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Hadley W, Houck C, Brown LK, Spitalnick JS, Ferrer M, Barker D. Moving Beyond Role-Play: Evaluating the Use of Virtual Reality to Teach Emotion Regulation for the Prevention of Adolescent Risk Behavior Within a Randomized Pilot Trial. J Pediatr Psychol 2019; 44:425-435. [PMID: 30551157 PMCID: PMC6481385 DOI: 10.1093/jpepsy/jsy092] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 11/01/2018] [Accepted: 11/01/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The purpose of the current pilot study was to evaluate the acceptability and preliminary impact of using immersive virtual reality environments (IVREs) paired with a brief emotion regulation and risk reduction intervention (ER + IVRE) relative to this same intervention content paired with role-plays (ER + RP). METHODS Eighty-five adolescents attending middle school (grades 6th-8th; ages 12-15 years) in an urban northeast city were recruited and randomized to ER + IVRE (n = 44) or ER + RP (n = 41) and had complete data. Data examining acceptability, feasibility, sexual knowledge and attitudes, and ER were collected at baseline and 3 months after intervention completion. Analyses of covariance controlling for baseline scores were used to evaluate study outcomes. Within and between intervention effect sizes were calculated with effect sizes ≥.20 considered meaningful. RESULTS At the 3-month follow-up assessment, several within intervention condition effect sizes were found to exceed d = 0.20 across the measured sexual attitudes and ER outcomes. Between intervention analyses found that adolescents randomized to ER + IVRE attended more intervention sessions, reported less difficulty accessing ER strategies (d = 0.46), and reported higher emotional self-efficacy (d = 0.20) at the 3-month follow-up relative to adolescents randomized to the ER + RP intervention. CONCLUSIONS This study provides preliminary evidence that using virtual reality environments to enhance ER skill building in risk situations was acceptable, feasible to deliver, and positively impacted ER abilities.
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Affiliation(s)
- Wendy Hadley
- Bradley/Hasbro Children’s Research Center/Rhode Island Hospital and the Warren Alpert Medical School of Brown University
| | - Christopher Houck
- Bradley/Hasbro Children’s Research Center/Rhode Island Hospital and the Warren Alpert Medical School of Brown University
| | - Larry K Brown
- Bradley/Hasbro Children’s Research Center/Rhode Island Hospital and the Warren Alpert Medical School of Brown University
| | | | | | - David Barker
- Bradley/Hasbro Children’s Research Center/Rhode Island Hospital and the Warren Alpert Medical School of Brown University
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Brown LK, Whiteley L, Houck CD, Craker LK, Lowery A, Beausoleil N, Donenberg G. The Role of Affect Management for HIV Risk Reduction for Youth in Alternative Schools. J Am Acad Child Adolesc Psychiatry 2017; 56:524-531. [PMID: 28545758 PMCID: PMC5465640 DOI: 10.1016/j.jaac.2017.03.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/28/2017] [Accepted: 03/27/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Adolescents in alternative schools for behavioral and emotional problems have an earlier sexual onset and higher rates of sexual risk than their peers. They also often have difficulty managing strong emotions, which can impair sexual decision making. Human immunodeficiency virus (HIV) prevention programs for these adolescents may be most effective if skills for coping with strong emotions during sexual situations are included. METHOD This article reports the 6-month outcomes of a three-arm randomized controlled trial comparing an HIV prevention intervention with affect management (AM) to a standard, skills-based HIV prevention intervention (SB), and a general health promotion intervention (HP). HP was similar to a general health class, and SB was based on previous effective HIV prevention programs used with community adolescents, whereas AM included affect management skills in addition to effective HIV prevention skills. Youth (N = 377) in two US cities were 13 to 19 years of age and attending alternative schools for behavioral and emotional problems. RESULTS Multiple logistic regression analyses, adjusted for the baseline scores, age, and gender, found that adolescents in AM were significantly less likely to report being sexually active at follow-up (80% versus 91%, adjusted odds ratio = 0.28, 95% CI = 0.08-0.96) and more consistently using condoms than those in HP at follow-up (62%, versus 39%, adjusted odds ratio = 3.42, CI = 1.10-10.63). CONCLUSION Affect management techniques tested in this project, focused on sexual situations, are similar to those that are used in dialectical behavioral therapy (DBT) and in clinical practice. These data suggest that these techniques might decrease risk behaviors and improve the health of adolescents with emotional/behavioral problems. Clinical trial registration information-Therapeutic Schools: Affect Management and HIV Prevention; http://clinicaltrials.gov/; NCT00500487.
