News

Community Intervention Reduces HIV Risk among Adolescents

A community-level intervention aimed at young adolescents delays early intercourse, increases condom use and reduces the type of risky sexual behavior that can result in sexually transmitted diseases (STDs) and HIV/AIDS, reports Yale researcher in AIDS.

Kathleen J. Sikkema, associate professor in the Yale School of Public Health's Division of Chronic Disease Epidemiology (CDE), finds that community-level interventions aimed at young adolescents reduces the risk of HIV.

“Our community intervention consisted of standard AIDS education, skills training, peer influence, and both family and neighborhood support to both avoid and reduce risk behavior among adolescents. Community-level interventions have previously been shown to be successful with gay men, injection drug users, and inner-city women, but this was one of the first to have targeted adolescents,” said lead author Kathleen J. Sikkema, Ph.D., associate professor in the Yale School of Public Health’s (YSPH) Division of Chronic Disease Epidemiology and YSPH’s Social and Behavioral Sciences Program.

Study participants ranged between 12- and 17-years old and resided in fifteen low-income housing developments throughout the U.S. Each development was randomly assigned to the community-level intervention, a skills training workshop-only condition, or an AIDS education-only control condition. At the outset and then 18 months later, all participants completed a “Teen Health Survey” that assessed HIV risk behavior and related factors.

The AIDS education session was made available to all participants. The skills training workshop consisted of two three-hour sessions led by two trained facilitators. Content included HIV/STD education, skills training in the avoidance and resistance of unwanted sexual activity, condom use, and the ability to better self-manage risk behavior. Themes of self-respect and pride were integrated throughout. The skills training focused on delaying onset of sexual activity, refraining from unwanted sex among those with sexual experience, and always using condoms when one is sexually active.

The adolescents living in developments that received the community-level intervention attended the workshop sessions and were involved in community activities and events. They attended follow-up sessions, participated in a Teen Health Project Leadership Council (THPLC), and developed THPLC-sponsored activities that created social support for reduction of HIV-risk. Workshops on HIV/AIDS risk were offered to parents. To change social norms and show community support, adolescents were encouraged to make public commitments to HIV risk-reduction through pledges and testimonials and endorse HIV prevention themes.

The adolescents who participated in the community-level intervention were both more likely to delay engaging in first intercourse and to use condoms when sexually active. “The program successfully delayed sexual debut as well as increased condom use,” Sikkema said. “Such programs are needed to promote sexual health among youth and young adults.”

Other authors on the study included researchers from the Medical College of Wisconsin¹, Virginia Polytechnic Institute and State University², and from the University of Washington³. Authors are Eileen S. Anderson², Jeffrey A. Kelly 1, Richard A.Winett², Cheryl Gore-Felton¹, Roger A. Roffman³, Timothy G. Heckman¹, Kristi Graves², Raymond G. Hoffmann¹ and Michael J. Brondino¹.