Izabel Ricardo

Increased protected sex and abstinence among Namibian youth following a HIV risk-reduction intervention: a randomized, longitudinal study

Objective:To evaluate an HIV risk-reduction intervention among Namibian adolescents. Methods:A randomized trial of a 14-session face-to-face intervention emphasizing abstinence and safer sexual practices conducted among 515 youths (median age 17 years and median grade 11) attending 10 secondary schools located in two districts in Namibia. Youths were randomly assigned to the intervention or control condition at the level of the individual. HIV risk behaviours, intentions and perceptions were assessed at baseline, immediately post-intervention and at 6 and 12 months post-intervention. Results:Among all 515 youths who enrolled in the programme, rates of either abstinence or sex with a condom were not different between control and intervention youths at baseline or in the follow-up period. However, analyses conducted among the subset of youths who were sexually inexperienced at baseline (n = 255) revealed that a higher percentage of intervention youths (17%) than control youths (9%, P < 0.05) remained sexually inexperienced one year later. Moreover, in the immediate post-intervention period, among baseline virgins who subsequently initiated sex, intervention youths were more likely than control youths to use a condom (18 versus 10%, P < 0.05). Additional HIV-related risk behaviours (failure to discuss previous HIV risk exposure with ones sexual partner and alcohol use), intentions to use condoms, and perceptions of the ability to use condoms were positively affected by the intervention. Conclusions:There is evidence that the ‘My Future is My Choice’ (MFMC) intervention is reducing HIV risk behaviours among sexually inexperienced participants aged 15–18. Related risk behaviours and perceptions are also positively impacted by the intervention.

“Talking” computers: A reliable and private method to conduct interviews on sensitive topics with children

To obtain valid results, interviews on sex‐related topics not only require confidentiality but also privacy. However, the typical solutions to this problem, self‐administered questionnaires or telephone interviews, may not be appropriate for pre‐ and early adolescents who may require face‐to‐face (FTF) interviews. In this research, we tested the hypothesis that interviews delivered by talking computers would elicit more reports of sexual experience and positive feelings toward sex than FTF interviews with children. To test the hypothesis, we compared the results of both interview methods administered to separate samples of 300 and 96 Black children ages 9 to 15 living in public housing. The results supported the hypothesis. In addition, a subsample of the children (n = 31) who had completed both interviews reported more favorable feelings toward sex in the computer interview. Computer interviews were reliable and did not produce higher levels of missing responses than FTF interviews. The results suggest t...

Longitudinal Stability and Predictability of Sexual Perceptions, Intentions, and Behaviors Among Early Adolescent African-Americans

PURPOSE To assess the stability and predictability of perceptions, intentions, and behaviors regarding intended sexual intercourse and condom use. METHODS One hundred and nineteen African-American youth aged 9-15 years living in urban public housing provided information at baseline and 6 months later using a theory-based and culturally- and developmentally-tailored instrument assessing perceptions, intentions, and sexual behaviors. RESULTS Over the 6-month study interval, individual behaviors, intentions, and perceptions demonstrated considerable stability. Intentions regarding sexual intercourse in the next half-year were predictive of subsequent coitus among the entire cohort and among the subset who were virgins at baseline. Youth who thought it likely that they would be sexually-active in the next 6 months were at significantly elevated risk of doing so, compared to youth who were uncertain or thought coitus unlikely. However, intentions regarding future coitus among the subset of youth who were sexually-experienced at baseline were not predictive of future coital behavior. CONCLUSIONS These data suggest that social cognitive behavioral models that incorporate intentions and perceptions are appropriate as the theoretical basis for interventions targeting these young adolescents.

Use of Western-based HIV risk-reduction interventions targeting adolescents in an African setting

PURPOSE To evaluate an intervention (based on one which had previously been successful in reducing adolescent human immunodeficiency virus (HIV) risk behaviors in the United States) among adolescents residing in Namibia, a country located in sub-Saharan Africa. METHODS A randomized trial of a 14-session face-to-face intervention emphasizing abstinence and safer sex was conducted among 515 youth (median age 17 years; median grade 11) attending 10 secondary schools located in two districts in Namibia. Knowledge, attitudes, intentions, and HIV risk behaviors were assessed at baseline and in the immediate postintervention period. RESULTS Knowledge increased significantly among intervention compared to control youth (88% vs. 82%; correct responses, p < .0001). At postintervention follow-up, more intervention than control youth believed that they could be intimate without having sex, could have a girlfriend or boyfriend for a long time without having sex, could explain the process of impregnation, knew how to use a condom, and could ask for condoms in a clinic. Fewer intervention than control youth believed that if a girl refused to have sex with her boyfriend it was permissible for him to strike her, and that condoms took away a boys pleasure. More intervention than control youth anticipated using a condom when they did have sex, and fewer expected to drink alcohol. Finally, after intervention, there was a trend for increased condom use. There were significant gender-related differences at baseline, although intervention impact was generally equivalent. CONCLUSIONS These findings provide support for the judicious adaptation of successful Western HIV prevention programs in other cultural settings. A single intervention approach appears to be effective in short-term follow-up with both genders.