Self-efficacy For Condom Use Research Articles

Knowledge, attitude, self-efficacy and estimation of frequency of condom use among Iranian students based on a crosswise model.

This study aimed to evaluate the knowledge, attitude and self-efficacy and condom use among Iranian students. Knowledge, attitudes towards condoms and self-efficacy of condom use questionnaire were translated and back translated. Then content validity ratio (CVR) and content validity index (CVI) questions higher than 0.6 and 0.71 were accepted, respectively. A "crosswise model" was used to estimate condom use. After pretest on 10 students, reliability test was done by test-re-test and Cronbach's α. A multi stage sampling was done for 1500 students in Shahroud universities. They filled in a self administered questionnaire and gave it back to the researcher after 40-50 min. Knowledge, in females was (3.03±1.1) and in males was (3.53±0.83) (p=0.001). Also a small percentage of the students, i.e. 83 girls (9.1%) and six boys (1.1%) had good self-efficacy of condom use (p=0.001). Estimates relating to the use of condoms with a crosswise test showed that 16% of girls (CI=16, 24) and 27% of boys (CI=17, 38) had used a condom during intercourse. It seems that these three important indicators of reproductive health should be incorporated in AIDS control programs and training programs should emphasize it more.

Perceptions of Factors Associated with Condom Use to Prevent HIV/AIDS among Persons with Physical Disability in an Urban Town of Cameroon: A Qualitative Study.

Persons with disabilities have been identified as one of the groups vulnerable to HIV, due to several challenges posed by their disabilities. They also suffer external stigma from their able bodied peers. However, they have largely been ignored as part of HIV prevention programs, largely due to the perceptions that they are not at risk, and information is not being accessible. About 5.4% of the Cameroon population lives with a disability. In Cameroon, no official statistics exist on perception of factors associated with condom use to prevent HIV among persons with disabilities, which creates a challenge for understanding the extent of the pandemic in this population. The objective of this study was therefore to investigate perceptions of factors associated with condom use among persons with physical disability in an urban town of Cameroon. The qualitative study from which this paper is based, used semi-structured in-depth interviews, conducted with a purposive sample of ten (5 male and 5 female) persons with physical disability, aged 18 years and above, in April 2015. The findings of this study as interpreted according to the components of the Health Belief Model, indicated that perceived susceptibility to HIV, perceived severity of HIV, perceived benefit of condom use, perceived barriers to condom use and perceived self-efficacy for condom use were the factors perceived by persons with physical disability, to be associated with condom use. It is therefore recommended that there should be educational programs in HIV/AIDS targeted specifically at persons with physical disability. These programs should pertinently promote the understanding and perceptions of persons with physical disability of the real threat of HIV/AIDS, and also equip them with condom negotiation skills and strategies to overcome barriers to condom use.

Applying the pre-intentional phase of the Health Action Process Approach (HAPA) Model to investigate factors associated with intention on consistent condom use with various types of female sex partners among males who inject drugs in China

ABSTRACTBoth drug injection and sexual transmission are the primary drivers of the HIV epidemic in China. This study investigated the prevalence and associated factors of intention of consistent condom use during sexual intercourse with female regular partners (RP), non-regular partners (NRP) and sex workers (FSW) among male people who inject drugs (PWID)in China. A total of 529 male non-institutionalized PWID aged 18–45 years with negative/unknown HIV status were recruited by multiple methods in Dazhou and Hengyang, China. The constructs of the pre-intention phase of the Health Action Process Approach (HAPA) Model, including partner-specific HIV risk perception, condom use positive outcome expectancies, condom use negative outcome expectancies, and self-efficacy of condom use, were assessed. The prevalence of behavioral intention of consistent condom use with RP, NRP, and FSW was 32.1%, 49.1%, and 63.6%, respectively. In multivariate stepwise analysis, conditional risk perception of HIV transmission via unprotected sex with RP/NRP/FSW was associated with intention of consistent condom use with these types of female sex partners (multivariate odds ratio (ORm) = 3.25–7.06). Condom use negative outcome expectancies were associated with intention of consistent condom use with RP and NRP (ORm = 0.30–0.46), while condom use self-efficacy was associated with intention of consistent condom use with RP and FSW in the next six months (ORm = 2.24–3.81). Male PWID are at high risk of HIV transmission through sexual behaviors. The pre-intention phase of the HAPA model may be applied to plan interventions to increase behavioral intention of consistent condom use with various types of female partners. Such interventions are warranted.