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Affiliation(s)
- Larry K Brown
- Rhode Island Hospital in Providence, RI; Warren Alpert Medical School, Brown University, Providence.
| | - Laura Whiteley
- Rhode Island Hospital in Providence, RI; Warren Alpert Medical School, Brown University, Providence
| | - Christopher D Houck
- Rhode Island Hospital in Providence, RI; Warren Alpert Medical School, Brown University, Providence
| | | | | | | | - Geri Donenberg
- College of Medicine at the University of Illinois-Chicago
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Hadley W, Brown LK, Barker D, Warren J, Weddington P, Fortune T, Juzang I. Work It Out Together: Preliminary Efficacy of a Parent and Adolescent DVD and Workbook Intervention on Adolescent Sexual and Substance Use Attitudes and Parenting Behaviors. AIDS Behav 2016; 20:1961-72. [PMID: 27155880 PMCID: PMC5003055 DOI: 10.1007/s10461-016-1418-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The purpose of the current study was to test an interactive DVD and workbook specifically designed for African-American parents and adolescents (ages 13-18), based on an efficacious face-to-face intervention, to address key factors associated with risk. A total of 170 parent-adolescent dyads were enrolled and randomly assigned to receive either the "Work It Out Together" DVD or a General Health Promotion DVD (HP). Parents and adolescents completed measures of HIV knowledge, self-efficacy, and parenting behaviors. Immediately after receiving the Work It Out Together intervention, parents and adolescents demonstrated higher HIV knowledge and greater HIV prevention self-efficacy. Three months after receiving the Work It Out Together intervention, parents and adolescents reported higher levels of parental monitoring and sexually active adolescents reported higher levels of condom use self-efficacy and a lower rate of recent sex. These outcomes provide preliminary evidence that the "Work It Out Together" DVD impacted individual attitudes and protective parenting behaviors.
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Affiliation(s)
- Wendy Hadley
- Department of Psychiatry and Human Behavior, Bradley/Hasbro Children's Research Center (BHCRC), Rhode Island Hospital and Brown Medical School, One Hoppin Street, Suite 204, Providence, RI, 02903, USA.
