The broad objective of the proposed research is to identify effective sustainable interventions to dissuade South African adolescents from engaging in behaviors that increase their risk for sexually transmitted diseases (STDs), including HIV. This is a collaborative effort by a multidisciplinary team of researchers from the US and South Africa to implement a clustered randomized trial. The participants will be 1,072 6th- grade South African adolescents at 16 schools in Mdantsane, Eastern Cape Province, South Africa. We will randomly assign the schools to implement a 12-hour HIV Risk-Reduction Intervention adapted from the Be Proud! Be Responsible! curricula found to be effective with Black adolescents in the U.S., or a 12-hour general health promotion intervention concerning health issues unrelated to sexual behavior that will serve as the control condition. Male and female co-facilitators from the community will lead both interventions. The approach draws on social cognitive theory, the theory of reasoned actiodtheory of planned behavior, the applicants? previous HIV/STD risk-reduction research with inner-city African American adolescents, and formative research with members of the study population. The primary outcome measures are the self- reported frequency of unprotected sexual intercourse, sexual intercourse, and condom use. Secondary outcome measures include theoretically relevant variables hypothesized to mediate intervention effects, including intentions, beliefs, and self-efficacy. We will collect data at baseline, immediately postintervention, and at 3-, 6-, and 12-month follow-up. To address the Specific Aims, we will analyze the data with generalized estimating equations (GEE). For instance, we will examine (a) the effects of the interventions on self-reported sexual behavior and mediators of sexual behavior and (b) whether intervention effects are systematically different depending on key moderator variables, including sexual experience, age, gender, intimate-partner violence, and sexual abuse history. The results of this project will contribute to the development of effective sustainable HIV/STD risk-reduction programs for South African adolescents.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Special Emphasis Panel (ZRG1-AARR-7 (02))
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Brouwers, Pim
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University of Pennsylvania
Other Domestic Higher Education
United States
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Icard, Larry D; Jemmott, John B; Carty, Craig et al. (2017) Retention of South African Adolescents in a 54-Month Longitudinal HIV Risk Reduction Trial. Prev Sci 18:534-540
Teitelman, Anne M; Jemmott, John B; Bellamy, Scarlett L et al. (2016) Partner violence, power, and gender differences in South African adolescents' HIV/sexually transmitted infections risk behaviors. Health Psychol 35:751-760
Jemmott 3rd, John B; Jemmott, Loretta S; O'Leary, Ann et al. (2015) HIV/STI risk-reduction intervention efficacy with South African adolescents over 54 months. Health Psychol 34:610-21
O'Leary, Ann; Jemmott 3rd, John B; Jemmott, Loretta S et al. (2015) Associations between psychosocial factors and incidence of sexually transmitted disease among South African adolescents. Sex Transm Dis 42:135-9
Heeren, G Anita; Icard, Larry D; O'Leary, Ann et al. (2014) Protective factors and HIV risk behavior among South African men. AIDS Behav 18:1991-7
O'Leary, Ann; Jemmott 3rd, John B; Stevens, Robin et al. (2014) Optimism and education buffer the effects of syndemic conditions on HIV status among African American men who have sex with men. AIDS Behav 18:2080-8
Jemmott, L S; Jemmott 3rd, J B; Ngwane, Z et al. (2014) 'Let Us Protect Our Future' a culturally congruent evidenced-based HIV/STD risk-reduction intervention for young South African adolescents. Health Educ Res 29:166-81
O'Leary, Ann; Jemmott 3rd, John B; Jemmott, Loretta Sweet et al. (2012) Moderation and mediation of an effective HIV risk-reduction intervention for South African adolescents. Ann Behav Med 44:181-91
Heeren, G Anita; Jemmott 3rd, John B; Sidloyi, Lulama et al. (2012) Disclosure of HIV Diagnosis to HIV-Infected Children in South Africa: Focus Groups for Intervention Development. Vulnerable Child Youth Stud 7:47-54
Jemmott 3rd, John B; Jemmott, Loretta S; O'Leary, Ann et al. (2011) Cognitive-behavioural health-promotion intervention increases fruit and vegetable consumption and physical activity among South African adolescents: a cluster-randomised controlled trial. Psychol Health 26:167-85

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