Efficacy of an Abstinence-Only HIV Risk-Reduction Intervention for Young African-American Adolescents

Study Description

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Brief Summary:

This study will develop and evaluate the effectiveness of culturally appropriate HIV/sexually transmitted disease risk-reduction interventions in reducing sexual risk behavior among young African-American adolescents.

Condition or disease	Intervention/treatment	Phase
HIV Infections; Sexually Transmitted Diseases	Behavioral: Abstinence-only HIV/STD risk-reduction intervention; Behavioral: Safer-sex-only HIV/STD risk-reduction intervention; Behavioral: Long comprehensive HIV/STD risk-reduction intervention; Behavioral: Short comprehensive HIV/STD risk-reduction intervention; Behavioral: Health promotion control intervention	Not Applicable

Detailed Description:

Adolescents risk the negative consequences of early sexual involvement, including not only HIV, but other sexually transmitted diseases (STDs) and unintended pregnancies. Compared with older adults, young people, especially African-American young people, are at higher risk of acquiring an STD. Specifically, people 15 to 24 years of age acquire nearly 50% of all new STDs in the United States, but this age group represents only 25% of the sexually active population. Adolescents are especially vulnerable to STD infections because of a lack of education about proper condom use and consequences of sexual risk behaviors. Previous research has suggested that behavioral interventions can reduce adolescents' sexual behaviors tied to risk of acquiring STDs. Nevertheless, there is continuous debate over the appropriateness and effectiveness of different types of adolescent sexual-risk-reduction interventions, including abstinence education or comprehensive sexual education. Few studies have tested the long-term effectiveness of abstinence education, which emphasizes delaying sexual initiation for sexually inexperienced adolescents. This study will compare the effectiveness of an abstinence-only HIV/STD risk-reduction intervention with other types of interventions in reducing sexual risk behavior among young African-American adolescents.

Participation in this study will last 24 months. Participants at participating schools will be randomly assigned to one of five treatment groups:

• Abstinence-only group participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence. This is not an abstinence-until-marriage intervention; the target behavior is abstaining from sexual activity until later in life when the adolescent is more prepared to handle the consequences. The intervention is not designed to affect condom use.
• Safer-sex-only group participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for using condoms during sexual intercourse. The intervention is not designed to influence abstinence.
• Long comprehensive group participants will attend three sessions consisting of twelve 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence and for using condoms if participants decide to be sexually active. The intervention will consist of 4 hours each of the safer-sex-specific content, the abstinence-specific content, and the general content that is common to both of the single-component interventions.
• Short comprehensive group participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence and for using condoms if participants decide to be sexually active.
• Health promotion control participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for avoiding cigarette smoking and for incorporating a healthful diet, aerobic exercise, and breast and testicular self-examinations. The control intervention will focus on reducing risk of heart disease, hypertension, diabetes, and certain cancers.

Sessions for all groups will be led by trained adult facilitators and will include group discussions, videos, games, brainstorming, experiential exercises, and skill-building activities designed to be educational, interactive, and entertaining. All participants will complete self-reports concerning sexual behaviors, condom use, and knowledge about STDs at baseline and Months 3, 6, 12, 18, and 24 of follow-up.

Study Design

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	662 participants
Allocation:	Randomized
Intervention Model:	Parallel Assignment
Masking:	Single (Outcomes Assessor)
Primary Purpose:	Prevention
Official Title:	HIV/Sexually Transmitted Disease (STD) Prevention Interventions for Black Adolescents
Study Start Date :	September 2001
Actual Primary Completion Date :	August 2004
Actual Study Completion Date :	August 2004