| | - L K Brown
- Department of Psychiatry and Human Behavior, Bradley/Hasbro Children's Research Center (BHCRC), Rhode Island Hospital and Brown Medical School, One Hoppin Street, Suite 204, Providence, RI, 02903, USA
| | - D Barker
- Department of Psychiatry and Human Behavior, Bradley/Hasbro Children's Research Center (BHCRC), Rhode Island Hospital and Brown Medical School, One Hoppin Street, Suite 204, Providence, RI, 02903, USA
| | - J Warren
- Department of Psychiatry and Human Behavior, Bradley/Hasbro Children's Research Center (BHCRC), Rhode Island Hospital and Brown Medical School, One Hoppin Street, Suite 204, Providence, RI, 02903, USA
| | | | - T Fortune
- MEE Productions, Inc., Philadelphia, PA, USA
| | - I Juzang
- MEE Productions, Inc., Philadelphia, PA, USA
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McCart MR, Sheidow AJ, Letourneau EJ. Risk Reduction Therapy for Adolescents: Targeting Substance Use and HIV/STI-Risk Behaviors. COGNITIVE AND BEHAVIORAL PRACTICE 2014; 21:161-175. [PMID: 25419101 PMCID: PMC4235161 DOI: 10.1016/j.cbpra.2013.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This paper describes a family-based intervention for addressing both substance use and unprotected sexual behavior in adolescents presenting for outpatient substance use treatment. The intervention combines contingency management (CM) for adolescent substance use, which is a behavioral intervention modeled on the Community Reinforcement Approach, with a sexual risk reduction protocol that mirrors aspects of the CM model. As a family-based intervention, caregivers attend every session and actively collaborate with the therapist to address their youth's behavior problems. The treatment is criterion-based with treatment duration determined by the youth's achievement of reduced substance use and unprotected sexual behavior goals. A case study describes the implementation of this treatment with an adolescent presenting a history of polysubstance use and unprotected sexual intercourse. Following the adolescent and caregiver's participation in weekly sessions, the adolescent demonstrated improvements in substance use, unprotected sexual behavior, and other behavior problems. Clinical summary data from two outpatient clinics reveal similar positive outcomes for youth receiving the intervention. This paper illustrates the potential utility of an integrated treatment approach targeting substance use and unprotected sexual behavior in an adolescent population.
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Fair C, Wiener L, Zadeh S, Albright J, Mellins CA, Mancilla M, Tepper V, Trexler C, Purdy J, Osherow J, Lovelace S, Kapetanovic S. Reproductive health decision-making in perinatally HIV-infected adolescents and young adults. Matern Child Health J 2014; 17:797-808. [PMID: 22736033 DOI: 10.1007/s10995-012-1070-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
With widespread access to antiretroviral therapy in the United States, many perinatally HIV-infected (PHIV+) children are surviving into adolescence and adulthood, becoming sexually active and making decisions about their reproductive health. The literature focusing on the reproductive decisions of individuals behaviorally infected with HIV can serve as a springboard for understanding the decision-making process of PHIV+ youth. Yet, there are many differences that critically distinguish reproductive health and related decision-making of PHIV+ youth. Given the potential public health implications of their reproductive decisions, better understanding of factors influencing the decision-making process is needed to help inform the development of salient treatment and prevention interventions. To begin addressing this understudied area, a "think tank" session, comprised of clinicians, medical providers, and researchers with expertise in the area of adolescent HIV, was held in Bethesda, MD, on September 21, 2011. The focus was to explore what is known about factors that influence the reproductive decision-making of PHIV+ adolescents and young adults, determine what important data are needed in order to develop appropriate intervention for PHIV+ youth having children, and to recommend future directions for the field in terms of designing and carrying out collaborative studies. In this report, we summarize the findings from this meeting. The paper is organized around the key themes that emerged, including utilizing a developmental perspective to create an operational definition of reproductive decision-making, integration of psychosocial services with medical management, and how to design future research studies. Case examples are presented and model program components proposed.