Analysis of related factors for HIV transmission among 263 pairs of male spouses with positive HIV antibodies in Zhejiang province

To identify the status and risk factors of transmission in couples which males was HIV-positive in Zhejiang province. A cross-sectional study was conducted among HIV-serodiscordant couple (male positive) and HIV-seroconcordant couple (male first infected). A self-designed questionnaire was complimented containing basic information, the awareness of infection and HIV-testing, sexual relationship power, self-efficacy of condom use, sex. The univariated and multivariate logistic regression methods were used to analyze the influence factors. A total of 263 couples were enrolled in this study, including 210 HIV HIV-serodiscordant couples and 53 HIV-seroconcordant couples. HIV-positive males aged 30-50 accounted for 57.8% (152 cases) and females under junior high school accounted for 79.1% (208 cases). HIV/AIDS accounted for 41.1% (217 cases). The proportion of man who were diagnosed as HIV, MSM and ever heard HIV were 61.9% (130 cases), 38.3% (80 cases) and 81.9% (172 cases), which were higher than that in HIV positive 47.2% (25 cases), 7.5% (4 cases), 64.2% (34 cases); χ(2)=3.80, 18.33, 7.86;P=0.051, 0.001, 0.005. The results revealed that AIDS patients had high risk to infect their spouse than HIV patients (OR=2.93, 95% CI: 1.05-8.21). Male patients who had ever heard " HIV" before were less likely pass virus to their wives than those who had never heard " HIV" (OR=0.13, 95% CI: 0.04-0.41). Compared with heterosexuality man, homosexuality man' wives had high risk to get virus from their husbands (OR=0.14, 95% CI: 0.03-0.73). Female infected with STIs was the independent factors for HIV infection (OR=4.86, 95% CI: 1.23-19.11). Among the couples of male HIV-positive in Zhejiang Province, the risk of spouses infected with HIV virus has relationship with male disease progression, sexual orientation and awareness of AIDS knowledge. For females who infected with sexual diseases in last 6 months might be infected by their spouses.

Adolescents and parental caregivers as lay health advisers in a community-based risk reduction intervention for youth: baseline data from Teach One, Reach One

ABSTRACTThe purpose of the current study is to describe the demographic, behavioral, and psychosocial characteristics of adolescent and caregiver lay health advisers (LHAs) participating in an intervention designed to reduce risk behaviors among rural African-American adolescents. Teach One, Reach One integrates constructs from the Theory of Planned Behavior and Social Cognitive Theory. It acknowledges that changing the sexual behaviors of African-American adolescents requires changing one's knowledge, attitudes, normative beliefs about the behavior of peers, and self-efficacy regarding adolescent sexual behavior, parent–teen communication about sex, and healthy dating relations among adolescents. Study participants completed baseline questionnaires assessing demographics and psychosocial determinants (knowledge, attitudes, perceived social norms, and self-efficacy) of sexual behaviors. Sixty-two adolescent and caregiver dyads participated. Caregivers included biological parents, legal guardians, or other parental figures. Strengths and areas in need of improvement were determined using median splits. Few adolescents had initiated sex. Their strengths included high levels of open parent–teen communication; positive attitudes and normative beliefs regarding both sex communication and healthy dating relationships; and high knowledge and self-efficacy for healthy dating behaviors. Areas needing improvement included low knowledge, unfavorable attitudes, poor normative beliefs, and low self-efficacy regarding condom use. Caregiver strengths included positive attitudes, normative beliefs, and self-efficacy for sex communication; positive attitudes and self-efficacy for condom use; and low acceptance of couple violence. Areas needing improvement included low levels of actual communication about sex and low knowledge about effective communication strategies and condom use. The current study highlights the value of assessing baseline characteristics of LHAs prior to intervention implementation, as it enables a better understanding of the key characteristics necessary for planning and implementing interventions, as well as engaging in targeted training activities.

