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Toska E, Pantelic M, Meinck F, Keck K, Haghighat R, Cluver L. Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa. PLoS One 2017; 12:e0178106. [PMID: 28582428 PMCID: PMC5459342 DOI: 10.1371/journal.pone.0178106] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/06/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Evidence on sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa is urgently needed. This systematic review synthesizes the extant research on prevalence, factors associated with, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa. METHODS Studies were located through electronic databases, grey literature, reference harvesting, and contact with researchers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Quantitative studies that reported on HIV-positive participants (10-24 year olds), included data on at least one of eight outcomes (early sexual debut, inconsistent condom use, older partner, transactional sex, multiple sexual partners, sex while intoxicated, sexually transmitted infections, and pregnancy), and were conducted in sub-Saharan Africa were included. Two authors piloted all processes, screened studies, extracted data independently, and resolved any discrepancies. Due to variance in reported rates and factors associated with sexual risk-taking, meta-analyses were not conducted. RESULTS 610 potentially relevant titles/abstracts resulted in the full text review of 251 records. Forty-two records (n = 35 studies) reported one or multiple sexual practices for 13,536 HIV-positive adolescents/youth from 13 sub-Saharan African countries. Seventeen cross-sectional studies reported on individual, relationship, family, structural, and HIV-related factors associated with sexual risk-taking. However, the majority of the findings were inconsistent across studies, and most studies scored <50% in the quality checklist. Living with a partner, living alone, gender-based violence, food insecurity, and employment were correlated with increased sexual risk-taking, while knowledge of own HIV-positive status and accessing HIV support groups were associated with reduced sexual risk-taking. Of the four intervention studies (three RCTs), three evaluated group-based interventions, and one evaluated an individual-focused combination intervention. Three of the interventions were effective at reducing sexual risk-taking, with one reporting no difference between the intervention and control groups. CONCLUSION Sexual risk-taking among HIV-positive adolescents and youth is high, with inconclusive evidence on potential determinants. Few known studies test secondary HIV-prevention interventions for HIV-positive youth. Effective and feasible low-cost interventions to reduce risk are urgently needed for this group.
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Affiliation(s)
- Elona Toska
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- AIDS and Society Research Unit, Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Marija Pantelic
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Franziska Meinck
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- OPTENTIA, School of Behavioural Sciences, North-West University, Vanderbeijlpark, South Africa
| | - Katharina Keck
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- Oxford Policy Management, Johannesburg, South Africa
| | - Roxanna Haghighat
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Nöstlinger C, Jasna L, Sabrina BK, Obong'o C, Eric W, Buvé A. Translating primary into 'positive' prevention for adolescents in Eastern Africa. Health Promot Int 2015; 31:653-64. [PMID: 26048865 DOI: 10.1093/heapro/dav044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
There is an urgent need to develop positive prevention interventions for adolescents living with HIV in high endemic regions. Adapting existing evidence-based interventions for resource-constrained settings is effective when the intervention's theoretical core elements are preserved while achieving cultural relevance. We describe the process of adapting a primary prevention to a secondary/positive prevention programme for adolescents living with HIV in Kenya and Uganda. The systematic adaptation was guided by the Centers for Diseases Control's map for the adaptation process, describing an iterative process. The procedure included: assessing the target positive prevention group's needs (safer sex; fertility-related issues), identifying the potential interventions through a literature review, conducting qualitative adaptation research to identify areas for adaptation by ensuring cultural relevance (revising the intervention logic by adding topics such as adherence; HIV-related stigma; HIV-disclosure; safer sex), pilot-testing the adapted programme and conducting a process evaluation of its first implementation. Areas added onto the original intervention's logic framework, based on social cognitive theory, the theories of reasoned action and planned behaviour were information and skills building on sexual relationships and protection behaviour, prevention of vertical HIV transmission, contraception, HIV-disclosure, HIV-related stigma, HIV-treatment and adherence. The process evaluation using mixed methods showed that we delivered a feasible and acceptable intervention for HIV-positive adolescents aged 13-17 years. The systematic approach adopted facilitated the development of a contextualized and developmentally appropriate (i.e. age-specific) intervention for adolescents living with HIV.
