Efficacy of sexually transmitted disease/human immunodeficiency virus sexual risk-reduction intervention for african american adolescent females seeking sexual health services: a randomized controlled trial

Arch Pediatr Adolesc Med. 2009 Dec;163(12):1112-21. doi: 10.1001/archpediatrics.2009.205.

Abstract

Objectives: To evaluate the efficacy of an intervention to reduce incident sexually transmitted disease (STD) and enhance STD/human immunodeficiency virus (HIV)-preventive behaviors and psychosocial mediators.

Design: A randomized controlled trial of an HIV prevention program.

Setting: Clinic-based sample in Atlanta, Georgia.

Participants: African American adolescent females (N = 715), aged 15 to 21 years, seeking sexual health services. Participants completed an audio computer-assisted self-interview and provided self-collected vaginal specimens for STD testing. Intervention Intervention participants received two 4-hour group sessions and 4 telephone contacts over a 12-month period, targeting personal, relational, sociocultural, and structural factors associated with adolescents' STD/HIV risk, and were given vouchers facilitating male partners' STD testing/treatment. Main Outcome Measure Incident chlamydial infections.

Results: Over the 12-month follow-up, fewer adolescents in the intervention had a chlamydial infection (42 vs 67; risk ratio [RR], 0.65; 95% confidence interval [CI], 0.42 to 0.98; P = .04) or recurrent chlamydial infection (4 vs 14; RR, 0.25; 95% CI, 0.08 to 0.83; P = .02). Adolescents in the intervention also reported a higher proportion of condom-protected sex acts in the 60 days preceding follow-up assessments (mean difference, 10.84; 95% CI, 5.27 to 16.42; P < .001) and less frequent douching (mean difference, -0.76; 95% CI, -1.15 to -0.37; P = .001). Adolescents in the intervention were also more likely to report consistent condom use in the 60 days preceding follow-up assessments (RR, 1. 41; 95% CI, 1.09 to 1.80; P = .01) and condom use at last intercourse (RR, 1.30; 95% CI, 1.09 to 1.54; P = .005). Intervention effects were observed for psychosocial mediators of STD/HIV-preventive behaviors.

Conclusion: Interventions for African American adolescent females can reduce chlamydial infections and enhance STD/HIV-preventive behaviors and psychosocial mediators of STD/HIV-preventive behaviors. Trial Registration clinicaltrials.gov Identifier: NCT00633906.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • African Americans*
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / ethnology*
  • Chlamydia Infections / prevention & control*
  • Female
  • Georgia / epidemiology
  • HIV Infections / epidemiology
  • HIV Infections / ethnology*
  • HIV Infections / prevention & control*
  • Humans
  • Least-Squares Analysis
  • Logistic Models
  • Male
  • Outcome Assessment, Health Care
  • Patient Acceptance of Health Care
  • Prevalence
  • Risk Reduction Behavior*
  • Sexual Behavior / ethnology*
  • Sexually Transmitted Diseases / epidemiology
  • Sexually Transmitted Diseases / ethnology*
  • Sexually Transmitted Diseases / prevention & control*
  • Surveys and Questionnaires
  • Urban Population
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT00633906