Sales Jessica M, Brown Jennifer L, Diclemente Ralph J, Rose Eve
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
AIDS Res Treat. 2012;2012:231417. doi: 10.1155/2012/231417. Epub 2012 May 29.
To enhance future STI/HIV prevention efforts, this study examined factors associated with adolescents' failure to improve their condom use behaviors after participating in an STI/HIV prevention intervention. African-American adolescent females (N = 205; M age = 17.9) in an STI/HIV prevention intervention trial completed ACASI interviews and provided self-collected vaginal swabs to assess two prevalent STIs at baseline and 6 months after intervention. Analyses compared those who increased condom use after intervention (change group) to those whose condom use did not increase (nonchange group). 43.4% did not increase their condom use after the intervention and were more likely to have an STI at followup (χ(2) = 4.64, P = .03). In a multivariate logistic regression model, the nonchange group was more likely to have (a) higher sensation seeking (AOR = .91, P = .023), (b) a boyfriend (AOR = .32, P = .046), and/or (c) a physical abuse history (AOR = .56, P = .057). There were also differences in the extent to which psychosocial mediators changed between the two groups. Findings highlight the need to tailor STI/HIV interventions to adolescents with a greater degree of sensation seeking and address key relationship characteristics and trauma histories to bolster intervention efficacy.
为加强未来的性传播感染/艾滋病毒预防工作,本研究调查了青少年在参与性传播感染/艾滋病毒预防干预后未改善其避孕套使用行为的相关因素。参加性传播感染/艾滋病毒预防干预试验的非裔美国青少年女性(N = 205;平均年龄 = 17.9岁)完成了计算机辅助自我访谈,并提供了自行采集的阴道拭子,以在基线和干预后6个月评估两种常见的性传播感染。分析比较了干预后增加避孕套使用的人群(改变组)和避孕套使用未增加的人群(未改变组)。43.4%的人在干预后未增加避孕套使用,且在随访时更有可能感染性传播感染(χ(2) = 4.64,P = .03)。在多变量逻辑回归模型中,未改变组更有可能(a)有更高的寻求刺激倾向(优势比 = .91,P = .023),(b)有男朋友(优势比 = .32,P = .046),和/或(c)有身体虐待史(优势比 = .56,P = .057)。两组之间心理社会调节因素的变化程度也存在差异。研究结果强调,需要针对寻求刺激程度较高的青少年量身定制性传播感染/艾滋病毒干预措施,并解决关键的人际关系特征和创伤史问题,以提高干预效果。