than in the other 2 groups. Compared with youths in the 7-session group, those in the control condition reported an average of 7.9 more risk acts and those in the 3-session group had an average of 7.2 more risk acts. The factors mediating risk reduction behavior changed in a complex manner. For example, perceived vulnerability increased more among those with initially lower vulnerability scores among youth in the 7-session group and self-approval of condom use was higher for those with initially low scores in the 7-session compared to the 3-session regimen. Self-efficacy for both risk avoidance and condom use was significantly higher in the 3-session condition for those with initially low scores, however. On the role-play measure, those with higher baseline scores in the low-pressure situation improved significantly only in the 3-session intervention; in the high-pressure situation, adolescents reported significantly higher scores in the 7-session condition and those with higher scores improved the most. These findings support an HIV/AIDS intervention strategy of shorter educational sessions spread over a brief span of time.