A Cluster Randomized Controlled Trial of an Adolescent HIV Prevention Program Among Bahamian Youth: Effect at 12 Months Post-Intervention
A Cluster Randomized Controlled Trial of an Adolescent HIV Prevention Program Among Bahamian Youth: Effect at 12 Months Post-Intervention
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DOI：
10.1007/s10461-008-9511-0
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发表时间：
2009-06-01
影响因子：
4.4
通讯作者：
Stanton, Bonita
中科院分区：
文献类型：
--
作者：
Chen, Xinguang;Lunn, Sonja;Stanton, Bonita
基于保护动机理论（PMT）的行为干预已被证明可以在全球不同环境中降低中老年青少年的艾滋病毒风险行为，但尚未在加勒比国家进行评估，并且在青少年前接受了有限的评估。确定(1)巴哈马群岛以PMT为基础的艾滋病预防项目“关注加勒比青年”（FOYC）的有效性；(2)有针对性的PMT构建在干预效果中的作用。来自巴哈马新普罗维登斯15所城市学校的1360名六年级青少年（10-11岁）被随机分配到接受FOYC或对照条件的学校。对基线、干预后6个月和12个月收集的数据进行分析。一项评估性行为进展的五步计划，从“1”=“无意发生性行为的处女”到“5”=“不戴避孕套发生性行为”。采用基于分组的轨迹分析对项目效果进行评估。两种性行为进展模式被检测到：缓慢进展和快速进展。接受FOYC降低了青少年成为快速进展者的可能性（调整后OR = 0.77, 95% CI: 0.64-1.00）。观察到的有效性特别受到目标PMT结构子集的影响。FOYC有效地延缓了巴哈马前青少年的性风险。以群体为基础的轨迹分析提供了一种分析方法，用于评估对性行为发生率低、进展模式多样的青少年的干预措施。
Behavioral interventions based on the Protection Motivation Theory (PMT) have been demonstrated to reduce HIV risk behavior among mid- and older adolescents in different settings across the globe but have not been evaluated among Caribbean nations and have received limited evaluation among pre-adolescents. To determine (1) the effectiveness among pre-adolescents in The Bahamas of a PMT-based HIV prevention program "Focus on Youth in the Caribbean" (FOYC) and (2) the role of the targeted PMT constructs in intervention effect. 1,360 sixth grade youth (10-11 years of age) from 15 urban schools in New Providence, The Bahamas were randomized by school to receive either FOYC or a control condition. Data collected at baseline, 6 and 12 months post intervention were analyzed. A five-step scheme was used to assess sexual behavior progression, ranging from "1" = "a virgin without intention to have sex" to "5" = "having sex without a condom". Group-based trajectory analysis was utilized in assessing the program effect. Two sexual behavior progression patterns were detected: slow progressors and quick progressors. Receiving FOYC reduced the likelihood for adolescents to become quick progressors (adjusted OR = 0.77, 95% CI: 0.64-1.00). The observed effectiveness was especially impacted by a subset of the targeted PMT constructs. FOYC effectively delays sexual risk among Bahamian pre-adolescents. The group-based trajectory analysis provides an analytical approach for assessing interventions among adolescents with low rates and diverse progression patterns of sexual activity.