Correlates of Sexual HIV Risk Among African American Men Who Have Sex With Men.

We examined correlates of condomless anal intercourse with nonmain sexual partners among African American men who have sex with men (MSM). We recruited social networks composed of 445 Black MSM from 2012 to 2014 in Milwaukee, Wisconsin; Cleveland, Ohio; and Miami Beach, Florida. Participants reported past-3-month sexual behavior, substance use, and background, psychosocial, and HIV-related characteristics. Condomless anal intercourse outside main concordant partnerships, reported by 34.4% of MSM, was less likely in the case of no alcohol and marijuana use in the past 30 days, and higher risk-reduction behavioral intentions. High frequency of condomless anal intercourse acts with nonmain partners was associated with high gay community participation, weak risk-reduction intentions, safer sex not being perceived as a peer norm, low condom-use self-efficacy, and longer time since most recent HIV testing. Condomless anal intercourse with nonmain partners among Black MSM was primarily associated with gay community participation, alcohol and marijuana use, and risk-reduction behavioral intentions.

Adolescent HIV Risk Reduction in the Bahamas: Results from Two Randomized Controlled Intervention Trials Spanning Elementary School Through High School.

To address global questions regarding the timing of HIV-prevention efforts targeting youth and the possible additional benefits of parental participation, researchers from the USA and The Bahamas conducted two sequential longitudinal, randomized trials of an evidence-based intervention spanning the adolescent years. The first trial involved 1360 grade-6 students and their parents with three years of follow-up and the second 2564 grade-10 students and their parents with two years of follow-up. Through grade-12, involvement in the combined child and parent-child HIV-risk reduction interventions resulted in increased consistent condom-use, abstinence/protected sex, condom-use skills and parent-child communication about sex. Receipt of the grade-6 HIV-prevention intervention conferred lasting benefits regarding condom-use skills and self-efficacy. Youth who had not received the grade-six intervention experienced significantly greater improvement over baseline as a result of the grade-10 intervention. The HIV-risk reduction intervention delivered in either or both grade-6 and grade-10 conferred sustained benefits; receipt of both interventions appears to confer additional benefits.

Community Collectivization and Consistent Condom Use Among Female Sex Workers in Southern India: Evidence from Two Rounds of Behavioral Tracking Surveys.

Community collectivization is an integral part of condom use and HIV risk reduction interventions among key population. This study assesses community collectivization among female sex workers (FSWs), and explores its relationship with sex workers’ consistent condom use (CCU) with different partners considering the interaction effect of time and collectivization. Data were drawn from two rounds of cross-sectional surveys collected during 2010 (N1 = 1986) and 2012 (N2 = 1973) among FSWs in Andhra Pradesh, India. Results of the multiple logistic regression analysis show that, CCU with regular and occasional clients increased over the inter-survey period among FSWs with a high collective efficacy (AOR 2.9 and 6.1) and collective agency (AOR 14.4 and 19.0) respectively. The association of high levels of collectivization with CCU and self-efficacy for condom use are central to improve the usefulness and sustainability of HIV prevention programs worldwide.

Identifying Barriers to Human Immunodeficiency Virus Testing for Men Who Have Sex with Men in South Korea

ObjectivesThe principal objective of this study was to identify the barriers to testing for men who have sex with men (MSM) in Korea, something that might prove useful in future studies of this nature. MethodsThis study was conducted at gay bars nationwide in Korea. After considering several offline locations (gay bars) where MSM candidates are commonly located, random recruitment was performed using time–location sampling. A total of 944 individuals participated in this survey. A total sample of 921 cases (23 cases were excluded) was used for analysis. A self-administered questionnaire measuring the individuals' demographics, human immunodeficiency virus (HIV)/AIDS knowledge, stigma, phobia, optimism bias, self-efficacy for condom use, and sexual practices was used. ResultsAbout 61.8% (N = 569) of respondents reported having been tested at least once in their lifetime, and 38.9% (N = 358) acknowledged being tested within the past 12 months. After adjusting for age, education, and number of partners in a logistic regression analysis, awareness of testing place [odds ratio (OR) = 4.04], exposure to HIV prevention campaign (1.54), fear (OR = 1.13), and discrimination toward people with HIV/AIDS (OR = 0.94) were the main factors associated with HIV testing. ConclusionTo accomplish widespread HIV testing for Korean MSM, the accessibility of testing centers and advertisement of voluntary counseling and testing to MSM are needed.

Mediation of an efficacious HIV risk reduction intervention for South African men.

"Men, Together Making a Difference!" is an HIV/STD risk-reduction intervention that significantly increased self-reported consistent condom use during vaginal intercourse compared with a health-promotion attention-control intervention among men (N=1181) in Eastern Cape Province, South Africa. The present analyses were designed to identify mediators of the intervention's efficacy. The potential mediators were Social Cognitive Theory (SCT) constructs that the intervention targeted, including several aspects of condom-use self-efficacy, outcome expectancies, and knowledge. Mediation was assessed using a product-of-coefficients approach where an α path (the intervention's effect on the potential mediator) and a β path (the potential mediator's effect on the outcome of interest, adjusting for intervention) were estimated independently in a generalized estimating equations framework. Condom-use negotiation self-efficacy, technical-skill self-efficacy, and impulse-control self-efficacy were significant mediators. Although not mediators, descriptive norm and expected friends' approval of condom use predicted subsequent self-reported condom use, whereas the expected approval of sexual partner did not. The present results suggest that HIV/STD risk-reduction interventions that draw upon SCT and that address self-efficacy to negotiate condom use, to apply condoms correctly, and to exercise sufficient control when sexually aroused to use condoms may contribute to efforts to reduce sexual risk behavior among South African men. Future research must examine whether approaches that build normative support for condom use among men's friends are also efficacious.

On the Efficacy and Mediation of a One-on-One HIV Risk-Reduction Intervention for African American Men Who Have Sex with Men: A Randomized Controlled Trial.

We examined the efficacy and mediation of Being Responsible for Ourselves (BRO), an HIV/STI risk-reduction intervention for African American men who have sex with men (MSM), the population with the highest HIV-diagnosis rate in the US. We randomized African American MSM to one of two interventions: BRO HIV/STI risk-reduction, targeting condom use; or attention-matched control, targeting physical activity and healthy diet. The interventions were based on social cognitive theory, the reasoned-action approach, and qualitative research. Men reporting anal intercourse with other men in the past 90 days were eligible and completed pre-intervention, immediately post-intervention, and 6 and 12 months post-intervention surveys. Of 595 participants, 503 (85 %) completed the 12-month follow-up. Generalized-estimating-equations analysis indicated that, compared with the attention-matched control intervention, the BRO intervention did not increase consistent condom use averaged over the 6- and 12-month follow-ups, which was the primary outcome. Although BRO did not affect the proportion of condom-protected intercourse acts, unprotected sexual intercourse, multiple partners, or insertive anal intercourse, it did reduce receptive anal intercourse compared with the control, a behavior linked to incident HIV infection. Mediation analysis using the product-of-coefficients approach revealed that although BRO increased seven of nine theoretical constructs it was designed to affect, it increased only one of three theoretical constructs that predicted consistent condom use: condom-use impulse-control self-efficacy. Thus, BRO indirectly increased consistent condom use through condom-use impulse-control self-efficacy. In conclusion, although BRO increased several theoretical constructs, most of those constructs did not predict consistent condom use; hence, the intervention did not increase it. Theoretical constructs that interventions should target to increase African American MSM’s condom use are discussed.

Testing a Risky Sex Behavior Intervention Pilot Website for Adolescents

Each year, teenagers account for about one-fifth of all unintended pregnancies in the United States. As such, delivering sexual risk reduction educational materials to teens in a timely fashion is of critical importance. Web-based delivery of these materials shows promise for reaching and persuading teens away from risky sexual and substance abuse behaviors. The purpose of this study was to pilot test a web-based program aimed at reducing risky sexual behavior and related outcomes among adolescents in a high school setting. A beta-test of the website was conducted in three public schools in New Mexico, USA with 173 students in 9th and 10th grades recruited from existing health education classes. Participants spent approximately three hours over a period of two days completing the online program in school computer labs. Pretest to posttest results indicated that self-efficacy for condom use and condom use intentions, two theoretical mediators of changes in condom use behavior, were significantly changed. Adolescents also reported high satisfaction with the website content. BReady4it provided an innovative sex and substance abuse education to teenagers that revealed promising positive changes in cognitive constructs that are inversely related to risky sexual behavior among users.

HIV Risk Reduction Intervention for Rural Adolescents in Malawi

Malawian adolescents are at risk for HIV infection. Using a quasi-experimental two-group research design, we determined the efficacy of Mzake ndi Mzake Kuunikira Achinyamata (MMKA) in enhancing 13- to 19-year-old Malawian males’ and females’ HIV knowledge, attitude about HIV, self-efficacy for condom use and for safer sex, and HIV risk reduction behaviors. The regression analyses revealed that compared with their cohorts in the control community, the adolescents in the MMKA community had significantly better scores on the outcome variables. The intervention had significant benefits for male and 16- to 19-year-old adolescents but not for 13- to 15-year-old female adolescents. Tailored interventions are needed for these females.

Development and Adaptation of Iranian Youth Reproductive Health Questionnaire

Iran is a young country, and sexual behavior is shaped in this period. This research aimed to provide an assessment tool to evaluate Iranian youth reproductive health. This multistage research was conducted to design a valid questionnaire in the domains of knowledge, attitude, and behavior of the youth in order to evaluate behavior change programs. For this reason, after conducting a careful literature review and a qualitative research, the questionnaire was prepared. Forward and backward translations were performed. Professionals and students were used to make sure of qualitative and quantitative content and face validity. After conducting the pilot study on 100 students and eliminating defects in performance, reliability was evaluated by test-retest and Cronbach's alpha was calculated. In this study, out of 268 questions, 198 were retained after face and content validity. Self-efficacy of communication with father and mother, self-efficacy of condom use, and self-efficacy of abstinence had the highest Cronbach's alpha. Moreover, communication with parents regarding reproductive health issues and attitude to abstinence had a high Cronbach's alpha, as well. It seems to be a good instrument for assessment of Iranian reproductive health, and we are going to assess youth reproductive health in the future.

Correlates of Self-Efficacy for Condom Use Among Male Clients of Female Sex Workers in Tijuana, Mexico

