HIV/STI risk-reduction intervention efficacy with South African adolescents over 54 months

SOURCE: Health Psychology
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2014
TITLE AUTHOR(S): J.B.Jemmott III, L.S.Jemmott, A.O'Leary, Z.Ngwane, D.A.Lewis, S.L.Bellamy, L.D.Icard, C.Carty, G.A.Heeren, J.C.Tyler, M.B.Makiwane, A.Teitelman
KEYWORDS: ADOLESCENTS, HIV/AIDS, INTERVENTION, RISK BEHAVIOUR, SEXUAL BEHAVIOUR, SEXUALLY TRANSMITTED INFECTIONS
DEPARTMENT: Human and Social Development (HSD)
Print: HSRC Library: shelf number 8349

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Abstract

Little research has tested HIV/sexually transmitted infection (STI) risk-reduction interventions' effects on early adolescents as they age into middle and late adolescence. This study tested whether intervention-induced reductions in unprotected intercourse during a 12-month period endured over a 54-month period and whether the intervention reduced the prevalence of STIs, which increase risk for HIV. Grade 6 learners (mean age = 12.4 years) participated in a 12-month trial in Eastern Cape Province, South Africa, in which 9 matched pairs of schools were randomly selected and within pairs randomized to a theory-based HIV/STI risk-reduction intervention or an attention-control intervention. They completed 42- and 54-month post-intervention measures of unprotected intercourse (the primary outcome), other sexual behaviors, theoretical constructs, and, at 42- and 54-month follow-up only, biologically confirmed curable STIs (chlamydial infection, gonorrhea, and trichomoniasis) and herpes simplex virus 2. Results: The HIV/STI risk-reduction intervention reduced unprotected intercourse averaged over the entire follow-up period, an effect not significantly reduced at 42- and 54-month follow-up compared with 3-, 6-, and 12-month follow-ups. The intervention caused positive changes on theoretical constructs averaged over the 5 follow-ups, although most effects weakened at long-term follow-up. Although the intervention's main effect on STIs was nonsignificant, an Intervention Condition X Time interaction revealed that it significantly reduced curable STIs at 42-month follow-up in adolescents who reported sexual experience. These results suggest that theory-based behavioral interventions with early adolescents can have long-lived effects in the context of a generalized severe HIV epidemic.