Outcomes of a randomized, controlled community-level HIV prevention intervention for adolescents in low-income housing developments.
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.
Sikkema
Kathleen J
KJ
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
Anderson
Eileen S
ES
Kelly
Jeffrey A
JA
Winett
Richard A
RA
Gore-Felton
Cheryl
C
Roffman
Roger A
RA
Heckman
Timothy G
TG
Graves
Kristi
K
Hoffmann
Raymond G
RG
Brondino
Michael J
MJ
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