title: A cluster randomized controlled trial of an adolescent HIV prevention program among Bahamian youth: effect at 12 months post-intervention.
abstract: Behavioral interventions based on the Protection Motivation Theory (PMT) have been demonstrated to reduce HIV risk behavior among mid- and older adolescents in different settings across the globe but have not been evaluated among Caribbean nations and have received limited evaluation among pre-adolescents. To determine (1) the effectiveness among pre-adolescents in The Bahamas of a PMT-based HIV prevention program "Focus on Youth in the Caribbean" (FOYC) and (2) the role of the targeted PMT constructs in intervention effect. 1,360 sixth grade youth (10-11 years of age) from 15 urban schools in New Providence, The Bahamas were randomized by school to receive either FOYC or a control condition. Data collected at baseline, 6 and 12 months post intervention were analyzed. A five-step scheme was used to assess sexual behavior progression, ranging from "1" = "a virgin without intention to have sex" to "5" = "having sex without a condom". Group-based trajectory analysis was utilized in assessing the program effect. Two sexual behavior progression patterns were detected: slow progressors and quick progressors. Receiving FOYC reduced the likelihood for adolescents to become quick progressors (adjusted OR = 0.77, 95% CI: 0.64-1.00). The observed effectiveness was especially impacted by a subset of the targeted PMT constructs. FOYC effectively delays sexual risk among Bahamian pre-adolescents. The group-based trajectory analysis provides an analytical approach for assessing interventions among adolescents with low rates and diverse progression patterns of sexual activity.
authors.affiliation: Department of Pediatrics, Pediatric Prevention Research Center, Wayne State University School of Medicine, 4201 St. Antoine Street, UHC-6D, Detroit, MI, USA. jimchen@med.wayne.edu
authors.forename: Xinguang
authors.initials: X
authors.lastname: Chen
authors.forename: Sonja
authors.initials: S
authors.lastname: Lunn
authors.forename: Lynette
authors.initials: L
authors.lastname: Deveaux
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Li
authors.forename: Nanika
authors.initials: N
authors.lastname: Brathwaite
authors.forename: Lesley
authors.initials: L
authors.lastname: Cottrell
authors.forename: Bonita
authors.initials: B
authors.lastname: Stanton
mesh_terms: D000293:Adolescent; D001444:Bahamas; D002648:Child; D016000:Cluster Analysis; D003466:Cultural Characteristics; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control* / Q000523:psychology; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D010290:Parents; D015397:Program Evaluation; D012309:Risk-Taking; D013334:Students; D011795:Surveys and Questionnaires; D014505:Urban Population