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Risky behaviours among young people living with HIV attending care and treatment clinics in Dar Es Salaam, Tanzania: implications for prevention with a positive approach. J Int AIDS Soc 2013; 16:17342. [PMID: 24119708 PMCID: PMC3796216 DOI: 10.7448/ias.16.1.17342] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 06/30/2013] [Accepted: 08/16/2013] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Prevention with a positive approach has been advocated as one of the main strategies to reduce new instances of HIV infection. Risky sexual behaviours among people living with HIV/AIDS are the cornerstone for this approach. Understanding the extent to which infected individuals practice risky behaviours is fundamental in designing appropriate population-specific interventions. With the HIV infection transmission rates remaining high among young people in sub-Saharan Africa, continued prevention among them remains a priority. This study therefore seeks to describe the magnitude and determinants of risky sexual behaviours among young people living with HIV. METHODS A cross-sectional study was conducted between June and July 2010 in selected Care and Treatment Clinics (CTCs) in Dar Es Salaam, Tanzania. A total of 282 HIV-positive patients aged 15-24 were interviewed about their sexual behaviours using a questionnaire. RESULTS Prevalence of unprotected sex was 40.0% among young males and 37.5% among young females (p<0.001). Multiple sexual partnerships were reported by 10.6% of males and 15.9% of females (p<0.005). More than 50% of the participants did not know about the HIV status of their sexual partners. A large proportion of participants had minimal knowledge of transmission (46.7% males vs. 60.4% females) and prevention (65.3% males vs. 73.4% females) of sexually transmitted infections (STIs). Independent predictors of condom use included non-use of alcohol [adjusted odds ratio (AOR), 0.40 95% confidence interval (CI); 0.17-0.84] and younger age (15-19 years) (AOR, 2.76, 95% CI: 1.05-7.27). Being on antiretroviral therapy (AOR, 0.38, 95% CI: 0.17-0.85) and not knowing partners' HIV sero-status (AOR, 2.62, 95% CI: 1.14-5.10) predicted the practice of multiple sexual partnership. CONCLUSIONS Unprotected sex and multiple sexual partnerships were prevalent among young people living with HIV. Less knowledge on STI and lack of HIV disclosure increased the vulnerability and risk for HIV transmission among young people. Specific intervention measures addressing alcohol consumption, risky sexual behaviours, and STI transmission and prevention knowledge should be integrated in the routine HIV/AIDS care and treatment offered to this age group.
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Aluzimbi G, Barker J, King R, Rutherford G, Ssenkusu JM, Lubwama GW, Muyonga M, Hladik W. Risk factors for unplanned sex among university students in Kampala, Uganda: a qualitative study. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2013. [DOI: 10.1080/02673843.2012.685947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Bauermeister JA, Elkington KS, Robbins RN, Kang E, Mellins CA. A prospective study of the onset of sexual behavior and sexual risk in youth perinatally infected with HIV. JOURNAL OF SEX RESEARCH 2011; 49:413-22. [PMID: 21797715 PMCID: PMC3208075 DOI: 10.1080/00224499.2011.598248] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Perinatally HIV-infected (PHIV+) youth are surviving into adolescence and young adulthood. Understanding the sexual development of PHIV+ youth is vital to providing them with developmentally appropriate HIV-prevention programs. Using pooled data (N = 417) from two longitudinal studies focused on HIV among youth (51% female; 39% HIV+) and their caregivers (92% female; 46% HIV+), the rate of sexual onset during adolescence across four youth-caregiver combinations was compared: PHIV+ youth with HIV+caregivers (12%), PHIV+ youth with HIV- caregivers (27%), HIV- youth with HIV+caregivers (34%), and HIV- youth with HIV- caregivers (27%). Youth with HIV- caregivers were more likely than other youth-caregiver groups to have had their sexual onset. Youth with HIV+ caregivers reported a slower rate of onset of penetrative sex across the adolescent years. Findings are discussed by highlighting the role that both youth and caregiver HIV status play in the onset of sexual behavior across adolescence.
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Affiliation(s)
- José A Bauermeister
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 48109-2029, USA.
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9
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Mergui A, Giami A. [The sexuality of HIV-infected-adolescents: literature review and thinking on the unthinkables of sexuality]. Arch Pediatr 2011; 18:797-805. [PMID: 21652188 DOI: 10.1016/j.arcped.2011.04.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 02/09/2011] [Accepted: 04/19/2011] [Indexed: 11/17/2022]
Abstract
The objective of this review was to analyze the scientific literature on the sexuality of HIV-positive adolescents. The first point was to identify how sexuality is addressed and secondly the impact of HIV infection on HIV-positive adolescents. Fifty-four articles were selected for this review. The review demonstrates that sexuality is mainly considered under the angle of sexual and reproductive behavior and preventive practices (condom use and contraception), based on questionnaire studies. Some studies investigated the physiological impact of HIV and its treatment, especially in relation to puberty. On the other hand, the subjective experience of an HIV-positive status among adolescents was rarely studied. Overall, HIV has a negative impact on the sexual life of HIV-positive adolescents. The vast majority of them practice sexual abstinence, notably adolescents infected through mother-to-child contamination, for whom the access to sexuality seems to be delayed. Among those who are sexually active, nearly one-half continue having unprotected sex. The problems related to living with HIV induce a climate of anxiety and dissatisfaction that affects behaviors and sexual practices, and disrupts the quality of sexual life. Some results suggest that the type and mode of contamination has an effect on the general sexual experience of being an HIV-positive adolescent. More research should be developed to study the subjective experience of HIV-positive adolescent sexuality and its impact on sexual experience according to the type of contamination in this population.
