title: Using culturally sensitive media messages to reduce HIV-associated sexual behavior in high-risk African American adolescents: results from a randomized trial.
abstract: OBJECTIVE
  To test the long-term effects of a mass media intervention that used culturally and developmentally appropriate messages to enhance human immunodeficiency virus (HIV)-preventive beliefs and behavior of high-risk African American adolescents.
  
  
  METHODS
  Television and radio messages were delivered for more than 3 years in two cities (Syracuse, NY; and Macon, GA) that were randomly selected within each of the two regionally matched city pairs, with the other cities (Providence, RI; and Columbia, SC) serving as controls. African American adolescents, aged 14-17 years (N = 1,710), recruited in the four cities over a 16-month period, completed audio computer-assisted self-interviews at recruitment and again at 3, 6, 12, and 18-months postrecruitment to assess the long-term effects of the media program. To identify the unique effects of the media intervention, youth who completed at least one follow-up and who did not test positive for any of the three sexually transmitted infections at recruitment or at 6-and 12-month follow-up were retained for analysis (N = 1,346).
  
  
  RESULTS
  The media intervention reached virtually all the adolescents in the trial and produced a range of effects including improved normative condom-use negotiation expectancies and increased sex refusal self-efficacy. Most importantly, older adolescents (aged 16-17 years) exposed to the media program showed a less risky age trajectory of unprotected sex than those in the nonmedia cities.
  
  
  CONCLUSIONS
  Culturally tailored mass media messages that are delivered consistently over time have the potential to reach a large audience of high-risk adolescents, to support changes in HIV-preventive beliefs, and to reduce HIV-associated risk behaviors among older youth.
authors.affiliation: Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6220, USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Sznitman
authors.forename: Peter A
authors.initials: PA
authors.lastname: Vanable
authors.forename: Michael P
authors.initials: MP
authors.lastname: Carey
authors.forename: Michael
authors.initials: M
authors.lastname: Hennessy
authors.forename: Larry K
authors.initials: LK
authors.lastname: Brown
authors.forename: Robert F
authors.initials: RF
authors.lastname: Valois
authors.forename: Bonita F
authors.initials: BF
authors.lastname: Stanton
authors.forename: Laura F
authors.initials: LF
authors.lastname: Salazar
authors.forename: Ralph
authors.initials: R
authors.lastname: Diclemente
authors.forename: Naomi
authors.initials: N
authors.lastname: Farber
authors.forename: Daniel
authors.initials: D
authors.lastname: Romer
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology*; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D001294:Attitude to Health / Q000208:ethnology*; D005260:Female; D015658:HIV Infections / Q000208:ethnology* / Q000517:prevention & control; D040261:Harm Reduction; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008402:Mass Media; D012309:Risk-Taking; D012424:Rural Population / Q000706:statistics & numerical data; D012736:Sex Education / Q000379:methods*; D012725:Sexual Behavior / Q000208:ethnology*; D014481:United States / Q000453:epidemiology; D047568:Unsafe Sex / Q000517:prevention & control; D014505:Urban Population / Q000706:statistics & numerical data