16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

RANDOMIZED CONTROLLED TRIAL OF AN HIV RISK-REDUCTION INTERVENTION FOR DEPRESSED AFRICAN AMERICAN ADOLESCENTS: A SUBSET ANALYSIS

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. WeAc0203

DiClemente R., Wingood G., Lang D.
Rollins School of Public Health and Center for AIDS Research, Atlanta, United States

BACKGROUND: African American female adolescents have a high prevalence of depression. Depressed adolescents report greater HIV-associated risk behaviors and STIs. Interventions designed for this vulnerable population are urgently needed.

METHODS: This study examines the efficacy of an HIV intervention, previously identified as efficacious, for the subsample of adolescents with scores on the Center for Epidemiologic Studies - Depression scale above the established criterion for depression. Linear and logistic generalized estimating equation models for continuous and categorical data, respectively, were calculated for the 12-month follow-up period, controlling for potential confounders, yielding adjusted means and odds ratios, their 95% confidence interval and corresponding p-value.

RESULTS: Over the 12-month follow-up, participants in the intervention, relative to the time-equivalent comparison condition, reported more consistent condom use in the 30 days preceding assessments (OR=1.78, 95% CI 1.01, 3.13; p=.04) and in the 6 months preceding assessments (OR=2.29, CI 1.24, 4.22; p=008), and at last sexual intercourse (OR=3.80, 95% CI 2.11, 6.82; p=.0001). Further, adolescents in the intervention reported a greater proportion of condom-protected episodes during the 30 days preceding assessments (p=.003) and in the 6 months preceding assessments (p=.0001). There were also substantial differences observed in psychosocial mediators of safer sex, including: greater HIV knowledge (p=.0001), more favorable condom attitudes (p=.0001), lower perceived fewer partner barriers to condom use (p=.002), higher condom self-efficacy (p=.002), and greater proficiency in condom application skills (p=.0001). Most important, adolescents in the intervention had a lower biologically-confirmed incidence of pregnancy (p=.03).

CONCLUSIONS: This is the first study to demonstrate a significant intervention effect for depressed adolescents. Given the high prevalence of depression among this population, the intervention could have a substantial impact in reducing adolescents' vulnerability for HIV infection.

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2006-08-13
WeAc0203

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