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Affiliation(s)
- A Mergui
- CESP-Inserm U1018 - équipe 7, 82, rue du Général-Leclerc, 94276 Le Kremlin-Bicêtre cedex, France.
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Abstract
We could not have predicted that HIV/AIDS would become one of our greatest public health challenges worldwide when the first cases were identified in the 1980s. More than 22 million people have died from the disease, and HIV is now the seventh-leading cause of death in the United States among 15- to 24-year-olds. At the beginning of this pandemic, most HIV infections of youth were acquired congenitally. Prenatal screening of pregnant women, early detection, and antiretroviral therapies have reduced mother-to-child transmission. Children born with HIV infections are now young adults living with HIV, while other adolescents are acquiring HIV primarily through high-risk behaviors. Associations between psychiatric symptoms and poor health outcomes have been recognized among adults. Few studies have examined these factors among youth. We review what is known about psychiatric syndromes among HIV-positive youth, and their treatments.
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Affiliation(s)
- Tami D Benton
- Department of Psychiatry, The University of Pennsylvania School of Medicine/The Children's Hospital of Philadelphia, The Behavioral Health Center, Suite 400, 3440 Market Street, Philadelphia, PA 19104, USA.
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Abstract
Glenda Gray discusses the implications of a new study that found that almost half of all adolescents hospitalized in Zimbabwe were HIV-infected.
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Abstract
Adolescence (10-19 years) is a phase of physical growth and development accompanied by sexual maturation, often leading to intimate relationships. Adolescent HIV/AIDS is a separate epidemic and needs to be handled and managed separately from adult HIV. The adolescents can be subdivided into student, slum and street youth; street adolescents being most vulnerable to HIV/AIDS. Among various risk factors and situations for adolescents contracting HIV virus are adolescent sex workers, child trafficking, child labor, migrant population, childhood sexual abuse, coercive sex with an older person and biologic (immature reproductive tract) as well as psychological vulnerability. The most common mode of transmission is heterosexual, yet increasing number of perinatally infected children are entering adolescence. This is due to "bimodal progression" (rapid and slow progressors) among the vertically infected children. Clinically, the HIV infected adolescents present as physically stunted individuals, with delayed puberty and adrenarche. Mental illness and substance abuse are important co-morbidities. The disclosure and declaration of HIV status to self and family is challenging and guilt in sexually infected adolescents and tendency to blame parents if vertically affected need special consideration and proper counseling. Serodiscordance of the twins and difference in disease progression of seroconcordant twins are added causes of emotional trauma. Treatment related issues revolve around the when and what of initiation of ART; the choice of antiretrovirals and their dosages; issues related to long term ADRs; sense of disinhibition following ART commencement; adherence and resistance.
