Moderation and Mediation of an Effective HIV Risk-Reduction Intervention for South African Adolescents
“Let Us Protect Our Future” is a sexual risk-reduction intervention for sixth-grade adolescents in South Africa. Tested in a cluster-randomized controlled trial, the intervention significantly reduced self-reported intercourse and unprotected intercourse during a 12-month follow-up period.
The present analyses were conducted to identify moderators of the intervention’s efficacy as well as, which theory-based variables mediated the intervention’s effects.
Intervention efficacy over the 3-, 6-, and 12-month follow-up was tested using generalized estimating equation models.
Living with their father in the home, parental strictness, and religiosity moderated the efficacy of the intervention in reducing unprotected intercourse. Self-efficacy to avoid risky situations and expected parental disapproval of their having intercourse, derived from Social Cognitive Theory, significantly mediated the intervention’s effect on abstinence.
This is the first study to demonstrate that Social Cognitive variables mediate the efficacy of a sexual risk-reduction intervention among South African adolescents.
KeywordsHIV prevention Behavioral intervention Adolescents South Africa Moderation Mediation
The authors appreciate the contributions of Sonya Coombs, Costa Gazi, MD, Nicole Hewitt, Ph.D., Janet Hsu, BA, Shasta Jones, Ph.D., Xoliswa Mtose, MEd, Pretty Ndyebi, Mwezeni Nela, Ph.D., Robert Shell, Ph.D., Lulama Sidloyi, Gladys Thomas, MSW, MBA, Dalena White, MBA, and Tukufu Zuberi, Ph.D. This study was supported by research grant R01 MH065867 from the National Institute of Mental Health to John B. Jemmott III. Some of these data were presented at the XVII International AIDS Conference, Mexico City, August 2008. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
Conflict of interest statement
The authors have no conflict of interest to disclose.
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