title: Efficacy of sexually transmitted disease/human immunodeficiency virus sexual risk-reduction intervention for african american adolescent females seeking sexual health services: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the efficacy of an intervention to reduce incident sexually transmitted disease (STD) and enhance STD/human immunodeficiency virus (HIV)-preventive behaviors and psychosocial mediators.
  
  
  METHODS
  A randomized controlled trial of an HIV prevention program.
  
  
  METHODS
  Clinic-based sample in Atlanta, Georgia.
  
  
  METHODS
  African American adolescent females (N = 715), aged 15 to 21 years, seeking sexual health services. Participants completed an audio computer-assisted self-interview and provided self-collected vaginal specimens for STD testing. Intervention Intervention participants received two 4-hour group sessions and 4 telephone contacts over a 12-month period, targeting personal, relational, sociocultural, and structural factors associated with adolescents' STD/HIV risk, and were given vouchers facilitating male partners' STD testing/treatment. Main Outcome Measure Incident chlamydial infections.
  
  
  RESULTS
  Over the 12-month follow-up, fewer adolescents in the intervention had a chlamydial infection (42 vs 67; risk ratio [RR], 0.65; 95% confidence interval [CI], 0.42 to 0.98; P = .04) or recurrent chlamydial infection (4 vs 14; RR, 0.25; 95% CI, 0.08 to 0.83; P = .02). Adolescents in the intervention also reported a higher proportion of condom-protected sex acts in the 60 days preceding follow-up assessments (mean difference, 10.84; 95% CI, 5.27 to 16.42; P < .001) and less frequent douching (mean difference, -0.76; 95% CI, -1.15 to -0.37; P = .001). Adolescents in the intervention were also more likely to report consistent condom use in the 60 days preceding follow-up assessments (RR, 1. 41; 95% CI, 1.09 to 1.80; P = .01) and condom use at last intercourse (RR, 1.30; 95% CI, 1.09 to 1.54; P = .005). Intervention effects were observed for psychosocial mediators of STD/HIV-preventive behaviors.
  
  
  CONCLUSIONS
  Interventions for African American adolescent females can reduce chlamydial infections and enhance STD/HIV-preventive behaviors and psychosocial mediators of STD/HIV-preventive behaviors. Trial Registration clinicaltrials.gov Identifier: NCT00633906.
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, GA 30322, USA. rdiclem@emory.edu
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: DiClemente
authors.forename: Gina M
authors.initials: GM
authors.lastname: Wingood
authors.forename: Eve S
authors.initials: ES
authors.lastname: Rose
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Sales
authors.forename: Delia L
authors.initials: DL
authors.lastname: Lang
authors.forename: Angela M
authors.initials: AM
authors.lastname: Caliendo
authors.forename: James W
authors.initials: JW
authors.lastname: Hardin
authors.forename: Richard A
authors.initials: RA
authors.lastname: Crosby
mesh_terms: D000293:Adolescent; D001741:Black or African American; D002690:Chlamydia Infections / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control*; D005260:Female; D005845:Georgia / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control*; D006801:Humans; D016018:Least-Squares Analysis; D016015:Logistic Models; D008297:Male; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D040242:Risk Reduction Behavior; D012725:Sexual Behavior / Q000208:ethnology*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult