Efficacy of an HIV/STI Sexual Risk-Reduction Intervention for African American Adolescent Girls in Juvenile Detention Centers: A Randomized Controlled Trial

Abstract

Background Few HIV/STI interventions exist for African American adolescent girls in juvenile detention. Objective The objective was to evaluate the efficacy of an intervention to reduce incident STIs, improve HIV-preventive behaviors, and enhance psychosocial outcomes. Methods 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. Intervention 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. Results 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. Conclusions 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.

Protagonismo de adolescentes na prevenção de doenças sexualmente transmissíveis

“…Space of educational intervention for STD/HIV/AIDS prevention as planned and prepared by adolescents of intervention. (8,9) This fact enabled us to understand the need for a different look to the experience of sexuality at this stage, which allowed the adolescents themselves propose strategies to bring and define subjects difficult to approach or with greater resistance to healthy behaviors.…”

“…(8,10) However, the practice of an active listening to adolescents about their expectations and needs in this theme allowed us not only learn but also form bonds and belief in the intervention goals.…”

Factors Associated with Pregnancy among Incarcerated African American Adolescent Girls

“…24 The prevention trial was developed using previously existing techniques for African American girls as well as information provided by adolescent girls with a history of detention in Georgia. 24 Eligible participants were unmarried, 13-17-year-old girls who self-identified as African American and reported a history of vaginal intercourse. Girls who were pregnant, Wards of the State of Georgia, or would be released to a restricted location such as a group home were considered ineligible.…”

“…The Emory University Institutional Review Board approved all study protocols; staff from the Centers for Diseases Control and Prevention did not have contact with study participants. For further details on the study methods, refer to DiClemente et al 24 Outcome Pregnancy History. Participants with a positive response to the question, BHave you ever been pregnant before (be sure to count abortions or miscarriages)?^(yes/no) were categorized as having a history of pregnancy.…”

Introduction: Health Equity Among Incarcerated Female Adolescents and Adult Women: Infectious and Other Disease Morbidity

“…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 indicating a critical need for interventions to reduce sexual risk remains (DiClemente et al, 2014).…”