Jemmott J B, Jemmott L S
Annenberg School for Communication, University of Pennsylvania, Philadelphia 19104-3309, USA.
AIDS. 2000 Sep;14 Suppl 2:S40-52.
This article provides a comprehensive review of research on the effects of behavioral interventions on heterosexual adolescents' HIV sexual-risk behavior. It details adolescents' risk of sexually transmitted HIV infection and describes challenges associated with adolescent intervention research, including obtaining school and parent approval and the validity of self-reported measures. It describes central characteristics of 36 controlled intervention studies assessing the HIV sexual-risk behavior of over 30,000 male and female adolescents 11-21 years of age. It summarizes the participants' race/ethnicity and age, the theoretical framework, and the intervention setting, duration and outcome. This review reveals that the most commonly assessed behavioral outcomes were condom use and abstinence, and the largest effects sized were on condom use and condom acquisition. Effect sizes for abstinence and number of sexual partners were the smallest. Perceived self-efficacy and behavioral interventions were the most commonly assessed theoretical mediators. Key questions this research engaged in included whether behavioral skills can be increased, whether intervention-induced behavior change can be sustained, whether matching the race/ethnicity and gender of facilitators and participants enhances the effectiveness of culturally sensitive interventions, whether classroom teachers can effectively facilitate interventions, whether the behavior of high-risk populations can be changed, and which kinds of interventions are most effective. This review concludes that carefully designed theory-based interventions that take into account the characteristics of the particular population or culture can cause positive changes in adolescents' HIV sexual-risk behavior, but boundary conditions for their effectiveness still need to be identified. Several suggestions for additional research are proffered.
本文全面综述了行为干预对异性恋青少年艾滋病毒性行为风险的影响研究。文中详述了青少年感染性传播艾滋病毒的风险，并描述了青少年干预研究面临的挑战，包括获得学校和家长的批准以及自我报告测量方法的有效性。文章介绍了36项对照干预研究的核心特征，这些研究评估了30000多名11至21岁青少年的艾滋病毒性行为风险。综述总结了参与者的种族/民族和年龄、理论框架、干预背景、持续时间和结果。该综述表明，最常评估的行为结果是避孕套使用和禁欲，最大的效应量出现在避孕套使用和获取方面。禁欲和性伴侣数量的效应量最小。自我效能感和行为干预是最常评估的理论中介因素。该研究涉及的关键问题包括行为技能是否可以提高、干预引起的行为改变是否可以持续、促进者与参与者的种族/民族和性别匹配是否能提高文化敏感干预的效果、课堂教师是否能有效促进干预、高危人群的行为是否可以改变以及哪种干预最有效。该综述得出结论，精心设计的基于理论的干预措施，若考虑到特定人群或文化的特征，可使青少年的艾滋病毒性行为风险产生积极变化，但其有效性的边界条件仍有待确定。文中还提出了一些进一步研究的建议。
