Psychological and behavioral interventions to reduce HIV risk: evidence from a randomized control trial among orphaned and vulnerable adolescents in South Africa.

Journal: AIDS care

Volume: 28 Suppl 1

Issue: sup1

Year of Publication: 2016

Affiliated Institutions:  a Tulane University School of Social Work, Highly Vulnerable Children Research Center , New Orleans , LA , USA. c Department of Preventive Medicine , Stony Brook Medicine, Health Sciences Center , Stony Brook , NY , USA. d Health Services Research , Louisiana Public Health Institute , New Orleans , LA , USA. e Impact Research International , Pretoria , South Africa.

Abstract summary 

Evidence-based approaches are needed to address the high levels of sexual risk behavior and associated HIV infection among orphaned and vulnerable adolescents. This study recruited adolescents from a support program for HIV-affected families and randomly assigned them by cluster to receive one of the following: (1) a structured group-based behavioral health intervention; (2) interpersonal psychotherapy group sessions; (3) both interventions; or (4) no new interventions. With 95% retention, 1014 adolescents were interviewed three times over a 22-month period. Intent-to-treat analyses, applying multivariate difference-in-difference probit regressions, were performed separately for boys and girls to assess intervention impacts on sexual risk behaviors. Exposure to a single intervention did not impact behaviors. Exposure to both interventions was associated with risk-reduction behaviors, but the outcomes varied by gender: boys reported fewer risky sexual partnerships (β = -.48, p = .05) and girls reported more consistent condom (β = 1.37, p = .02). There was no difference in the likelihood of sexual debut for either gender. Providing both psychological and behavioral interventions resulted in long-term changes in sexual behavior that were not present when either intervention was provided in isolation. Multifaceted approaches for reducing sexual risk behaviors among vulnerable adolescents hold significant promise for mitigating the HIV epidemic among this priority population.

Authors & Co-authors:  Thurman T R TR Kidman R R Carton T W TW Chiroro P P

Study Outcome 

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Statistics
Citations :  Bass J., Neugebauer R., Clougherty K. F., Verdeli H., Wickramaratne P., Ndogoni L., Bolton P. Group interpersonal psychotherapy for depression in rural Uganda: 6-month outcomes. The British Journal of Psychiatry. 2006;(6):567–573. doi: 10.1192/bjp.188.6.567.
Authors :  4
Identifiers
Doi : 10.1080/09540121.2016.1146213
SSN : 1360-0451
Study Population
Boys,Girls
Mesh Terms
Adolescent
Other Terms
HIV prevention;Orphans and vulnerable children;South Africa;evaluation;sexual risk behavior
Study Design
Randomized Control Trial,Case Control Trial,Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
England