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Affiliation(s)
- Christiana Nöstlinger
- Department of Public Health, Institute of Tropical Medicine (ITM), Nationalestraat 155, Antwerp B-2000, Belgium ITM HIV/AIDS Center, Nationalestraat 155, Antwerp B-2000, Belgium
| | - Loos Jasna
- Department of Public Health, Institute of Tropical Medicine (ITM), Nationalestraat 155, Antwerp B-2000, Belgium ITM HIV/AIDS Center, Nationalestraat 155, Antwerp B-2000, Belgium
| | - Bakeera-Kitaka Sabrina
- Baylor College of Medicine Children's Foundation, Kampala, Uganda Department of Pediatrics, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Wobudeya Eric
- Department of Pediatrics, Makerere University College of Health Sciences, Kampala, Uganda
| | - Anne Buvé
- Department of Public Health, Institute of Tropical Medicine (ITM), Nationalestraat 155, Antwerp B-2000, Belgium ITM HIV/AIDS Center, Nationalestraat 155, Antwerp B-2000, Belgium
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Carter MW, Kraft JM, Hatfield-Timajchy K, Snead MC, Ozeryansky L, Fasula AM, Koenig LJ, Kourtis AP. The reproductive health behaviors of HIV-infected young women in the United States: A literature review. AIDS Patient Care STDS 2013; 27:669-80. [PMID: 24320012 DOI: 10.1089/apc.2013.0208] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
HIV-infected young women in the United States have important reproductive health needs that are made more complex by their HIV status. We searched Pubmed and relevant bibliographies to identify 32 articles published from 2001 to July 2012 that described the prevalence, correlates, and characteristics of the sexual activity, relationships, pregnancy intentions, HIV status disclosure, and contraceptive and condom use among US HIV-infected adolescents and young women. Our synthesis of those articles found that, like youth not infected with HIV, substantial proportions of HIV-infected youth were sexually active, and most sought romantic or sexual relationships, though their serostatus may have affected the pace of physical and emotional intimacy. Disclosure was difficult, and large proportions of HIV-infected youth had not disclosed their serostatus to recent partners. A few studies suggest that most HIV-infected young women hoped to have children in the future, but many wanted to avoid pregnancy until later. Only one study described contraceptive use among this population in detail and found that condoms were a primary method of contraception. The results point to substantial gaps in published research, particularly in the areas of pregnancy intentions and contraceptive use. Much more needs to be done in research and health services to better understand and meet the complex health needs of HIV-infected young women.
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Affiliation(s)
| | - Joan M. Kraft
- Center for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Amy M. Fasula
- Center for Disease Control and Prevention, Atlanta, Georgia
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Chariyeva Z, Golin CE, Earp JA, Suchindran C. Does motivational interviewing counseling time influence HIV-positive persons' self-efficacy to practice safer sex? PATIENT EDUCATION AND COUNSELING 2012; 87:101-7. [PMID: 21890300 PMCID: PMC3782534 DOI: 10.1016/j.pec.2011.07.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 07/21/2011] [Accepted: 07/22/2011] [Indexed: 05/28/2023]
Abstract
OBJECTIVE This study examined the impact of motivational interviewing (MI) counseling time on self-efficacy to practice safer sex for people living with HIV/AIDS (PLWHA). METHODS In 4 month intervals we followed a cohort of 490 PLWHA for 12 months. We conducted hierarchical linear regression models to examine changes in safer sex self-efficacy when participants received zero, low to moderate (5-131 min) and high (132-320 min) doses of MI time. We conducted a similar analysis using number of counseling sessions as the predictor variable. RESULTS Participants with low to moderate doses of MI counseling had 0.26 higher self-efficacy scores than participants with zero MI time (p=0.01). Also, they had 0.26 lower self-efficacy scores than participants with high amounts of MI time (p=0.04). Participants with high doses of MI had a 0.5 higher self-efficacy score than participants with zero amount of MI time (p<0.0001). Participants who received 3-4 counseling sessions had 0.41 greater self-efficacy scores than participants who did not receive any sessions (p<0.0001) but did not differ from participants receiving 1-2 sessions. CONCLUSION MI time is a key to enhancing safer sex self-efficacy among PLWHA. PRACTICE IMPLICATIONS Safer sex self-efficacy improves the more MI counseling time and sessions PLWHA receive.
