title: Outcomes of a randomized, controlled community-level HIV prevention intervention for adolescents in low-income housing developments.
abstract: OBJECTIVE
  Youth are increasingly at risk for contracting HIV infection, and community-level interventions are needed to reduce behavioral risk.
  
  
  METHODS
  A randomized, controlled, multi-site community-level intervention trial was undertaken with adolescents living in 15 low-income housing developments in five US cities.
  
  
  METHODS
  Baseline (n = 1172), short-term follow-up (n = 865), and long-term follow-up (n = 763) risk assessments were conducted among adolescents, ages 12-17, in all 15 housing developments. The developments were randomly assigned in equal numbers to each of three conditions: experimental community-level intervention (five developments); "state-of-the-science" skills training workshops (five developments); and, education-only delayed control intervention (five developments).
  
  
  RESULTS
  At long-term follow-up, adolescents living in the housing developments receiving the community-level intervention were more likely to delay onset of first intercourse (85%) than those in the control developments (76%), while those in the workshop developments (78%) did not differ from control condition adolescents. Adolescents in both the community-level intervention (77%) and workshop (76%) developments were more likely to use a condom at last intercourse than those in control (62%) developments.
  
  
  CONCLUSIONS
  Community-level interventions that include skills training and engage adolescents in neighborhood-based HIV prevention activities can produce and maintain reductions in sexual risk behavior, including delaying sexual debut and increasing condom use.
authors.affiliation: Yale University School of Medicine and Centre for Interdisciplinary Research on AIDS (CIRA), 60 College Street, PO Box 208034, New Haven, CT 06520, USA. kathleen.sikkema@yale.edu
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Sikkema
authors.forename: Eileen S
authors.initials: ES
authors.lastname: Anderson
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Kelly
authors.forename: Richard A
authors.initials: RA
authors.lastname: Winett
authors.forename: Cheryl
authors.initials: C
authors.lastname: Gore-Felton
authors.forename: Roger A
authors.initials: RA
authors.lastname: Roffman
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Heckman
authors.forename: Kristi
authors.initials: K
authors.lastname: Graves
authors.forename: Raymond G
authors.initials: RG
authors.lastname: Hoffmann
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Brondino
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D003075:Coitus; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008297:Male; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D010379:Peer Group; D011638:Public Housing; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D015819:Substance Abuse, Intravenous / Q000517:prevention & control; D014481:United States