Male clients of female sex workers (FSWs) in Tijuana, Mexico engage in high levels of unprotected sex. While behavioral change theories posit that self-efficacy predicts condom use, correlates of self-efficacy for condom use remain largely unstudied. We examined these correlates among male clients of FSWs in Tijuana. Eligible male clients were at least 18 years of age, HIV-negative, lived in Tijuana or San Diego, reported unprotected sex with a Tijuana FSW at least once in the past 4 months, and agreed to be treated for sexually transmitted infections (STIs). Participants completed an interviewer-administered questionnaire including demographics, substance use, psychosocial and psychosexual characteristics (e.g., outcome expectancies for negotiation of safer sex, social support, and sexual sensation seeking), and sexual behaviors. Participants also underwent HIV/STI testing. A stepwise hierarchical multiple regression analysis identified correlates of self-efficacy for condom use. Of 393 male clients, median age was 37 years. Participants were mostly Spanish-speaking and employed. Factors independently associated with higher self-efficacy for condom use were higher positive outcome expectancies for negotiation of safer sex, lower sexual sensation seeking scores, and higher social support scores. Both psychosocial and psychosexual factors may influence self-efficacy for condom use among male clients of FSWs. These factors represent central constructs in sociocognitive models that explain behavioral change and could be intervention targets for improving self-efficacy for condom use and, ultimately, safer sex behavior.

P3.403 Knowledge, Optimism Regarding Hiv/Aids and Self-Efficacy in Condom Use of the Male Sex Workers in the City of Lisbon: The Results of the Project ”Encontros (In)Seguros”

BackgroundThis project arises from the lack of information about the reality of the sexual male workers in the city of Lisbon and from HIV/AIDS and other IST prevention projects, adapted...

Correlates of consistent condom use among female entertainment workers in Shanghai, China: a repeated measures analysis

Female entertainment workers (FEWs) in China are at increased risk of HIV and other sexually transmitted infections, but correlates of their risky sexual behaviour remain poorly understood. Using data from a series of four surveys, this paper employs repeated measures analysis to identify individual and social correlates of consistent condom use among FEWs in Shanghai. Results reveal that both individual cognitive and social influence factors are statistically significant in their bivariate relationships to consistent condom use with a stable or non-stable partner; only prevention motivation and perceived self-efficacy in condom use remain significant in the multiple regressions. When individual and social correlates are examined together, only peer support for condom use remains a significant and independent correlate of consistent condom use in sex with a non-stable partner. Behavioural intervention is urgently needed and should take a multilevel approach, emphasizing individual prevention motivation and behavioural skills training and promoting peer/social support.

Community collectivization and its association with consistent condom use and STI treatment-seeking behaviors among female sex workers and high-risk men who have sex with men/transgenders in Andhra Pradesh, India

We examine community collectivization among female sex workers (FSWs) and high-risk men who have sex with men and transgenders (HR-MSM) following several years of HIV prevention programming with these populations, and its association with selected outcome indicators measuring individual behaviors (condom use with different partners and sexually transmitted infection [STI] treatment-seeking from government health facilities). Data for this study were collected from a large-scale cross-sectional survey conducted in 2010–2011 among FSWs (sample size: 3557) and HR-MSM (sample size: 2399) in Andhra Pradesh, India. We measured collectivization among FSWs in terms of three binary (low, high) indices of collective efficacy, collective agency, and collective action. Collectivization among HR-MSM was measured by participation in a public event (no, yes), and a binary (low, high) index of collective efficacy. Adjusted odds ratios (adjusted OR) and their 95% confidence intervals (CI) were computed to assess the relationships between collectivization and outcome indicators directly and through mediation of variables such as self-efficacy for condom use and utilization of government health facilities. Results show that among FSWs, high levels of collective efficacy (adjusted OR: 1.3, 95% CI: 1.1–1.7) and collective action (adjusted OR:1.3, 95% CI: 1.1–1.8) were associated with consistent condom use (CCU) with regular clients. Among HR-MSM, participation in a public event (adjusted OR: 2.7, 95% CI: 2.0–3.6) and collective efficacy (adjusted OR: 1.9, 95% CI: 1.5–2.3) were correlated with condom use with paying partners. The association between collectivization and outcome indicators continued to be significant in most cases even after adjusting for the potential mediators. Indicators of collectivization exhibited significant positive association with self-efficacy for condom use and service utilization from government health facilities among both FSWs and HR-MSM. The association of high levels of collectivization with CCU, STI treatment-seeking from government health facilities, ability to negotiate for condom use, and self-efficacy in utilizing government health facilities is relevant to effort to improve the effectiveness and sustainability of HIV prevention programs in India and beyond.