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Affiliation(s)
- Smriti Naswa
- Department of Skin VD, Government Medical College & SSG Hospital, Vadodara, India
| | - Y. S. Marfatia
- Department of Skin VD, Government Medical College & SSG Hospital, Vadodara, India
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Markham CM, Shegog R, Leonard AD, Bui TC, Paul ME. +CLICK: harnessing web-based training to reduce secondary transmission among HIV-positive youth. AIDS Care 2009; 21:622-31. [PMID: 19444671 DOI: 10.1080/09540120802385637] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Adolescents and young adults account for over 10 million HIV infections worldwide. Prevention of secondary transmission is a major concern as many HIV-positive youth continue to engage in risky sexual behavior. This study pilot-tested " + CLICK", an innovative, web-based, sexual risk reduction intervention for HIV-positive youth as an adjunct to traditional clinic-based, self-management education. The theory-based application, developed for perinatally and behaviorally infected youth 13-24 years of age, provides tailored activities addressing attitudes, knowledge, skills, and self-efficacy related to sexual risk reduction. HIV-positive youth (N=32) pilot-tested " + CLICK" to assess usability (ease of use, credibility, understandability, acceptability, motivation) and short-term psychosocial outcomes (importance and self-efficacy related to abstinence and condom use) using a single group, pre-/post-test study design in a hospital-based pediatric clinic and community locations. A subsample of participants (n=20) assessed feasibility for clinic use. Participants were 62.5% female, 68.8% Black, and 28.1% Hispanic. Mean age was 17.8 years (SD = 2.55), 43.8% were infected behaviorally, 56.2% perinatally, and 68.8% were sexually experienced. Usability ratings were high: 84.4% rated the application very easy to use; 93.8% perceived content as trustworthy; 87.5% agreed most words were understandable; 87.5% would use the application again. Short-term psychosocial outcomes indicate a significant increase in condom use self-efficacy (p=0.008) and positive trends toward importance (p=0.067) and self-efficacy (p=0.071) for waiting before having sex. Regarding feasibility, participants accessed " + CLICK" during waiting periods (average time, 15 minutes) in their routine clinic visit. Clinic staff rated " + CLICK" highly in providing consistent, confidential, and motivational sexual health education without significant disruption to clinic flow. Results suggest that the application is a feasible tool for use in the clinic and has the potential to affect psychological antecedents to sexual behavior change. Further research on long-term and behavioral effects is indicated prior to broader dissemination into clinical practice.
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Affiliation(s)
- Christine Margaret Markham
- Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, TX, USA.
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Grossman C, Hadley W, Brown LK, Houck CD, Peters A, Tolou-Shams M. Adolescent sexual risk: factors predicting condom use across the stages of change. AIDS Behav 2008; 12:913-22. [PMID: 18427971 DOI: 10.1007/s10461-008-9396-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2007] [Accepted: 04/01/2008] [Indexed: 11/30/2022]
Abstract
This study examined factors associated with high-risk adolescents' movement toward or away from adopting consistent condom use behavior using the Transtheoretical Model Stages of Change. Participants drawn from the inactive comparison condition of a randomized HIV prevention trial (Project SHIELD) responded to items assessing pros and cons of condom use, peer norms, condom communication, and perceived invulnerability to HIV. Participants were categorized based on their condom use behavior using the Transtheoretical Model. Multiple logistic regressions found that progression to consistent condom use was predicted by continuing to perceive more advantages to condom use, reporting greater condom use communication with partners, and less perceived invulnerability to HIV. Movement away from adopting consistent condom use was predicted by a decrease in perceived advantages to condom use, increased perceived condom disadvantages, and fewer condom discussions. Future interventions may be tailored to enhance these factors that were found to change over time.
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Affiliation(s)
- Cynthia Grossman
- National Institute of Mental Health, 6001 Executive Blvd., Bethesda, MD 20892, USA.
