A human immunodeficiency virus risk reduction intervention for incarcerated youth: a randomized controlled trial.
OBJECTIVE
To evaluate, by gender, the impact of a structured, comprehensive risk reduction intervention with and without boosters on human immunodeficiency virus (HIV) knowledge, attitudes and behaviors in incarcerated youth; and to determine predictors of increasing HIV knowledge and reducing high-risk attitudes and behaviors.


METHODS
This randomized controlled trial involved participants completing structured interviews at 1, 3, and 6 months. Repeated measures analysis of variance was used to analyze changes over time. The study was conducted in secure custody facilities and in the community. The study sample comprising 391 incarcerated youth, 102 female and 289 male aged 12-18, formed the voluntary sample. Participants were randomly assigned to one of three conditions: education intervention; education intervention with booster; or no systematic intervention. The outcome and predictor measures included the Rosenberg Self-Esteem Scale, Youth Self Report, Drug Use Inventory, and HIV Knowledge, Attitudes and Behavior Scale.


RESULTS
The 6-month retention rate was 59.6%. At 6 months, males in the education and booster groups sustained increases in knowledge scores (p < 0.001). Females in these groups sustained increased condom attitude scores (p = 0.004). Males in the booster group sustained increased prevention attitude scores (p = 0.017). Females in the booster group reported more consistent condom use (odds ratio [OR] = 4.20; 95% confidence interval [CI] = 1.81, 9.77). Age, gender, drug use, and psychological profiles were predictive of outcome.


CONCLUSIONS
The intervention and boosters led to gender-specific improvements in knowledge, attitudes, and condom use. Result variations by gender underline the importance of gender issues in prevention interventions. Predictors of success were identified to inform future HIV education interventions.
Goldberg
Eudice
E
Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada. Electronic address: eudice.goldberg@sickkids.ca.
Millson
Peggy
P
HIV Social, Behavioral and Epidemiological Studies Unit, Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada.
Rivers
Stephen
S
Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Manning
Stephanie Jeanneret
SJ
Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
Leslie
Karen
K
Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
Read
Stanley
S
Division of Infectious Diseases, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
Shipley
Caitlin
C
Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
Victor
J Charles
JC
Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada.
D000293:Adolescent; D002648:Child; D017280:Condoms / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006678:HIV; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D021841:Safe Sex / Q000706:statistics & numerical data; D012647:Self-Assessment; D012737:Sex Factors; D011795:Surveys and Questionnaires; D047568:Unsafe Sex