Efficacy of an HIV prevention intervention for African American adolescent girls: A randomized controlled trial

Ralph DiClemente, Gina M. Wingood, Kathy F. Harrington, Delia L. Lang, Susan L. Davies, Edward W. Hook, M. Kim Oh, Richard A. Crosby, Vicki Stover Hertzberg, Angelita B. Gordon, James W. Hardin, Shan Parker, Alyssa Robillard

Research output: Contribution to journalArticle

Abstract

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<.001). Using generalized estimating equation analyses over the 12-month follow-up, adolescents in the intervention were more likely to use a condom at last intercourse, less likely to have a new vaginal sex partner in the past 30 days, and more likely to apply condoms to sex partners and had better condom application skills, a higher percentage of condom-protected sex acts, fewer unprotected vaginal sex acts, and higher scores on measures of mediators. Promising effects were also observed for chlamydia infections and self-reported pregnancy. Conclusion: 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 chlamyclia infection.

Original languageEnglish (US)
Pages (from-to)171-179
Number of pages9
JournalJournal of the American Medical Association
Volume292
Issue number2
DOIs
StatePublished - Jul 14 2004

Fingerprint

Condoms
African Americans
Randomized Controlled Trials
HIV
Sexually Transmitted Diseases
Outcome Assessment (Health Care)
Pregnancy
Chlamydia Infections
Risk-Taking
Sexual Behavior
Odds Ratio
Confidence Intervals
Safe Sex
Unsafe Sex
Virus Diseases
Communication
Interviews
Exercise

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Efficacy of an HIV prevention intervention for African American adolescent girls : A randomized controlled trial. / DiClemente, Ralph; Wingood, Gina M.; Harrington, Kathy F.; Lang, Delia L.; Davies, Susan L.; Hook, Edward W.; Oh, M. Kim; Crosby, Richard A.; Hertzberg, Vicki Stover; Gordon, Angelita B.; Hardin, James W.; Parker, Shan; Robillard, Alyssa.

In: Journal of the American Medical Association, Vol. 292, No. 2, 14.07.2004, p. 171-179.

Research output: Contribution to journalArticle

DiClemente, R, Wingood, GM, Harrington, KF, Lang, DL, Davies, SL, Hook, EW, Oh, MK, Crosby, RA, Hertzberg, VS, Gordon, AB, Hardin, JW, Parker, S & Robillard, A 2004, 'Efficacy of an HIV prevention intervention for African American adolescent girls: A randomized controlled trial', Journal of the American Medical Association, vol. 292, no. 2, pp. 171-179. https://doi.org/10.1001/jama.292.2.171
DiClemente, Ralph ; Wingood, Gina M. ; Harrington, Kathy F. ; Lang, Delia L. ; Davies, Susan L. ; Hook, Edward W. ; Oh, M. Kim ; Crosby, Richard A. ; Hertzberg, Vicki Stover ; Gordon, Angelita B. ; Hardin, James W. ; Parker, Shan ; Robillard, Alyssa. / Efficacy of an HIV prevention intervention for African American adolescent girls : A randomized controlled trial. In: Journal of the American Medical Association. 2004 ; Vol. 292, No. 2. pp. 171-179.
@article{91554f412f5545c99dca47d8beb180b9,
title = "Efficacy of an HIV prevention intervention for African American adolescent girls: A randomized controlled trial",
abstract = "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<.001). Using generalized estimating equation analyses over the 12-month follow-up, adolescents in the intervention were more likely to use a condom at last intercourse, less likely to have a new vaginal sex partner in the past 30 days, and more likely to apply condoms to sex partners and had better condom application skills, a higher percentage of condom-protected sex acts, fewer unprotected vaginal sex acts, and higher scores on measures of mediators. Promising effects were also observed for chlamydia infections and self-reported pregnancy. Conclusion: 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 chlamyclia infection.",
author = "Ralph DiClemente and Wingood, {Gina M.} and Harrington, {Kathy F.} and Lang, {Delia L.} and Davies, {Susan L.} and Hook, {Edward W.} and Oh, {M. Kim} and Crosby, {Richard A.} and Hertzberg, {Vicki Stover} and Gordon, {Angelita B.} and Hardin, {James W.} and Shan Parker and Alyssa Robillard",
year = "2004",
month = "7",
day = "14",
doi = "10.1001/jama.292.2.171",
language = "English (US)",
volume = "292",
pages = "171--179",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "2",

}

TY - JOUR

T1 - Efficacy of an HIV prevention intervention for African American adolescent girls

T2 - A randomized controlled trial

AU - DiClemente, Ralph

AU - Wingood, Gina M.

AU - Harrington, Kathy F.

AU - Lang, Delia L.

AU - Davies, Susan L.

AU - Hook, Edward W.

AU - Oh, M. Kim

AU - Crosby, Richard A.

AU - Hertzberg, Vicki Stover

AU - Gordon, Angelita B.

AU - Hardin, James W.

AU - Parker, Shan

AU - Robillard, Alyssa

PY - 2004/7/14

Y1 - 2004/7/14

N2 - 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<.001). Using generalized estimating equation analyses over the 12-month follow-up, adolescents in the intervention were more likely to use a condom at last intercourse, less likely to have a new vaginal sex partner in the past 30 days, and more likely to apply condoms to sex partners and had better condom application skills, a higher percentage of condom-protected sex acts, fewer unprotected vaginal sex acts, and higher scores on measures of mediators. Promising effects were also observed for chlamydia infections and self-reported pregnancy. Conclusion: 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 chlamyclia infection.

AB - 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<.001). Using generalized estimating equation analyses over the 12-month follow-up, adolescents in the intervention were more likely to use a condom at last intercourse, less likely to have a new vaginal sex partner in the past 30 days, and more likely to apply condoms to sex partners and had better condom application skills, a higher percentage of condom-protected sex acts, fewer unprotected vaginal sex acts, and higher scores on measures of mediators. Promising effects were also observed for chlamydia infections and self-reported pregnancy. Conclusion: 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 chlamyclia infection.

UR - http://www.scopus.com/inward/record.url?scp=3042728480&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3042728480&partnerID=8YFLogxK

U2 - 10.1001/jama.292.2.171

DO - 10.1001/jama.292.2.171

M3 - Article

C2 - 15249566

AN - SCOPUS:3042728480

VL - 292

SP - 171

EP - 179

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 2

ER -