A Human Immunodeficiency Virus Risk Reduction Intervention for Incarcerated Youth: A Randomized Controlled Trial

Goldberg, Eudice; Millson, Peggy; Rivers, Stephen; Manning, Stephanie Jeanneret; Leslie, Karen; Read, Stanley; Shipley, Caitlin; Victor, J. Charles

doi:10.1016/j.jadohealth.2008.07.021

« Previous Next »Journal of Adolescent Health
Volume 44, Issue 2 , Pages 136-145, February 2009

A Human Immunodeficiency Virus Risk Reduction Intervention for Incarcerated Youth: A Randomized Controlled Trial

Eudice Goldberg, M.D., FRCPC
- Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
- Address correspondence to: Eudice Goldberg, M.D., F.R.C.P.C., Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
Peggy Millson, M.D., FRCPC
- HIV Social, Behavioral and Epidemiological Studies Unit, Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada
Stephen Rivers, Ph.D., C. Psych.
- Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
Stephanie Jeanneret Manning, B.A.
- Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
Karen Leslie, M.D., FRCPC
- Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
Stanley Read, M.D., Ph.D., FRCPC
- Division of Infectious Diseases, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
Caitlin Shipley, M.S.W.
- Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
J. Charles Victor, M.Sc.
- Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada

Received 21 December 2007; accepted 31 July 2008. published online 07 November 2008.

Abstract

Purpose

To evaluate, by gender, the impact of a structured, comprehensive risk reduction intervention with and without boosters on human immunodeficiency virus (HIV) knowledge, attitudes and behaviors in incarcerated youth; and to determine predictors of increasing HIV knowledge and reducing high-risk attitudes and behaviors.

Methods

This randomized controlled trial involved participants completing structured interviews at 1, 3, and 6 months. Repeated measures analysis of variance was used to analyze changes over time. The study was conducted in secure custody facilities and in the community. The study sample comprising 391 incarcerated youth, 102 female and 289 male aged 12–18, formed the voluntary sample. Participants were randomly assigned to one of three conditions: education intervention; education intervention with booster; or no systematic intervention. The outcome and predictor measures included the Rosenberg Self-Esteem Scale, Youth Self Report, Drug Use Inventory, and HIV Knowledge, Attitudes and Behavior Scale.

Results

The 6-month retention rate was 59.6%. At 6 months, males in the education and booster groups sustained increases in knowledge scores (p < 0.001). Females in these groups sustained increased condom attitude scores (p = 0.004). Males in the booster group sustained increased prevention attitude scores (p = 0.017). Females in the booster group reported more consistent condom use (odds ratio [OR] = 4.20; 95% confidence interval [CI] = 1.81, 9.77). Age, gender, drug use, and psychological profiles were predictive of outcome.

Conclusions

The intervention and boosters led to gender-specific improvements in knowledge, attitudes, and condom use. Result variations by gender underline the importance of gender issues in prevention interventions. Predictors of success were identified to inform future HIV education interventions.

Keywords: HIV prevention, HIV education, Incarcerated youth, HIV prevention and gender, Randomized controlled trial