The AIDS rate is rapidly increasing among adolescents, with heterosexual contact the primary transmission mode among adolescent girls. Pregnant adolescents and young mothers are a particularly vulnerable population as, often, they engage in unprotected sex and/or have multiple sex partners and, largely, belong to ethnic minorities disproportionately affected by the virus. Effective prevention programs are urgently needed to reduce costs for services to HIV-infected women and their children. The purpose of this quasi- experimental study is to conduct an intensive evaluation of a school- based HIV prevention program aimed at reducing sexual risk behaviors in inner-city pregnant and parenting teens, predominantly of Latino and African-American backgrounds. Participants (400 treatment; 142 comparison) will be recruited from pregnant minor/teen mother programs in four Los Angeles County school districts. Schools will be randomly assigned to the treatment or comparison group, alternating programs on a yearly basis. The treatment group will receive an 8-hour HIV program based on Social Cognitive Theory, the Theory of Reasoned Action, and the Theory of Planned Behavior. The curriculum, based on the CDC model """"""""Be Proud, Be responsible"""""""", is adapted for the targeted population by using feeling of maternal protectiveness to motivate behavior change. Activities include small group discussions, interactive games, viewing of videotapes, skill-building exercises (sexual negotiation and condom use), and a presentation by an HIV-positive mother. The comparison (placebo) group will receive a health promotion program of similar length. Outcome variables (intentions to use condoms, sexual-risk behaviors, AIDS knowledge) and mediating variables (self-efficacy, outcome expectancy, subjective norms, perceived behavioral control) will be measured pre- and immediately post-intervention, and at 3, 6, and 12 months thereafter. Indirect indices of sexual-risk behaviors are unintended repeat pregnancy rates and redemption of condom coupons. The Investigator hypothesizes that treatment group adolescents will have (1) stronger intentions to use condoms, lower sexual-risk behaviors, fewer unplanned repeat pregnancies, and greater AIDS knowledge; and (2) greater perceived self-efficacy and perceived behavioral control to use condoms, and more favorable outcome expectancies and subjective norms, postintervention than the comparison group.
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| Koniak-Griffin, Deborah; Lesser, Janna; Nyamathi, Adeline et al. (2003) Project CHARM: an HIV prevention program for adolescent mothers. Fam Community Health 26:94-107 |
| Koniak-Griffin, Deborah; Lesser, Janna; Uman, Gwen et al. (2003) Teen pregnancy, motherhood, and unprotected sexual activity. Res Nurs Health 26:4-19 |
| Lesser, Janna; Oakes, Rachel; Koniak-Griffin, Deborah (2003) Vulnerable adolescent mothers' perceptions of maternal role and HIV risk. Health Care Women Int 24:513-28 |
