title: A clinic-based motivational intervention improves condom use among subgroups of youth living with HIV.
abstract: OBJECTIVE
  More than 50% of youth living with HIV (YLH) have unprotected sex. In previous studies, we reported effects of a motivational interviewing-based multirisk reduction intervention, "Healthy Choices" in improving motivation, depression, and viral load in YLH. In this study, we report the effect of the intervention on increasing condom use.
  
  
  METHODS
  Six waves of longitudinal data (n = 142) across a period from baseline through 15 months postintervention were analyzed. The developmental trajectory modeling method was used for program effect evaluation.
  
  
  RESULTS
  The three groups detected with distinct sexual risks were: Persistent low sexual risk (PLSR), delayed high sexual risk, and high and growing sexual risk with regard to levels and time trajectories of condom use throughout the trial. Receiving Healthy Choices increased the likelihood to be in the PLSR group (63% vs. 32%, p < .01) and reduced the likelihood to be in the delayed high sexual risk group (16% vs. 50%, p < .05). Receiving the intervention was also associated with progressive reductions in no-condom sex for PLSR youth (adjusted β = -.325, p < .01) and high and growing sexual risk youth (adjusted β = -.364, p < .01).
  
  
  CONCLUSIONS
  The motivational interviewing-based program Healthy Choices, when delivered in clinic settings, can prevent unprotected sex in subgroups of YLH, although more intensive interventions may be needed to change risk trajectories among those at highest risk of transmitting the AIDS virus. Developmental trajectory analysis provides an alternative approach to evaluate program effects for study samples that contain distinct subgroups.
authors.affiliation: Prevention Research Center, Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI 48201, USA. jimchen@med.wayne.edu
authors.forename: Xinguang
authors.initials: X
authors.lastname: Chen
authors.forename: Debra A
authors.initials: DA
authors.lastname: Murphy
authors.forename: Sylvie
authors.initials: S
authors.lastname: Naar-King
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Parsons
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D017280:Condoms / Q000706:statistics & numerical data*; D003863:Depression / Q000453:epidemiology; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008297:Male; D009042:Motivation; D012309:Risk-Taking; D012736:Sex Education / Q000379:methods; D019562:Viral Load; D055815:Young Adult