AEGiS-14IAC: Outcomes of a community-level intervention among adolescents in inner-city housing developments.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Outcomes of a community-level intervention among adolescents in inner-city housing developments.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WeOrD1276)

Sikkema KJ, Hoffmann RG, Brondino MJ, Anderson ES, Felton CG, Roffman RA, Kelly JA, Winett RA, Heckman TG, Solomon LJ, Somlai AM
Yale University School of Medicine, New Haven, United States

BACKGROUND: A randomized, multisite community-level trial was undertaken with ethnically-diverse adolescents living in low-income housing in the U.S.

METHODS: Developments were randomly assigned to one of three conditions: 1) a multi-component community intervention of skills training plus social/peer norm change to reinforce and support risk avoidance; 2) skills training; or, 3) education only. Computer-assisted surveys were administered to 1172 adolescents between the ages of 12 and 17 living in 15 housing developments in 3 urban areas (85% of all adolescents in the 3 areas were assessed). 74% and 65% of adolescents completed the 3- and 9- month follow-up assessments, respectively. Data were analyzed using multilevel, general estimating equations, and nonparametric techniques appropriate for a group-randomized trial.

RESULTS: Average age was 14.5 years and 73% of adolescents had not yet had sexual intercourse. Among sexually active teens, average age of first intercourse was 12.5 years, 46% of females and 70% of males reported multiple partners, half reported inconsistent condom use, 23% had been pregnant, and 9% had an STD. Delayed onset of first intercourse was the primary outcome variable. The proportion of adolescents reporting initiation of first intercourse at the 9-month follow-up was 26% in education only, 23% in skills training, and 17% in community intervention developments (p<.05). The effect for delayed onset of first intercourse was stronger for male adolescents, and was related to age, family structure, and behavioral intentions and outcome expectations both related to risk avoidance.

CONCLUSIONS: A multi-component community-level intervention that included social norm change was shown to be more effective than education or skills training alone in delaying the onset of first intercourse among adolescents. Higher risk youth must be identified earlier and may need more intensive intervention.

Keywords: AEGIS, Housing, Adolescent Behavior, Sexual Partners, Human Development, Coitus, Poverty, Public Housing, Health Education, United States, Adolescent, Human, Female, Male, Adolescence, Pregnancy, nursing, Education

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