(2012) Relative Efficacy of a Pregnancy, Sexually Transmitted Infection, or Human Immunodeficiency Virus Prevention–Focused Intervention on Changing Sexual Risk Behavior Among Young Adults (original) (raw)
Related papers
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2011
and Introduction Abstract Objective: In the absence of an effective HIV vaccine, safer sexual practices are necessary to avert new infections. Therefore, we examined the efficacy of behavioral interventions to increase condom use and reduce sexually transmitted infections (STIs), including HIV. Design: Studies that examined a behavioral intervention focusing on reducing sexual risk, used a randomized controlled trial or a quasi-experimental design with a comparison condition, and provided needed information to calculate effect sizes for condom use and any type of STI, including HIV. Methods: Studies were retrieved from electronic databases (eg, PubMed, PsycINFO) and reference sections of relevant papers. Forty-two studies with 67 separate interventions (N = 40,665; M age = 26 years; 68% women; 59% Black) were included. Independent raters coded participant characteristics, design and methodological features, and intervention content. Weighted mean effect sizes, using both fixed-effects and random-effects models, were calculated. Potential moderators of intervention efficacy were assessed. Results: Compared with controls, intervention participants increased their condom use [d+ = 0.17, 95% confidence interval (CI) = 0.04, 0.29; k = 67], had fewer incident STIs (d+ = 0.16, 95% CI = 0.04, 0.29; k = 62), including HIV (d+ = 0.46, 95% CI = 0.13, 0.79; k = 13). Sample (eg, ethnicity) and intervention features (eg, skills training) moderated the efficacy of the intervention. Conclusions: Behavioral interventions reduce sexual risk behavior and avert STIs and HIV. Translation and widespread dissemination of effective behavioral interventions are needed.
Effects of a Sexual Risk-Reduction Intervention for Teenagers: A Cluster-Randomized Control Trial
This study evaluated the efficacy of the COMPAS program in the short term and 6 months after its application. For the initial sample, 2047 teenagers aged 14-19 years from 14 schools in 11 Colombian cities participated; eight schools were randomly assigned to the experimental condition and six to the control group. The participants completed self-report assessments that evaluated several variables theoretically associated with protective sexual behaviors. In the short term, the experimental group showed increased knowledge about HIV and other STIs, sexual assertiveness, self-efficacy, greater behavioral intention toward condom use, and more favorable attitudes toward HIV and condom use than the control group. After 6 months, most psychological and health variables also showed a significant positive change. In conclusion, the COMPAS program is the first school-based sexuality education program that has been shown to be effective in reducing mediating and behavioral variables associated with sexual risk reduction in Colombia.
American journal of public health, 2016
To test the efficacy of Reducing the Risk (RTR) and Love Notes (LN) on reducing risky sexual behavior among youths yet to experience or cause a pregnancy. The four dependent variables were ever had sex, condom use, birth control use, and number of sexual partners at 3- and 6-month follow-up in a 3-arm cluster randomized controlled trial of 1448 impoverished youths, aged 14 to 19 years, in 23 community-based organizations in Louisville, Kentucky, from September 2011 through March 2014. At 3 and 6 months, compared with the control condition, youths in RTR reported fewer sexual partners and greater use of birth control. At 6 months, LN participants reported greater use of birth control and condoms, fewer sexual partners, and were less likely to have ever had sex compared with the control condition. We provided additional evidence for the continued efficacy of RTR and the first rigorous study of LN, which embeds sex education into a larger curriculum on healthy relationships and violenc...
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2006
A meta-analytic review of the influence of HIV-risk reduction interventions on sexual occasions, number of partners, and abstinence was conducted, in order to assess whether condom-related interventions inadvertently undermine sexual health promotion efforts by increasing the frequency of sexual behavior. Included studies examined sexual-risk-reduction strategies, used a controlled design, and provided sufficient information to calculate effect sizes. Data from 174 studies (206 interventions, N=116,735 participants) were included. In general, HIV-risk reduction interventions (including condom education /promotion programs) neither increased nor decreased sexual occasions or number of partners reported. Participants in intervention conditions were less likely to be sexually active than those in control conditions. When samples included more Black participants, interventions reduced the number of sexual occasions; interventions were more successful at reducing the number of partners in samples that included more men who have sex with men (MSM) or individuals engaged in sex trading. Samples that included more MSM were more likely to adopt abstinence as a risk reduction strategy. Consistent with behavioral science theory, interventions that included more information, motivational enhancement, and skills training also led to greater risk reduction. HIV-risk reduction interventions do not increase the overall frequency of sexual activity. To the contrary, for some particularly at risk sub-groups, interventions reduce the frequency of sexual events and partners, especially when interventions include components recommended by behavioral science theory.
Perspectives Do Abstinence-Plus Interventions Reduce Sexual Risk Behavior among Youth?
