Effect of a grade 6 HIV risk reduction intervention four years later among students who were and were not enrolled in the study trial

Abstract

Purpose: To assess the long-term impact of HIV-prevention interventions delivered to youth before sexual initiation and the effects of interventions delivered in nonstudy settings.

Methods: A five-group comparison of HIV knowledge, and condom-use skills, self-efficacy, intentions, and practice among 1,997 grade 10 students attending one of the eight government high schools in Nassau, The Bahamas. Group 1 received an HIV-prevention intervention, Focus on Youth in the Caribbean (FOYC), in grade 6 as part of a randomized trial; group 2 received FOYC as part of the regular school curriculum but outside of the trial; group 3 received the control condition as part of the trial; group 4 received the control condition as part of the school curriculum but outside of the trial; and individuals in group 5 (naive controls) were not enrolled in a school receiving FOYC or the control conditon and did not participate in the trial.

Results: FOYC youth compared with the control youth and naive controls had higher HIV knowledge, condom-use skills, and self-efficacy 4 years later. By subgroups, group 1 demonstrated higher HIV/AIDS knowledge than all groups except group 2, higher condom skills than all groups, and higher condom self-efficacy than Naive Controls. Youth in group 2 demonstrated higher HIV knowledge than youth in groups 3-5. Behavioral effects were not found.

Conclusions: FOYC delivered to grade 6 students continued to have protective effects 4 years later. Positive effects are present among youth who received FOYC as part of the school curriculum but were not enrolled in the trial.

Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

Flowchart of the Study Design and Intersection of Longitudinal Studies #1 and #2 *Youth with uncertain exposure status to FOYC or WW as they were in a FOYC or WW school the year after the intervention was delivered to that school; thus some teachers may have continued to teach some or all of the curricula

Figure 2

Group comparison showing effect four years post intervention according to grade 6 exposure to FOYC and participation in intervention trial (n=1997) Note: Gender and age were used as covariates in mixed effect modeling analysis for significance testing. *p < .05; **p < .01. Legend: Group 1 consisted of youth who received FOYC and were enrolled in Longitudinal Study #1; Group 2 received FOYC but were not enrolled in Longitudinal Study #1; Group 3 received the control condition WW and were enrolled in Longitudinal Study #1; Group 4 received the control condition WW but were not enrolled in Longitudinal Study # 1; and Group 5 consisted of youth who were not exposed to either FOYC or WW , e.g. were “Naïve Controls” .