Effectiveness of an HIV/STD risk-reduction intervention for adolescents when implemented by community-based organizations: a cluster-randomized controlled trial.
OBJECTIVE
We evaluated the effectiveness of an HIV/STD risk-reduction intervention when implemented by community-based organizations (CBOs).


METHODS
In a cluster-randomized controlled trial, 86 CBOs that served African American adolescents aged 13 to 18 years were randomized to implement either an HIV/STD risk-reduction intervention whose efficacy has been demonstrated or a health-promotion control intervention. CBOs agreed to implement 6 intervention groups, a random half of which completed 3-, 6-, and 12-month follow-up assessments. The primary outcome was consistent condom use in the 3 months prior to each follow-up assessment, averaged over the follow-up assessments.


RESULTS
Participants were 1707 adolescents, 863 in HIV/STD-intervention CBOs and 844 in control-intervention CBOs. HIV/STD-intervention participants were more likely to report consistent condom use (odds ratio [OR] = 1.39; 95% confidence interval [CI] = 1.06, 1.84) than were control-intervention participants. HIV/STD-intervention participants also reported a greater proportion of condom-protected intercourse (beta = 0.06; 95% CI = 0.00, 0.12) than did the control group.


CONCLUSIONS
This is the first large, randomized intervention trial to demonstrate that CBOs can successfully implement an HIV/STD risk-reduction intervention whose efficacy has been established.
Jemmott
John B
JB
University of Pennsylvania, School of Medicine, Center for Health Behavior and Communication Research, Philadelphia, PA. 19104-3309, USA. jjemmott@asc.upenn.edu
Jemmott
Loretta S
LS
Fong
Geoffrey T
GT
Morales
Knashawn H
KH
D000293:Adolescent; D016009:Chi-Square Distribution; D017280:Condoms / Q000706:statistics & numerical data; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008297:Male; D009515:New Jersey; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D015143:Philadelphia; D011314:Preventive Health Services / Q000592:standards*; D040242:Risk Reduction Behavior; D021841:Safe Sex / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D012959:Socioeconomic Factors