Abstract
Effective interventions have been developed to promote STI/HIV protective behaviors among populations most vulnerable to infection, including African-American adolescent females. However, intervention effects show marked and rapid decay following cessation of the intervention. Consequently, the maintenance of protective behaviors for extended periods of time has become a priority for researchers and health professionals. The objective of this report is to describe the use of a supplemental treatment trial design of a behavioral STI/HIV prevention maintenance intervention, which includes a primary treatment (i.e., intervention workshop) followed by an additional treatment (i.e., calls) designed to maintain the effects of the primary treatment. The treatment was tested in a randomized controlled trial among 701 African-American adolescent females, ages 14-20, over a 36-month follow-up period. Upon completion of an evidence-based intervention (primary treatment), participants randomly assigned to the experimental condition received brief, telephone-delivered counseling sessions (supplemental treatment) reinforcing intervention content every 8 weeks over the 36-month follow-up period. Participants randomly assigned to the comparison condition after the primary treatment received time-match health and wellness calls. Experimental condition participants had significantly fewer incident chlamydial infections, and reported higher proportion condom use and fewer instances of sex while intoxicated by alcohol or drugs. Supplemental treatment trials are not frequently used in STI/HIV prevention but may be a promising approach for evaluating behavior change maintenance.
Highlights
Significant disparities in sexually transmitted infections (STIs) and HIV/AIDS exist between African-Americans and other racial/ethnic groups in the United States
In order to achieve significant, long-term decreases in STI/HIV disparities between African-Americans and other racial/ethnic groups in the United States it is critical that intervention effects are sustained over time
Since African-American adolescent females are at increased risk for infection, this vulnerable population remains a primary target for risk reduction intervention efforts
Summary
Significant disparities in sexually transmitted infections (STIs) and HIV/AIDS exist between African-Americans and other racial/ethnic groups in the United States. Preventing new STI/HIV infections among African-American adolescent females has garnered much attention among researchers and healthcare professionals. In response to the observed disparities in STIs and HIV, efficacious interventions targeting African-American adolescent females have been developed and identified as effective in reducing STI/HIV risk [6,7]. Behavioral interventions, such as SISTA [8], SiLHE [9], HORIZONS [10], Enhanced Negotiation [11], and Sister to Sister [12], among others, have demonstrated effectiveness in promoting the adoption of STI/HIV preventive behaviors and have been widely disseminated [13]. Evidence indicates that intervention effects decay rapidly following cessation of the intervention [14,15]
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