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Affiliation(s)
- Zulfiya Chariyeva
- Department of Health Behavior and Health Education, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Campus Box 7440, Chapel Hill 27599-7440, USA
| | - Carol E. Golin
- Department of Health Behavior and Health Education, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Campus Box 7440, Chapel Hill 27599-7440, USA
| | - Jo Anne Earp
- Department of Health Behavior and Health Education, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Campus Box 7440, Chapel Hill 27599-7440, USA
| | - Chirayath Suchindran
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
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Chen X, Murphy DA, Naar-King S, Parsons JT. A clinic-based motivational intervention improves condom use among subgroups of youth living with HIV. J Adolesc Health 2011; 49:193-8. [PMID: 21783053 PMCID: PMC3282587 DOI: 10.1016/j.jadohealth.2010.11.252] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Revised: 11/19/2010] [Accepted: 11/20/2010] [Indexed: 11/26/2022]
Abstract
PURPOSE More than 50% of youth living with HIV (YLH) have unprotected sex. In previous studies, we reported effects of a motivational interviewing-based multirisk reduction intervention, "Healthy Choices" in improving motivation, depression, and viral load in YLH. In this study, we report the effect of the intervention on increasing condom use. METHODS Six waves of longitudinal data (n = 142) across a period from baseline through 15 months postintervention were analyzed. The developmental trajectory modeling method was used for program effect evaluation. RESULTS The three groups detected with distinct sexual risks were: Persistent low sexual risk (PLSR), delayed high sexual risk, and high and growing sexual risk with regard to levels and time trajectories of condom use throughout the trial. Receiving Healthy Choices increased the likelihood to be in the PLSR group (63% vs. 32%, p < .01) and reduced the likelihood to be in the delayed high sexual risk group (16% vs. 50%, p < .05). Receiving the intervention was also associated with progressive reductions in no-condom sex for PLSR youth (adjusted β = -.325, p < .01) and high and growing sexual risk youth (adjusted β = -.364, p < .01). CONCLUSION The motivational interviewing-based program Healthy Choices, when delivered in clinic settings, can prevent unprotected sex in subgroups of YLH, although more intensive interventions may be needed to change risk trajectories among those at highest risk of transmitting the AIDS virus. Developmental trajectory analysis provides an alternative approach to evaluate program effects for study samples that contain distinct subgroups.
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Affiliation(s)
- Xinguang Chen
- Prevention Research Center, Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI 48201, USA.
| | - Debra A. Murphy
- Health Risk Reduction Projects, Integrated Substance Abuse Programs, Department of Psychiatry, University of California at Los Angeles
| | - Sylvie Naar-King
- Carman and Ann Adams Department of Pediatrics, Wayne State University
| | - Jeffrey T. Parsons
- Department of Psychology, Hunter College and the Graduate Center of the City University of New York
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Albarracin D, Durantini MR. Are we going to close social gaps in HIV? Likely effects of behavioral HIV-prevention interventions on health disparities. PSYCHOL HEALTH MED 2010; 15:694-719. [PMID: 21154022 PMCID: PMC3626434 DOI: 10.1080/13548506.2010.498892] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Although experimental behavioral interventions to prevent HIV are generally designed to correct undesirable epidemiological trends, it is presently unknown whether the resulting body of behavioral interventions is adequate to correct the social disparities in HIV-prevalence and incidence present in the United States. Two large, diverse-population meta-analytic databases were reanalyzed to estimate potential perpetuation and change in demographic and behavioral gaps as a result of introducing the available behavioral interventions advocating condom use. This review suggested that, if uniformly applied across populations, the analyzed set of experimental (i.e. under testing) interventions is well poised to correct the higher prevalence and incidence among males (vs. females) and African-Americans and Latinos (vs. other groups), but ill poised to correct the higher prevalence and incidence among younger (vs. older) people, as well as men who have sex with men, injection-drug users, and multiple partner heterosexuals (vs. other behavioral groups). Importantly, when the characteristics of the interventions most efficacious for each population were included in the analyses of behavior change, results replicated with three exceptions. Specifically, after accounting for interactions of intervention and facilitator features with characteristics of the recipient population (e.g. gender), there was no behavior change bias for men who have sex with men, younger individuals changed their behavior more than older individuals, and African-Americans changed their behavior less than other groups.
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Affiliation(s)
- Dolores Albarracin
- Department of Psychology, University of Illinois at Urbana Champaign, Champaign, IL, USA.
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Christiansen M, Lalos A, Johansson EE. The Law of Communicable Diseases Act and disclosure to sexual partners among HIV-positive youth. VULNERABLE CHILDREN AND YOUTH STUDIES 2008; 3:234-242. [PMID: 22639678 PMCID: PMC3357969 DOI: 10.1080/17450120802069109] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2007] [Revised: 03/19/2008] [Indexed: 06/01/2023]
Abstract
In Sweden, human immunodeficiency virus (HIV) is included among the venereal diseases covered by the Law of Communicable Diseases Act. HIV-positive (HIV(+)) people are required to inform their sexual partners about their infection and adopt safe sex behaviours. However, it is unclear how the law is perceived. This study explores how HIV(+) youth in Sweden perceive the law, handle their sexuality and disclose their HIV diagnosis to sexual partners. Ten HIV(+) women and men between 17 and 24 years of age were recruited from three different HIV infection clinics. These participants were interviewed in depth. The interviews were tape-recorded, transcribed verbatim and analysed according to a grounded theory approach. The core category-cultured to take responsibility-illuminates the informants' double-edged experiences regarding the law and how they handle disclosure to sexual partners. The legislation implies both support and burden for these HIV(+) youth; they feel that they have a great deal of responsibility, sometimes more than they can handle. 'Switch off lust', 'balancing lust, fear and obedience' and 'switch off the disease' are strategies that describe how the informants manage sexuality and disclosure. Young HIV(+) people have a difficult time informing partners of their HIV diagnosis and discussing safe sex strategies. These are challenges that health care providers need to take seriously. HIV(+) youth need better communication strategies to negotiate safer sex. Staff with extended education on sexuality should be a part of HIV health care.
