title: Moderation and mediation of an effective HIV risk-reduction intervention for South African adolescents.
abstract: BACKGROUND
  "Let Us Protect Our Future" is a sexual risk-reduction intervention for sixth-grade adolescents in South Africa. Tested in a cluster-randomized controlled trial, the intervention significantly reduced self-reported intercourse and unprotected intercourse during a 12-month follow-up period.
  
  
  OBJECTIVE
  The present analyses were conducted to identify moderators of the intervention's efficacy as well as, which theory-based variables mediated the intervention's effects.
  
  
  METHODS
  Intervention efficacy over the 3-, 6-, and 12-month follow-up was tested using generalized estimating equation models.
  
  
  RESULTS
  Living with their father in the home, parental strictness, and religiosity moderated the efficacy of the intervention in reducing unprotected intercourse. Self-efficacy to avoid risky situations and expected parental disapproval of their having intercourse, derived from Social Cognitive Theory, significantly mediated the intervention's effect on abstinence.
  
  
  CONCLUSIONS
  This is the first study to demonstrate that Social Cognitive variables mediate the efficacy of a sexual risk-reduction intervention among South African adolescents.
authors.affiliation: Prevention Research Branch, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. aao0@cdc.gov
authors.forename: Ann
authors.initials: A
authors.lastname: O'Leary
authors.forename: John B
authors.initials: JB
authors.lastname: Jemmott
authors.forename: Loretta Sweet
authors.initials: LS
authors.lastname: Jemmott
authors.forename: Scarlett
authors.initials: S
authors.lastname: Bellamy
authors.forename: Zolani
authors.initials: Z
authors.lastname: Ngwane
authors.forename: Larry
authors.initials: L
authors.lastname: Icard
authors.forename: Lynnette
authors.initials: L
authors.lastname: Gueits
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006293:Health Promotion; D006801:Humans; D008297:Male; D040242:Risk Reduction Behavior; D020377:Self Efficacy; D012725:Sexual Behavior / Q000523:psychology*; D013019:South Africa