Moderation and Mediation of an Effective HIV Risk-Reduction Intervention for South African Adolescents
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“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
- 2.UNAIDS. AIDS epidemic update: December 2009. Geneva: Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health Organization (WHO); 2010.Google Scholar
- 3.South African Department of Health. National HIV and syphilis antenatal sero-prevalence survey in South Africa 2005. 2006: Available from: http://www.doh.gov.za/docs/reports-f.html.
- 4.Dorrington RE, Johnson LF, Bradshaw D, Daniel T. The demographic impact of HIV/AIDS in South Africa: National and provincial indicators for 2006. Cape Town: Centre for Actuarial Research, South African Medical Research Council, and Actuarial Society of South Africa; 2006. Available from: http://www.mrc.ac.za/bod/DemographicImpactHIVIndicators.pdf.
- 5.Richter LM. Young people in South Africa: The status of youth report 2003. Pretoria: Human Sciences Research Council; 2005.Google Scholar
- 6.Marshall K, Crepaz N, O’Leary A. A systematic review of evidence-based behavioral interventions for African American youth at risk for HIV/STI infection, 1988–2007. In: McCree DH, Jones KT, O’Leary A, editors. African Americans and HIV/AIDS: Understanding and addressing the epidemic. New York: Springer; 2010. p. 151–80.Google Scholar
- 12.Bandura A. Social foundations of thought and action: A social cognitive theory. Englewood Cliffs: Prentice-Hall; 1986.Google Scholar
- 15.Koniak-Griffin D, Stein JA. Predictors of sexual risk behaviors among adolescent mothers in a human immunodeficiency virus prevention program. J Adolesc Health. 2006;38(3):297e1–11.Google Scholar
- 25.Richardson JB. The socially supportive role of the African American “uncle” in the lives of single-female headed households and at-risk African American youth. In: Johnson JW, editor. Social work with African American males: Health, mental health, and social policy. New York: Oxford University; 2010. p. 81–100.CrossRefGoogle Scholar
- 29.Fitzmaurice GM, Laird NM, Ware JH. Applied longitudinal analysis. New York: Wiley; 2004.Google Scholar
- 31.Aiken LS, West SG. Multiple regression: Testing and interpretating interactions. Newbury Park: Sage; 1991.Google Scholar