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Telephone interventions increased healthy sexual behaviors in teens
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Brief telephone counseling sustained long-term impact from an STI and HIV intervention program from the CDC among black adolescent girls, according to study findings in JAMA Pediatrics.
Ralph J. DiClemente, PhD, of the Rollins School of Public Health at Emory University in Atlanta, and colleagues randomized 701 black girls aged 14 to 20 years to receive HORIZONS, a CDC-defined evidence-based STI and HIV intervention for black adolescent girls, plus supplemental telephone counseling following the intervention or HORIZONS plus telephone counseling on general health information. Study participants were from three clinics that provided sexual health services in Atlanta and had at least one episode of unprotected vaginal sex in the past 6 months. Supplemental treatment consisted of a telephone conversation every 8 weeks for 36 months, totaling 18 telephone contacts during the study period.
Ralph J. DiClemente
HORIZONS is a group-based intervention for black adolescent girls that encourages STI and HIV-preventative behaviors, sexual negotiation and refusal skills, safer sex norms and preventative behaviors.
During the 36-month follow-up, 94 adolescents in the experimental group and 104 in the control group tested positive for chlamydia; 48 adolescents in the experimental group and 54 in the control group tested positive for gonococcal infection.
On average, adolescents in the experimental group were less likely to have incident chlamydial infections (RR=0.5; 95% CI, 0.28-0.88) and gonococcal infections (RR=0.4; 95% CI, 0.15-1.02) than those in the control. Adolescents from both groups who received more telephone contacts had a higher reduction of chlamydia (RR=0.95; 95% CI, 0.9-1.0).
Girls in the experimental group reported a higher proportion of condom-protected sexual acts in the 6 months and 90 days prior to follow-up assessments. Girls in the experimental group also reported fewer episodes of sex while under the influence of drugs or alcohol in the 90 days prior to follow-up. Number of partners in the 6 months prior to follow-up did not significantly differ between the two groups.
“Sustaining the long-term impact of an adapted CDC-defined evidence-based STI/HIV intervention is achievable with brief, tailored telephone counseling. Implementing a prevention maintenance intervention with a 36-month follow-up may be particularly relevant during adolescence, a developmental period characterized by high rates of STIs… Telephone counseling prevention maintenance interventions offer a potentially cost-effective strategy to provide tailored prevention information and behavioral skills coaching to sustain STI/HIV prevention behaviors… However, it is unclear whether these interventions can sustain behavioral change for protracted periods,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
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