Arms and Interventions

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Arm	Intervention/treatment
Experimental: Abstinence-only; Participants will receive the abstinence-only HIV/STD risk-reduction intervention.	Behavioral: Abstinence-only HIV/STD risk-reduction intervention; Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence. The intervention is not an abstinence-until-marriage intervention; the target behavior is abstaining from sexual activity until later in life when the adolescent is more prepared to handle the consequences. The intervention does not contain inaccurate information, portray sex in a negative light, or employ a moralistic tone. It is not designed to affect condom use.; Other Name: Abstinence
Experimental: Safer-sex only; Participants will receive the safer-sex-only HIV/STD risk-reduction intervention.	Behavioral: Safer-sex-only HIV/STD risk-reduction intervention; Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for using condoms during sexual intercourse. The intervention is not designed to influence abstinence.; Other Name: Condom-use intervention
Experimental: Comprehensive-long; Participants will receive the 12-h long comprehensive HIV/STD risk-reduction intervention.	Behavioral: Long comprehensive HIV/STD risk-reduction intervention; Participants will attend three sessions consisting of twelve 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence and for using condoms if participants decide to be sexually active. The intervention consists of the safer-sex-specific content (4 hours), the abstinence-specific content (4 hours), and the general content that is common to both of the single-component interventions (4 hours).; Other Names: Abstinence and condom-use intervention; Abstinence-plus intervention
Experimental: Comprehensive-short; Participants will receive the 8-h short comprehensive HIV/STD risk-reduction intervention.	Behavioral: Short comprehensive HIV/STD risk-reduction intervention; Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence and for using condoms if participants decide to be sexually active.; Other Names: Abstinence and condom-use intervention; Abstinence-plus intervention
Active Comparator: Health-promotion control; Participants will receive the health promotion control intervention.	Behavioral: Health promotion control intervention; Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for avoiding cigarette smoking and for incorporating a healthful diet, aerobic exercise, and breast and testicular self-examinations. The control intervention will focus on reducing risk of heart disease, hypertension, diabetes, and certain cancers. The intervention provides a control for "Hawthorne effects" to reduce the likelihood that the HIV/STD interventions' effects can be attributed to group interaction and special attention.; Other Name: Chronic disease prevention intervention

Outcome Measures

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Primary Outcome Measures :

1. Self-report of Ever Having Sexual Intercourse [ Time Frame: 24 months post-intervention ]
   Self-reported sexual initiation during the follow-up period among participants who reported never having sexual intercourse at baseline.

Secondary Outcome Measures :

1. Self-reported Sexual Intercourse in the Past 3 Months [ Time Frame: Measured at baseline and 3, 6, 12, 18, and 24 months post-intervention ]
   Self-report of having sexual intercourse in the past 3 months
2. Self-report of Having Multiple Sexual Partners in the Past 3 Months [ Time Frame: Measured at baseline and 3, 6, 12, 18, and 24 months post-intervention ]
   Self-report of having sexual intercourse with more than one partner in the pat 3 months.
3. Self-reported Consistent Condom Use in the Past 3 Months [ Time Frame: Measured at baseline and 3, 6, 12, 18, and 24 months post-intervention ]
   Self-report of using a condom during every sexual intercourse act in the past 3 months
4. Self-report of Having Sexual Intercourse Without Using a Condom During the Past 3 Months [ Time Frame: Measured at baseline and3, 6, 12, 18, and 24 months post-intervention ]

Eligibility Criteria

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Ages Eligible for Study:	Child, Adult, Senior
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	Yes

Criteria

Inclusion Criteria:

• Grade 6 or 7 student at a participating school
• Written parent or guardian consent to participate
• Self-identifies as African American or black

Exclusion Criteria:

- Those not meeting inclusion criteria were excluded.

Contacts and Locations

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Locations

United States, Pennsylvania
University of Pennsylvania
Philadelphia, Pennsylvania, United States, 19104

Sponsors and Collaborators

University of Pennsylvania

National Institute of Mental Health (NIMH)

Investigators

Principal Investigator:	John B. Jemmott III, PhD	University of Pennsylvania

More Information

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Publications of Results:

Jemmott JB 3rd, Jemmott LS, Fong GT. Efficacy of a theory-based abstinence-only intervention over 24 months: a randomized controlled trial with young adolescents. Arch Pediatr Adolesc Med. 2010 Feb;164(2):152-9. doi: 10.1001/archpediatrics.2009.267.

Zhang J, Jemmott JB 3rd, Jemmott LS. Mediation and moderation of an efficacious theory-based abstinence-only intervention for African American adolescents. Health Psychol. 2015 Dec;34(12):1175-84. doi: 10.1037/hea0000244. Epub 2015 Jul 27.

Responsible Party:	John Jemmott, Kenneth B. Clark Professor of Communication and Psychiatry, University of Pennsylvania
ClinicalTrials.gov Identifier:	NCT00640653 History of Changes
Other Study ID Numbers:	R01MH062049 ( U.S. NIH Grant/Contract ); DAHBR 9A-ASPA ( Other Identifier: National Institute of Mental Health )
First Posted:	March 21, 2008
Results First Posted:	December 13, 2017
Last Update Posted:	December 13, 2017
Last Verified:	November 2017

Keywords provided by John Jemmott, University of Pennsylvania:

Sexual Behavior; Abstinence; Intervention Studies; HIV	Sexually Transmitted Infection; Theory of Planned Behavior; HIV Seronegativity

Additional relevant MeSH terms:

HIV Infections; Sexually Transmitted Diseases; Lentivirus Infections; Retroviridae Infections; RNA Virus Infections; Virus Diseases	Sexually Transmitted Diseases, Viral; Immunologic Deficiency Syndromes; Immune System Diseases; Infection; Genital Diseases, Male; Genital Diseases, Female