title: Efficacy of an HIV/STI sexual risk-reduction intervention for African American adolescent girls in juvenile detention centers: a randomized controlled trial.
abstract: Few HIV/STI interventions exist for African American adolescent girls in juvenile detention. The objective was to evaluate the efficacy of an intervention to reduce incident STIs, improve HIV-preventive behaviors, and enhance psychosocial outcomes. We conducted a randomized controlled trial among African American adolescent girls (13-17 years, N = 188) in juvenile detention from March 2011 to May 2012. Assessments occurred at baseline and 3- and 6-months post-randomization and included: audio computer-assisted self-interview, condom skills assessment, and self-collected vaginal swab to detect Chlamydia and gonorrhea. The Imara intervention included three individual-level sessions and four phone sessions; expedited partner therapy was offered to STI-positive adolescents. The comparison group received the usual care provided by the detention center: STI testing, treatment, and counseling. At the 6-month assessment (3-months post-intervention), Imara participants reported higher condom use self-efficacy (p < 0.001), HIV/STI knowledge (p < 0.001), and condom use skills (p < 0.001) compared to control participants. No significant differences were observed between trial conditions in incident Chlamydia or gonorrhea infections, condom use, or number of vaginal sex partners. Imara for detained African American adolescent girls can improve condom use skills and psychosocial outcomes; however, a critical need for interventions to reduce sexual risk remains.
authors.affiliation: a Emory University Rollins School of Public Health , Department of Behavioral Sciences and Health Education , Atlanta , Georgia , USA.
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: DiClemente
authors.forename: Teaniese L
authors.initials: TL
authors.lastname: Davis
authors.forename: Andrea
authors.initials: A
authors.lastname: Swartzendruber
authors.forename: Amy M
authors.initials: AM
authors.lastname: Fasula
authors.forename: Lorin
authors.initials: L
authors.lastname: Boyce
authors.forename: Deborah
authors.initials: D
authors.lastname: Gelaude
authors.forename: Simone C
authors.initials: SC
authors.lastname: Gray
authors.forename: James
authors.initials: J
authors.lastname: Hardin
authors.forename: Eve
authors.initials: E
authors.lastname: Rose
authors.forename: Monique
authors.initials: M
authors.lastname: Carry
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Sales
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Brown
authors.forename: Michelle
authors.initials: M
authors.lastname: Staples-Horne
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D002690:Chlamydia Infections / Q000208:ethnology / Q000517:prevention & control; D017280:Condoms / Q000706:statistics & numerical data*; D005260:Female; D006069:Gonorrhea / Q000208:ethnology / Q000517:prevention & control; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D015994:Incidence; D011329:Prisoners; D011330:Prisons; D040242:Risk Reduction Behavior; D012725:Sexual Behavior / Q000208:ethnology / Q000523:psychology*; D012749:Sexually Transmitted Diseases / Q000208:ethnology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology
keywords: African Americans; HIV; adolescents; intervention; juvenile detention