HIV risk reduction among detained adolescents: a randomized, controlled trial.
OBJECTIVE
Criminally involved adolescents engage in high levels of alcohol-related risky sex. A theory-based sexual and alcohol risk-reduction intervention was designed, implemented, and evaluated in juvenile detention facilities.


METHODS
In a randomized, controlled trial, 484 detained adolescents received 1 of 3 group-based interventions: combined sexual and alcohol risk reduction (group psychosocial intervention [GPI] + group motivational enhancement therapy [GMET]); sexual risk reduction only (GPI); or HIV/sexually transmitted disease prevention information only (group information-only intervention [GINFO]). Follow-up data were obtained 3, 6, 9, and 12 months after the intervention. Behavioral outcomes were condom-use behavior, frequency of intercourse while drinking, and alcohol-related problems.


RESULTS
Condom-use behavior measured as frequency of condom use during sex (ranging from never to always) decreased over time, although the GPI and GPI + GMET interventions mitigated this tendency at the 3-, 6-, and 9-month follow-up assessments. Although both active interventions were significantly more successful than the GINFO condition and the pattern of effects favored the GPI + GMET, there were no statistically significant differences between the GPI and GPI + GMET interventions.


CONCLUSIONS
Findings support the feasibility of integrating alcohol-specific sexual risk content into a theory-based sexual risk-reduction intervention and provide additional evidence that theory-based interventions are effective at reducing risky sex in this population. There was limited evidence of intervention effects on alcohol-use outcomes. Future research should focus on strengthening the GPI + GMET to most effectively target risky sexual behavior among at-risk adolescents.
Bryan
Angela D
AD
Department of Psychology, University of New Mexico, Albuquerque, New Mexico 87131, USA. abryan@unm.edu
Schmiege
Sarah J
SJ
Broaddus
Michelle R
MR
D000293:Adolescent; D000435:Alcoholic Intoxication / Q000517:prevention & control / Q000523:psychology; D003120:Colorado; D017280:Condoms; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007604:Juvenile Delinquency / Q000331:legislation & jurisprudence / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D009042:Motivation; D010043:Outcome and Process Assessment, Health Care; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control / Q000523:psychology; D011329:Prisoners / Q000523:psychology*; D011615:Psychotherapy, Group; D040242:Risk Reduction Behavior; D012736:Sex Education; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000517:prevention & control / Q000523:psychology; D047568:Unsafe Sex / Q000517:prevention & control / Q000523:psychology