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15
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Sexual behavior and perceived peer norms: comparing perinatally HIV-infected and HIV-affected youth. J Youth Adolesc 2008; 38:1110-22. [PMID: 19636775 DOI: 10.1007/s10964-008-9315-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Accepted: 07/16/2008] [Indexed: 10/21/2022]
Abstract
A large proportion of perinatally HIV-infected (PHIV) children are becoming adolescents and exploring their sexuality. This study explored the prevalence of sexual behaviors (kissing, touching, engaging in oral sex, or having vaginal/anal intercourse) in a sample of predominantly ethnic minority youths (N = 339; 54.1% Black and 30.4% Latino; 51% female; ages 9-16) perinatally exposed to HIV (61% HIV+). Using logistic regression, we tested the association between sexual behavior and HIV status, demographic characteristics, and peer influences regarding sexual behavior. PHIV youth were less likely to be sexually active. Among sexually active youth, PHIV youth were more likely to engage in touching behavior than HIV-negative youth and were less likely to engage in penetrative sex. Youths reporting that a greater number of their peers believed that sexually active boys were "cool" or "popular" were more likely to report sexual behavior. The association between sexual behavior and peers believing sexually active girls were "cool" or "popular" varied by age, gender, and HIV status. Furthermore, friends' sexual activity was associated with sexual intercourse. Prevention programs should strengthen messages addressing peer norms regarding sexuality, as well as address specific issues related to adolescent HIV.
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Les adolescents infectés par le VIH à la naissance : sexualité et procréation ; mise en perspective avec la maladie du cancer. PSYCHO-ONCOLOGIE 2007. [DOI: 10.1007/s11839-007-0052-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wiener LS, Battles HB, Wood LV. A longitudinal study of adolescents with perinatally or transfusion acquired HIV infection: sexual knowledge, risk reduction self-efficacy and sexual behavior. AIDS Behav 2007; 11:471-8. [PMID: 17028994 PMCID: PMC2408713 DOI: 10.1007/s10461-006-9162-y] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
As HIV-positive children are surviving to adolescence and beyond, understanding their HIV knowledge and sexual behavior is critical. Forty HIV+ adolescents/young adults were interviewed twice, approximately 21 months apart (mean age 16.6 and 18.3 years, respectively). Data on demographics, safer sex knowledge, sexual risk behaviors, risk reduction self-efficacy, and Tanner stage were collected. Twenty-eight percent of HIV+ youth at Time 1 and 41% at Time 2 reported being sexually active. HIV transmission/safer sex knowledge was low, increased with age, and both self-efficacy for and actual condom use was relatively high. Secondary prevention messages should be incorporated into routine medical settings.
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Affiliation(s)
- Lori S Wiener
- HIV/AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Building 10, Pediatric Clinic I-SE, Room I-6466, Bethesda, MD 20892, USA.
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Abstract
BACKGROUND Birthweight and length have been reported to be important determinants of infant growth and future nutritional status. The study aims to describe the weight and length growth patterns during the first year of life of low-birthweight (LBW) ethnic minority infants in the mountainous province Backan, Vietnam. METHODS A total of 64 LBW and normal birthweight infants of ethnic minority mothers were recruited from 2001 to 2002 into a prospective cohort study. The weight and length of infants were measured monthly for 1 year. Data on nutritional status and feeding practices of the infants were collected from monthly health records and face-to-face interviews with mothers while their infants were 6 and 12 months of age. RESULTS Most of the increase in weight, length and catch-up to the 10th percentile for LBW infants occurred during the first 3 and 6 months for boys and for girls, respectively. After these ages, the mean weight and length diverged from National Center for Health Statistics (NCHS) reference curves to below the 10th percentile. LBW infants' weight-for-age z-scores was below the NCHS standard at birth (-2.16 SD), caught up after birth, became sustainable by 4 months, fell rapidly from the sixth month, then decreased to -2 SD at 12 months of age. LBW infants' length-for-age z-scores increased in the first month after birth, decreased in the second month and sharply increased again until 5 months of age before decreasing. CONCLUSIONS For LBW infants, it is difficult to achieve the same weight or length curves at 12 months of age as the NCHS standard.
