title: A multimodal behavioral intervention to impact adherence and risk behavior among perinatally and behaviorally HIV-infected youth: description, delivery, and receptivity of adolescent impact.
abstract: Secondary prevention programs are needed to help HIV-positive youth reduce risk behavior and improve adherence to HIV medications. This article provides an overview of Adolescent Impact, a secondary HIV prevention intervention, including its description, delivery, and receptivity among the two unique groups of participants. Adolescent Impact, a 12-session behavioral intervention incorporating individual and group components was designed to increase HIV knowledge, disease management and risk reduction skills, and motivate healthy lifestyles among HIV-infected adolescents. A standardized protocol was implemented at three sites in the northeastern United States. One hundred sixty-six HIV-positive youth, aged 13-21 (mean = 16.8 years), enrolled in the study were randomized to receive either the intervention (n = 83) or standard of care (n = 83). Participants were predominantly of minority race/ethnicity (94% African American or Hispanic); 53% were female and 59.6% were perinatally infected. Perinatally infected youth were significantly more likely to be young, had experienced HIV Class C-related symptoms and had CD4-positive T lymphocyte counts of fewer than 200 cells (all p values < .01). The mean number of sessions attended was 9.4, with most (83.3%) participants attending at least half (≥ 6) of the intervention sessions (86% perinatally infected, 78.6% behaviorally infected, p = .5). Participants' sociodemographic and clinical characteristics mirrored those of the larger HIV adolescent cohort in the United States Relatively high attendance rates suggest that youth were receptive to the program and its content. Through use of multiple intervention modalities, Adolescent Impact was able to accommodate a diverse group of clinic-attending HIV-positive youth and address the need for a compact intervention for use in the clinical setting.
authors.affiliation: New York University School of Medicine, New York 10016, USA. sulachni.chandwani@nyumc.org
authors.forename: Sulachni
authors.initials: S
authors.lastname: Chandwani
authors.forename: Susan
authors.initials: S
authors.lastname: Abramowitz
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Koenig
authors.forename: William
authors.initials: W
authors.lastname: Barnes
authors.forename: Lawrence
authors.initials: L
authors.lastname: D'Angelo
mesh_terms: D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001521:Behavior Therapy / Q000379:methods*; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008297:Male; D010342:Patient Acceptance of Health Care; D017064:Process Assessment, Health Care; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D055502:Secondary Prevention; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents