Lead author Ralph J. DiClemente, Ph.D., from Emory University's Rollins School of Public Health and Center for AIDS Research, Atlanta, presented the findings from this study at a JAMA media briefing at the International AIDS Conference in Bangkok, Thailand.
According to background information in the article, adolescents are a known population at increased risk of HIV infection, especially African American girls. A recent study reported that "HIV prevalence among African American adolescent girls was significantly higher than among their white or Hispanic female peers and exceeds that of white, Hispanic, and African American male adolescents." African American girls in the South had the highest prevalence compared to girls from other regions of the U.S.
In this study, Dr. DiClemente and colleagues analyzed data from 522 sexually experienced African American girls aged 14 to 18 years who were screened from December 1996 through April 1999. The participants were randomized into two groups. The intervention group (n=251) received information on ethnic and gender pride, HIV knowledge, communication, condom use skills, and healthy relationships. The comparison group (n=271) received information on exercise and nutrition. All participants received four 4-hour group sessions. Data were collected at the start of the programs, and at 6- and 12-month follow-up.
"…participants in the HIV intervention were more likely to report using condoms consistently in the 30 days preceding the six-month assessment (75.3 percent vs. comparison, 58.2 percent) and the 12-month assessment (intervention, 73.3 percent vs. comparison, 56.5 percent) and over the entire 12-month period," the authors found. "Additionally, participants in the HIV intervention were more likely to report using a condom at last vaginal sexual intercourse, less likely to self-report a pregnancy, and less likely to report having a new vaginal sex partner in the 30 days prior to assessments." The authors add, "Promising intervention effects were also observed for self-reported pregnancy and laboratory-confirmed chlamydia. Because STDs, particularly chlamydia, are prevalent among adolescents and facilitate HIV transmission, even small reductions in incidence could result in considerable reductions in treatment costs as well as sizable reductions in HIV morbidity and its associated treatment costs."
In conclusion the authors write: "In response to the growing HIV epidemic among adolescents, there is a clear, cogent, and compelling urgency to develop and implement prevention interventions. Ultimately, to be optimally effective, the primary prevention of HIV among adolescents must emerge from the stigma of a hidden epidemic and become a public health priority." (JAMA. 2004;292: 171-179. Available post-embargo at JAMA.com)
Editor's Note: This study was supported by a grant from the Center for Mental Health Research on AIDS, National Institute of Mental Health.
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