Assessing the impact of intensive programme utilisation on HIV and sexually transmitted infection prevalence among a high-risk population in urban settings of Karnataka: evidence from three cross-sectional surveys, 2005–12

BackgroundWe evaluate the impact since 2003 of the Bill & Melinda Gates Foundation's Indian AIDS initiative, Avahan, in four districts of Karnataka, south India. The programme involved comprehensive outreach, clinical care, and other services to reduce the risk of HIV and other sexually transmitted infections (STIs) among high-risk women and men by promoting behavioural changes. Though there were reviews of the programme performance through periodic cross-sectional surveys, the actual impact of the programme could not be assessed in the absence of a suitable control group. MethodsUsing three rounds of biobehavioural assessment data gathered between 2005 and 2012 in four districts of Karnataka, south India, we used the propensity score matching (PSM) method to demonstrate the true effect of different components of programme exposure on HIV/STI prevalence and consistent condom use with different sexual partners. This method creates a contrafactual group of control individuals who were not exposed to the programme intensively and compares the outcome measures with each respective case that was intensively exposed to the programme. Principal component analysis was used to generate a composite indicator of intensity of programme exposure. FindingsOf the 7071 study individuals, 6364 (90%) received any services from the programme; however, only 4455 (63%) utilised the programme intensively. The PSM analysis indicated that intensive programme utilisation could account for an 18, 11, and 5 percentage point increase in self-efficacy in condom use with clients (p<0·0001), regular partners (p=0·023), and with all partners (p=0·035), respectively, compared with programme utilisation that was not intensive. There was a reduction of 2% (95% CI 1·02–2·34) to 5% (4·86–5·93) prevalence in STIs and about 2% (0·96–2·74) in prevalence of HIV among those who utilised the programme intensively. InterpretationPSM has methodologically gained importance in programme evaluation studies. Findings clearly conclude that programme utilisation could bring effective behavioural change; nevertheless, emphasis should also be placed on intensity of programme utilisation. FundingAvahan, the India AIDS Initiative of the Bill & Melinda Gates Foundation.

Let's Talk!, A South African Worksite-Based HIV Prevention Parenting Program

South African adolescents have high HIV risk, yet few prevention interventions are effective. Parents play a pivotal role in youths' healthy sexual development and may be at risk themselves. We tested whether Let's Talk!, a worksite-based parenting program, improves parent-child communication about HIV and sexual health and parent condom use self-efficacy and behavior. We culturally adapted Let's Talk! in two languages, drawing on formative research and community stakeholder input. We then conducted a small randomized test at a large public worksite in Cape Town, South Africa. The intervention consisted of 5 weekly 2-hour group sessions for parents of youth aged 11-15. Sixty-six parents (64% female) and their 64 adolescents (41% female) completed surveys before and 1-2 weeks post-intervention; surveys assessed comfort with talking about sex, communication about 16 HIV- and sex-related topics, and parents' condom use self-efficacy and behavior. Thirty-four black African (Xhosa language) and 32 coloured (mixed-race; Afrikaans language) parent-child dyads participated. Parents were randomized to intervention (n = 34) and control (n = 32) groups; randomization was stratified by language. Multivariate regressions indicated that the intervention significantly increased parents' comfort with talking to their adolescent about sex, b(SE) = .98(.39), p = .02, and the number of sex- and HIV-related topics discussed with their adolescent, b(SE) = 3.26(1.12), p = .005. Compared with control parents, intervention parents were more likely to discuss new sex- and HIV-related topics not discussed before the intervention, b(SE) = 2.85(.80), p <.001. The intervention significantly increased parents' self-efficacy for condom use, b(SE) = .60(.21), p = .007. Let's Talk! holds promise for improving parent-child communication, a critical first step in preventing HIV among youth.