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Affiliation(s)
| | - Ann Lalos
- Department of Clinical Sciences/Obstetrics and Gynaecology, Urneå, Sweden
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Bakeera-Kitaka S, Nabukeera-Barungi N, Nöstlinger C, Addy K, Colebunders R. Sexual risk reduction needs of adolescents living with HIV in a clinical care setting. AIDS Care 2008; 20:426-33. [PMID: 18449819 DOI: 10.1080/09540120701867099] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
As anti-retroviral therapy becomes increasingly available, young people living with HIV need tailored support to adopt healthy sexual behaviors. There has been a gap in the availability of culturally appropriate techniques for secondary prevention and sexual risk reduction in this target group. This formative study assessed sexual and reproductive health needs and problems, as well as determinants of sexual risk-taking among young people living with HIV aged 11-21 years attending the Paediatric Infectious Disease Clinic in Kampala, Uganda. Theoretical guidance was provided by the Information-Motivation-Behavioral Skills Model. Socio-demographic and selected psychosexual data were assessed using a brief anonymous questionnaire. A total of 75 young people living with HIV participated in eight focus group discussions. In addition, one focus group was conducted with adult key informants (service providers). About a quarter of the young participants reported prior or current sexual experience. The study revealed knowledge gaps relating to reproductive health, HIV transmission, and contraceptive methods. Motivations for protection included hope for the future, good counseling, and fear of the consequences of sexual activity such as unwanted pregnancies. Barriers to adopting preventive behaviors included peer pressure, poverty, HIV-related stigma, ignorance of their partners, alcohol use, and a desire to have children for the older ones. Young sero-positive people in this setting lacked specific behavioral skills, such as disclosure of HIV status to their sexual partners, this being closely linked to fear of rejection and stigma. HIV-positive youths need support in developing the appropriate behavioral skills to adopt healthy sexual behaviors. Interventions in this field need to be developmentally appropriate and tailored to young people's specific needs. Structural interventions should at the same time address and reduce HIV-related stigma and socio-economic needs of young people living with HIV.
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Affiliation(s)
- Sabrina Bakeera-Kitaka
- Makerere University, Faculty of Medicine, Department of Paediatrics and Child Health, Kampala, Uganda.
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Albarracin J, Albarracin D, Durantini M. Effects of HIV-prevention interventions for samples with higher and lower percents of Latinos and Latin Americans: a meta-analysis of change in condom use and knowledge. AIDS Behav 2008; 12:521-43. [PMID: 17265011 PMCID: PMC3626439 DOI: 10.1007/s10461-007-9209-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2006] [Accepted: 01/08/2007] [Indexed: 10/23/2022]
Abstract
This meta-analysis (N=110,092) assessed the efficacy of HIV-prevention interventions across samples with higher and lower concentrations of Latinos/Latin Americans. Findings indicated that groups with higher percents of Latinos increased condom and HIV-related knowledge to a lesser extent than groups with lower percents of Latinos/ Latin Americans. Moreover, groups with greater percents of Latinos/Latin Americans only benefited from intervention strategies that included threat-inducing arguments, whereas groups with lower percents of Latinos/Latin Americans benefited from numerous strategies. In addition, groups with greater percents of Latinos/Latin Americans increased condom use when interventions were conducted by a lay community member, whereas groups with lower percents of these groups increased condom use the most in response to experts. Not surprisingly, there were important differences among Latinos/Latin Americans with different education levels, different genders, and US/Latin American nationality.
