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Randomized Controlled Trial
. 2011 Aug;49(2):193-8.
doi: 10.1016/j.jadohealth.2010.11.252. Epub 2011 Mar 12.

A clinic-based motivational intervention improves condom use among subgroups of youth living with HIV

Xinguang Chen  1 , Debra A Murphy, Sylvie Naar-King, Jeffrey T Parsons; Adolescent Medicine Trials Network for HIV/AIDS Interventions
Collaborators, Affiliations
Randomized Controlled Trial

A clinic-based motivational intervention improves condom use among subgroups of youth living with HIV

Xinguang Chen et al. J Adolesc Health. 2011 Aug.

Abstract

Purpose: More than 50% of youth living with HIV (YLH) have unprotected sex. In previous studies, we reported effects of a motivational interviewing-based multirisk reduction intervention, "Healthy Choices" in improving motivation, depression, and viral load in YLH. In this study, we report the effect of the intervention on increasing condom use.

Methods: Six waves of longitudinal data (n = 142) across a period from baseline through 15 months postintervention were analyzed. The developmental trajectory modeling method was used for program effect evaluation.

Results: The three groups detected with distinct sexual risks were: Persistent low sexual risk (PLSR), delayed high sexual risk, and high and growing sexual risk with regard to levels and time trajectories of condom use throughout the trial. Receiving Healthy Choices increased the likelihood to be in the PLSR group (63% vs. 32%, p < .01) and reduced the likelihood to be in the delayed high sexual risk group (16% vs. 50%, p < .05). Receiving the intervention was also associated with progressive reductions in no-condom sex for PLSR youth (adjusted β = -.325, p < .01) and high and growing sexual risk youth (adjusted β = -.364, p < .01).

Conclusion: The motivational interviewing-based program Healthy Choices, when delivered in clinic settings, can prevent unprotected sex in subgroups of YLH, although more intensive interventions may be needed to change risk trajectories among those at highest risk of transmitting the AIDS virus. Developmental trajectory analysis provides an alternative approach to evaluate program effects for study samples that contain distinct subgroups.

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Figures

Figure 1
Figure 1
Flow Chart of the Trial
Figure 2
Figure 2
Comparison of Trajectories of No condom Use Between Intervention and Control Youths Note: Group 1: Persistent Low Sexual Risk (PLSR), Group 2: Delayed High Sexual Risk (DHSR) and Group 3: High and Growing Sexual Risk (HGSR)
See this image and copyright information in PMC

References

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    1. Murphy DA, Durako SJ, Moscicki AB, et al. No change in health risk behaviors over time among HIV infected adolescents in care: role of psychological distress. J Adolesc Health. 2001;29(3 Suppl):57–63. - PubMed

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