Effectiveness of a Theory-Based Risk Reduction HIV Prevention Program for Rural Vietnamese Adolescents

Abstract

As of April 2003, 64,801 HIV cases have been documented in Vietnam (Policy Project 2003), 53.9 % of which are among individuals 20-29 years of age. Although HIV education efforts have increased, there remains a need for proven effective programs. We present findings from a randomized-controlled effectiveness trial of an HIV prevention program for adolescents 15-20 years. Four hundred eighty adolescents were randomized into control and intervention groups. Evaluation data were collected using the Vietnamese Youth Health Risk Behavior Instrument, including scales based on the protection motivation theory (PMT). Findings presented show significant differences in knowledge of severity and vulnerability of HIV/AIDS ( p < .05), perceptions of self-efficacy ( p < .001), and response efficacy for condom use ( p < .05) between control and intervention youth at immediate and 6-month postintervention. A significant difference was also found for response cost of condom use ( p < .05) at immediate postintervention. No significant difference was found for the construct of response cost at 6 months, and there were no significant differences for the constructs external and internal rewards. Reported engagement in vaginal sex (1.7%), or anal and/or oral sex (3.1%) was extremely low, and therefore changes in actual behaviors could not be accurately measured. However, intention to use condoms in possible future sexual encounters increased significantly ( p < .05) for the intervention youth compared to control youth between baseline (74/240, 30.8%) and both immediate postintervention (132/230, 57.4%), and six month follow-up (123/228: 53.9%). These data suggest the potential applicability of the PMT for HIV program development with non-Western adolescents but also point to the need for further studies on how constructs within behavioral theories might need to be modified in different sociocultural settings.

Respecting the circle of life: one year outcomes from a randomized controlled comparison of an HIV risk reduction intervention for American Indian adolescents

“…Our evaluation shows that a behavioral health intervention rooted in PMT and adapted for an AI community can improve condom use self-efficacy, but it does not provide evidence of long-term intervention impact on high-risk behaviors. Attenuation of initially strong intervention effects is consistent with past evaluations of the original EBI, FOY (Gong et al, 2009;Kaljee et al, 2005;Lerdboon et al, 2008;Li, Stanton, Feigelman, & Galbraith, 2002;Lwin et al, 2010;Stanton et al, 1996Stanton et al, , 1997.…”

“…The EBI "Focus on Youth" (FOY), developed for African-American adolescents and successfully implemented in various populations around the world, was selected for adaptation (Gong et al, 2009;Kaljee et al, 2005;Lerdboon et al, 2008;Lwin, Stanaland, & Chan, 2010). The Protection Motivation Theory (PMT) underpinning FOY posits that the perceived threat of HIV infection initiates two cognitive pathways: (1) threat-appraisal (risk) balances the threat of contracting HIV including intrinsic/extrinsic rewards vs. the severity of HIV and one's perceived vulnerability; (2) coping-appraisal (protective) balances one's ability to avoid the threat through self-efficacy and response efficacy vs. the relative cost of the adaptive behavior.…”

Sexual Stigma, Sexual Behaviors, and Abstinence Among Vietnamese Adolescents: Implications for Risk and Protective Behaviors for HIV, Sexually Transmitted Infections, and Unwanted Pregnancy

“…Survey Instrument-The survey instrument contained a series of items and scales designed to address issues of attitudes and perceptions of sexuality and risk behaviors, engagement in sexual behaviors, intentions to engage in sexual behaviors, communication with parents and partners, perceptions of gender roles and responsibilities, as well as scales to measure the social learning theory Protection Motivation Theory (Rogers 1983;Floyd, Prentice-Dunn, Rogers 2000) on which the intervention curricula will be based (Kaljee, Genberg, Riel 2005). Utilizing the qualitative data, we conducted searches on the coded data on key terms to obtain series of texts from these interviews.…”

Applying the Information-Motivation-Behavioral Skills Model in Medication Adherence Among Thai Youth Living with HIV: A Qualitative Study

“…8 Because of the significant cultural difference, the analysis of qualitative data can provide a conduit for exploration and cultural adaptation of Western-based behavioral theories and is an essential first step toward utilization of these theories in non-Western contexts. 9,10 The present study was designed to begin this exploration of the potential cross-culture adaptation of an established model of health behaviors, the informationmotivation-behavioral skills (IMB) model in a Thai setting.…”