2013
Abstinence until marriage has emerged as a primary policy goal in efforts to promote adolescent sexual and reproductive health—in the United States and increasingly world-wide. While few would argue with abstinence as a personal choice (no one should be forced to have sex), there are serious questions about whether government promotion of abstinence should be a public health goal. Marriage is not free of HIV risk. Early marriage— particularly of young women to older, sexually experienced men—carries a substantial risk of HIV infection. Around the globe, a young woman’s primary risk of HIV infection is often through sex with her husband [1]. Sexual intercourse is almost universally initiated during adolescence worldwide. By age 20, 77 % of young people in the US have initiated sex, and 76 % have had premarital sex [2]. By age 25, over 90 % people have had sex, with only about 3 % waiting for marriage. Over the past 40 years, the median age at first intercourse has dropped (and stabil...
Safer choices: reducing teen pregnancy, HIV, and STDs
Public Health Reports
This study evaluated the long-term effectiveness of Safer Choices, a theory-based, multi-component educational program designed to reduce sexual risk behaviors and increase protective behaviors in preventing HIV, other STDs, and pregnancy among high school students. The study used a randomized controlled trial involving 20 high schools in California and Texas. A cohort of 3869 ninth-grade students was tracked for 31 months from fall semester 1993 (baseline) to spring semester 1996 (31-month follow-up). Data were collected using self-report surveys administered by trained data collectors. Response rate at 31-month follow-up was 79%. Safer Choices had its greatest effect on measures involving condom use. The program reduced the frequency of intercourse without a condom during the three months prior to the survey, reduced the number of sexual partners with whom students had intercourse without a condom, and increased use of condoms and other protection against pregnancy at last interco...
Journal of Adolescent Health, 2012
Purpose-To evaluate the efficacy of two, theory-based, multi-media, middle school sexual education programs in delaying sexual initiation. Methods-Three-armed, randomized controlled trial comprising fifteen urban middle schools; 1,258 predominantly African-American and Hispanic 7 th grade students followed into 9 th grade. Both programs included group and individualized, computer-based activities addressing psychosocial variables. The risk avoidance (RA) program met federal abstinence education guidelines; the risk reduction (RR) program emphasized abstinence and included computer-based condom skills-training. The primary outcome assessed program impact on delayed sexual initiation; secondary outcomes assessed other sexual behaviors and psychosocial outcomes. Results-Participants were 59.8% female, mean age 12.6 years. Relative to controls, the RR program delayed any type of sexual initiation (oral, vaginal or anal sex) in the overall sample (adjusted odds ratio [AOR]: 0.65, 95% CI: 0.54-0.77), among females (AOR: 0.43, 95% CI: 0.31-0.60) and African-Americans (AOR: 0.38, 95% CI: 0.18-0.79). RR students also reduced unprotected sex at last intercourse (AOR: 0.67, 95% CI: 0.47-0.96), past three months' frequency of anal sex (AOR: 0.53, 95% CI: 0.33-0.84) and unprotected vaginal sex (AOR: 0.59, 95% CI: 0.36-0.95). The RA program delayed any sexual initiation among Hispanics (AOR: 0.40, 95% CI: 0.19-0.86), reduced unprotected sex at last intercourse (AOR: 0.70, 95% CI: 0.52-0.93) but increased the number of recent vaginal sex partners (AOR: 1.69, 95% CI: 1.01-2.82). Both programs positively impacted psychosocial outcomes. Conclusions-The RR program positively impacted sexually inexperienced and experienced youth; the RA program delayed initiation among Hispanics and had mixed effects among sexually experienced youth.
American Journal of Preventive Medicine, 2012
Community Preventive Services Task Force Context: Adolescent pregnancy, HIV, and other sexually transmitted infections (STIs) are major public health problems in the U.S. Implementing group-based interventions that address the sexual behavior of adolescents may reduce the incidence of pregnancy, HIV, and other STIs in this group. Evidence acquisition: Methods for conducting systematic reviews from the Guide to Community Preventive Services were used to synthesize scientifıc evidence on the effectiveness of two strategies for group-based behavioral interventions for adolescents: (1) comprehensive risk reduction and (2) abstinence education on preventing pregnancy, HIV, and other STIs. Effectiveness of these interventions was determined by reductions in sexual risk behaviors, pregnancy, HIV, and other STIs and increases in protective sexual behaviors. The literature search identifıed 6579 citations for comprehensive risk reduction and abstinence education. Of these, 66 studies of comprehensive risk reduction and 23 studies of abstinence education assessed the effects of group-based interventions that address the sexual behavior of adolescents, and were included in the respective reviews. Evidence synthesis: Meta-analyses were conducted for each strategy on the seven key outcomes identifıed by the coordination team-current sexual activity; frequency of sexual activity; number of sex partners; frequency of unprotected sexual activity; use of protection (condoms and/or hormonal contraception); pregnancy; and STIs. The results of these meta-analyses for comprehensive risk reduction showed favorable effects for all of the outcomes reviewed. For abstinence education, the meta-analysis showed a small number of studies, with inconsistent fındings across studies that varied by study design and follow-up time, leading to considerable uncertainty around effect estimates. Conclusions: Based on these fındings, group-based comprehensive risk reduction was found to be an effective strategy to reduce adolescent pregnancy, HIV, and STIs. No conclusions could be drawn on the effectiveness of group-based abstinence education.