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Affiliation(s)
- Nguyen Thanh Hien
- Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Funck-Brentano I, Dalban C, Veber F, Quartier P, Hefez S, Costagliola D, Blanche S. Evaluation of a peer support group therapy for HIV-infected adolescents. AIDS 2005; 19:1501-8. [PMID: 16135904 DOI: 10.1097/01.aids.0000183124.86335.0a] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the effects of a peer support group therapy on HIV-infected adolescents. DESIGN A prospective study of a cohort of HIV-infected adolescents participating or not participating in a psychodynamic oriented, emotional support group. METHODS From a group of 30 perinatally HIV-infected adolescents who attended an outpatient clinic, 10 agreed to participate in the peer support group (group 1), 10 declined (group 2) and 10 others who lived too far from the clinic were not invited to participate (group 3). The three groups were compared at baseline and 2 years later using the outcome measures: perceived illness experience scale, perceived treatment inventory, self-esteem inventory. RESULTS At baseline, the three groups had similar characteristics overall. The adolescents' self-esteem was in the normal range. After 2 years, worries about illness had decreased in group 1, whereas the scores had increased or remained the same for the other adolescents (P = 0.026). The adolescents in group 1 had less negative perception of treatment at 2 years than those in groups 2 and 3 (P = 0.030). After intervention, the percentage of adolescents with an undetectable viral load had increased in group 1 from 30 to 80% (P = 0.063) but was unchanged in groups 2 and 3. Considering the three groups altogether, the decrease in the viral load correlated with improvement of the perceived treatment inventory (Spearman R = 0.482 P = 0.015). CONCLUSIONS : This pilot study suggests that a peer support group intervention is associated with an improvement in adolescents' emotional well being, and that this can have a positive influence on medical outcomes.
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Affiliation(s)
- Isabelle Funck-Brentano
- Unité d'Immunologie-hématologie pédiatrique, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75743 Paris cedex 15, France
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Horowitz SM. Applying the transtheoretical model to pregnancy and STD prevention: a review of the literature. Am J Health Promot 2003; 17:304-28. [PMID: 12769045 DOI: 10.4278/0890-1171-17.5.304] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To conduct a systematic review of the peer-reviewed literature on the Transtheoretical Model (TTM) and pregnancy and STD prevention. DATA SOURCES Computer database search (Applied Social Science Index and Abstracts [ASSIA], Biological Abstracts, Criminal Justice Abstracts, CINAHL-Allied Health, Current Contents, Current Index to Journals in Education, Education Index, ERIC, Excerpta Medica, Family Index, Index Medicus, Medline, Multicultural Education Abstracts, PsychInfo, Psychological Abstracts, Research Alert, Social Science Citation Index, Social Work Abstracts, and Sociological Abstracts), and manual journal search. STUDY INCLUSION AND EXCLUSION CRITERIA All English, peer-reviewed, original articles on the TTM as it relates to pregnancy and STD prevention published prior to December 31, 2001, were included. Editorials, commentaries, thesis/dissertations, unpublished studies, technical reports, and books were not included. DATA EXTRACTION METHODS Articles were categorized as Intervention, Population (stage distribution), or Validation studies. Within each category, articles were subdivided into groups, summarized, and analyzed. DATA SYNTHESIS The 32 articles reviewed included 9 intervention studies, 11 population studies, and 12 validation studies. Studies represented a variety of U.S. populations of a broad demographic range. Evidence both for and against criterion-related and construct validity of the TTM was found. MAJOR CONCLUSIONS Age, partner type, gender, reasons for engaging in safer sex behaviors (i.e., pregnancy vs. disease prevention), self-efficacy, sexual assertiveness, and perceived advantages and disadvantages of condom use were related to stage of change. The use of the TTM to reduce risk of pregnancy and STDs is a relatively new, but important, area of research. However, because of the wide-ranging differences in methodologies and samples, no strong conclusions about its effectiveness can yet be made.
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Affiliation(s)
- Stephen M Horowitz
- 212 Eppler North, Bowling Green State University, Bowling Green, OH 43403, USA
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