Stanton B F, Li X, Ricardo I, Galbraith J, Feigelman S, Kaljee L
Division of General Pediatrics, Department of Pediatrics, University of Maryland Medical School, Baltimore, USA.
Arch Pediatr Adolesc Med. 1996 Apr;150(4):363-72. doi: 10.1001/archpedi.1996.02170290029004.
Some interventions to reduce the risk of the acquired immunodeficiency syndrome (AIDS) that target youths have resulted in short-term increases in self-reported condom use. However, long-term intervention effects have not been assessed.
Can a theoretically and culturally based, AIDS-risk reduction intervention delivered to naturally formed peer groups increase self-reported condom use among African-American early adolescents at 6 and 12 months of follow-up?
A randomized, controlled trial of a community-based intervention delivered in eight weekly sessions involved 76 naturally formed peer groups consisting of 383 (206 intervention and 177 control) African-American youths 9 to 15 years of age. A theory-based, culturally and developmentally tailored instrument that assessed perceptions, intentions, and self-reported sexual behaviors was administered to all subjects at baseline (preintervention) and 6 and 12 months later.
At baseline, 36% of youths were sexually experienced, and by 12 months of follow-up, 49% were sexually experienced. Self-reported condom use rates were significantly higher among intervention than control youths (85% vs 61%; P<.05) at the 6-month follow-up. However, by 12 months, rates were no longer significantly higher among intervention youths. The intervention impact at 6 months was especially strong among boys (85% vs 57%; P<.05) and among early teens (13 to 15 years old) (95% vs 60%; P<.01). Self-reported condom use intention was also increased among intervention youths at 6 months but not at 12 months. Some perceptions were positively affected at 6 months, but the change did not persist at 12 months.
High rates of sexual intercourse underscore the urgent need for effective AIDS-risk reduction interventions that target low-income urban, African-American preteens and early teens. A developmentally and culturally tailored intervention based on social-cognitive theory and delivered to naturally formed peer groups recruited from community settings can increase self-reported condom use. The strong short-term improvements in behaviors and intentions followed by some relapse over longer periods argue for a strengthened program and research focus on sustainability.
一些针对青少年的降低获得性免疫缺陷综合征（艾滋病）风险的干预措施已导致自我报告的避孕套使用短期增加。然而，长期干预效果尚未得到评估。
向自然形成的同伴群体提供基于理论和文化的艾滋病风险降低干预措施，能否在随访6个月和12个月时增加非裔美国青少年早期自我报告的避孕套使用情况？
一项基于社区的干预措施的随机对照试验，每周进行8次，涉及76个自然形成的同伴群体，由383名（206名干预组和177名对照组）9至15岁的非裔美国青少年组成。在基线（干预前）以及6个月和12个月后，对所有受试者使用一种基于理论、针对文化和发展进行调整的工具进行评估，该工具用于评估认知、意图和自我报告的性行为。
在基线时，36%的青少年有过性经历，到随访12个月时，49%的青少年有过性经历。在6个月的随访中，干预组青少年自我报告的避孕套使用率显著高于对照组（85%对61%；P<0.05）。然而，到12个月时，干预组青少年的使用率不再显著更高。6个月时的干预效果在男孩中尤其显著（85%对57%；P<0.05）以及在青少年早期（13至15岁）中（95%对60%；P<0.01）。干预组青少年在6个月时自我报告的使用避孕套意图也有所增加，但在12个月时没有。一些认知在6个月时受到积极影响，但这种变化在12个月时没有持续。
高性交率凸显了针对低收入城市非裔美国青少年和青少年早期开展有效艾滋病风险降低干预措施的迫切需求。基于社会认知理论、针对文化和发展进行调整并提供给从社区环境中招募的自然形成的同伴群体的干预措施，可以增加自我报告的避孕套使用情况。行为和意图在短期内有显著改善，但在较长时期内出现一些复发，这表明需要加强项目并将研究重点放在可持续性上。
