Outcomes of a randomized, controlled community-level HIV... : AIDS (original) (raw)

EPIDEMIOLOGY AND SOCIAL

Outcomes of a randomized, controlled community-level HIV prevention intervention for adolescents in low-income housing developments

Sikkema, Kathleen Ja,b; Anderson, Eileen Sc; Kelly, Jeffrey Ab; Winett, Richard Ac; Gore-Felton, Cherylb; Roffman, Roger Ad; Heckman, Timothy Gb; Graves, Kristic; Hoffmann, Raymond Gb; Brondino, Michael Jb

From the aYale University School of Medicine and Centre for Interdisciplinary Research on AIDS (CIRA), New Haven, Connecticut

bMedical College of Wisconsin, Milwaukee, Wisconsin

cVirginia Polytechnic Institute and State University, Blacksburg, Virginia

dUniversity of Washington, Seattle, Washington, USA.

Received 12 November, 2004

Revised 10 June, 2005

Accepted 27 June, 2005

Correspondence to Kathleen J. Sikkema, PhD, Department of Epidemiology and Public Health, Yale University, 60 College Street, P. O. Box 208034, New Haven, CT 06520-8034, USA. E-mail: [email protected]

Abstract

Objectives:

Youth are increasingly at risk for contracting HIV infection, and community-level interventions are needed to reduce behavioral risk.

Design:

A randomized, controlled, multi-site community-level intervention trial was undertaken with adolescents living in 15 low-income housing developments in five US cities.

Methods:

Baseline (n = 1172), short-term follow-up (n = 865), and long-term follow-up (n = 763) risk assessments were conducted among adolescents, ages 12–17, in all 15 housing developments. The developments were randomly assigned in equal numbers to each of three conditions: experimental community-level intervention (five developments); ‘state-of-the-science’ skills training workshops (five developments); and, education-only delayed control intervention (five developments).

Results:

At long-term follow-up, adolescents living in the housing developments receiving the community-level intervention were more likely to delay onset of first intercourse (85%) than those in the control developments (76%), while those in the workshop developments (78%) did not differ from control condition adolescents. Adolescents in both the community-level intervention (77%) and workshop (76%) developments were more likely to use a condom at last intercourse than those in control (62%) developments.

Conclusions:

Community-level interventions that include skills training and engage adolescents in neighborhood-based HIV prevention activities can produce and maintain reductions in sexual risk behavior, including delaying sexual debut and increasing condom use.