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Affiliation(s)
| | | | - Marta Durantini
- Psychology Department, University of Florida, Gaineville, FL 32608, USA
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Inoue Y, Yamazaki Y, Kihara M, Wakabayashi C, Seki Y, Ichikawa S. The intent and practice of condom use among HIV-positive men who have sex with men in Japan. AIDS Patient Care STDS 2006; 20:792-802. [PMID: 17134353 DOI: 10.1089/apc.2006.20.792] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To evaluate the intent and practice of condom use among Japanese HIV-positive men who have sex with men (MSM), a survey using anonymous questionnaires was carried out and 117 respondents were investigated. For anal sex and oral sex, respectively, 58.1% and 15.2% intended to use condoms and 47.2% and 12.4% used condoms all of the time. The intent of condom use decisively affected the practice of condom use and was closely related to the perceived risk level of HIV/sexually transmitted (STI) transmission. In anal sex, willingness to protect sexual partners from HIV infection was strongly related not only to the intent but also to the practice. Enhancement of willingness to protect oneself from STI was suggested to enhance willingness to protect his/her sexual partners from HIV infection with secondary enhancement of the intent or the practice of condom use. Specific support of MSM with HIV for improving the intent and practice of condom use is urgently needed.
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Affiliation(s)
- Yoji Inoue
- School of Nursing, Mie Prefectural College of Nursing, Mie, Japan.
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Naar-King S, Wright K, Parsons JT, Frey M, Templin T, Lam P, Murphy D. Healthy choices: motivational enhancement therapy for health risk behaviors in HIV-positive youth. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2006; 18:1-11. [PMID: 16539572 DOI: 10.1521/aeap.2006.18.1.1] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
This study piloted a brief individual motivational intervention targeting multiple health risk behaviors in HIV-positive youth aged 16-25. Interviews about sexual behavior and substance use and viral load testing were obtained from 51 HIV-positive youth at baseline and post intervention. Youth were randomized to receive a four-session motivational enhancement intervention (N = 25) or to a wait-list control (N = 26). Of the eligible youth approached, 88% agreed to participate, and 80% percent of participants completed at least three of four sessions. The treatment group showed significantly greater reductions in unprotected sex acts and in viral load compared with controls. Although change scores for substance use were not significantly different between the two groups, paired t tests demonstrated that reductions in alcohol use and marijuana use were significant for the treatment group at the trend level. There were no significant differences in substance use from baseline to posttest for the control group. Findings demonstrate the potential of a brief motivational enhancement intervention to improve health risk behaviors in HIV-positive youth. Larger randomized clinical trials are warranted. Resources required for retention should not be underestimated.
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Affiliation(s)
- Sylvie Naar-King
- Department of Pediatrics, Wayne State University, Detroit, MI, USA.
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Albarracín D, Gillette JC, Earl AN, Glasman LR, Durantini MR, Ho MH. A test of major assumptions about behavior change: a comprehensive look at the effects of passive and active HIV-prevention interventions since the beginning of the epidemic. Psychol Bull 2005. [PMID: 16351327 DOI: 10.1037/0033–2909.131.6.856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This meta-analysis tested the major theoretical assumptions about behavior change by examining the outcomes and mediating mechanisms of different preventive strategies in a sample of 354 HIV-prevention interventions and 99 control groups, spanning the past 17 years. There were 2 main conclusions from this extensive review. First, the most effective interventions were those that contained attitudinal arguments, educational information, behavioral skills arguments, and behavioral skills training, whereas the least effective ones were those that attempted to induce fear of HIV. Second, the impact of the interventions and the different strategies behind them was contingent on the gender, age, ethnicity, risk group, and past condom use of the target audience in ways that illuminate the direction of future preventive efforts.
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Affiliation(s)
- Dolores Albarracín
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA.
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Albarracín D, Gillette JC, Earl AN, Glasman LR, Durantini MR, Ho MH. A test of major assumptions about behavior change: a comprehensive look at the effects of passive and active HIV-prevention interventions since the beginning of the epidemic. Psychol Bull 2005; 131:856-97. [PMID: 16351327 PMCID: PMC2713787 DOI: 10.1037/0033-2909.131.6.856] [Citation(s) in RCA: 430] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This meta-analysis tested the major theoretical assumptions about behavior change by examining the outcomes and mediating mechanisms of different preventive strategies in a sample of 354 HIV-prevention interventions and 99 control groups, spanning the past 17 years. There were 2 main conclusions from this extensive review. First, the most effective interventions were those that contained attitudinal arguments, educational information, behavioral skills arguments, and behavioral skills training, whereas the least effective ones were those that attempted to induce fear of HIV. Second, the impact of the interventions and the different strategies behind them was contingent on the gender, age, ethnicity, risk group, and past condom use of the target audience in ways that illuminate the direction of future preventive efforts.
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Affiliation(s)
- Dolores Albarracín
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA.
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