Adolescents' input on the development of an HIV risk reduction intervention.

School of Nursing, University of Rochester, USA.
Journal of the Association of Nurses in AIDS Care (Impact Factor: 1.23). 01/2002; 13(1):21-7. DOI: 10.1016/S1055-3290(06)60238-0
Source: PubMed

ABSTRACT Adolescence is a developmental period often associated with sexual debut as well as risk taking. Given these considerations, HIV prevention interventions need to become an important component of adolescent health care. This article describes the use of formative research to guide intervention refinement. To refine an HIV risk reduction intervention that has been used successfully with adults, the authors conducted focus groups with 30 adolescent females. These participants identified misconceptions regarding HIV-related information and factors that influence motivation to participate in risky behaviors. They also suggested strategies for recruitment and retention in a longitudinal study. Formative research such as this can be used to develop interventions that are gender specific and developmentally and culturally appropriate for adolescents.

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Available from: Dianne Morrison-Beedy, Aug 28, 2014
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    ABSTRACT: Objective: To present the preintervention data collected for a pilot HIV-prevention randomized controlled trial specifically developed for single, sexually active adolescent girls.Design: Comparative, descriptive design using confidential self-administered questionnaires.Setting: An urban family planning clinic that provided gynecologic services to adolescents.Participants: One hundred twenty-nine single, sexually active adolescent girls 15 to 19 years of age (44% minority, 34% economically disadvantaged).Main Outcome Measures: In addition to demographics and risk behaviors, the following were assessed: HIV-related information (i.e., knowledge) and motivation to reduce risk (i.e., perceived vulnerability, readiness to change HIV risk behaviors, behavioral intentions, pros and cons of condom use, and confidence in condom use).Results: Assessments revealed limited HIV-related knowledge, ambivalence regarding risk reduction, and considerable risk behaviors. Compared with girls at lower risk for HIV infection (i.e., consistent condom users), those at higher risk (i.e., inconsistent or non-condom-users) were more likely to be White and older and to have better HIV-related knowledge but less motivation to reduce risk (i.e., behavioral intentions to use condoms, condom-use confidence) than girls at lower risk.Conclusion: These data document (a) the need for HIV prevention interventions targeted to all sexually active adolescent girls and (b) the importance of including a motivational component in the intervention.
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    ABSTRACT: Developing effective prevention programs for women living with HIV/AIDS hinges on understanding and responding to the myriad contexts in which women make sexual decisions. These include the challenges imposed on women by intersecting social inequities that can limit their relationship power, such as gender, racial/ethnic, and economic inequality. Existing behavioral research on the reasons why HIV positive women make sexual decisions is limited in scope, however, and current prevention programs posit male condoms as a panacea for HIV positive women’s complex safer sex needs. This study explored HIV positive women’s experiences of structural violence (oppression) and stress-related growth (growth from adversity) in order to understand better the context of their sexual practices. Methods: The participants included 24 women living with HIV/AIDS who attended skill and peer support groups that were part of the Protect and Respect program. The women were predominantly Black (83%), reported earning less than $10,000/year (80%) and reported acquiring HIV through sex with a male partner (58%). I transcribed 30 group sessions verbatim, editing for clarity only; entered the transcripts into Atlas.ti.5.2, a qualitative software analysis package; and employed analytic strategies of grounded theory and narrative analysis to explore women’s structural violence and stress-related growth experiences. Results: Structural violence manifested in the women’s lives in three primary ways: (1) daily and overwhelming stress; (2) AIDS related stigma; and (3) unhealthy and violent relationships. The women associated these experiences with emotional pain, suffering and substance use. In addition, the participants responded to these challenges through their examples of: (1) stress-related growth; (2) resilience; and (3) resistance. Conclusions: Women’s experiences with structural violence and stress-related growth revealed their barriers and facilitators to having safer sex and suggested that traditional HIV prevention interventions for women living with HIV/AIDS fail to account for women’s challenges and their strengths. The analysis of women’s experiences with structural violence revealed that women have fundamental health and safety challenges that must be addressed in order for them to be able to have safer sex. The analysis of women’s stress related growth experiences revealed that women possess various strengths that are ignored in current HIV prevention programming, but that women associate with their health and ability to have safer sex. These findings suggested that interventions that are not grounded in women’s experiences may do more harm than good by instructing women to engage in behaviors that are unrealistic or harmful in the context of their challenges (e.g., condom use in violent relationships), reinforcing women’s sense of powerlessness, and obscuring the root causes of and solutions for women’s sexual risk practices. I discuss the theoretical, practical, research and methodological implications of these findings, all of which focus on the significance of holistic and multi-leveled prevention strategies for women and addressing the precursors that facilitate or hinder safe sex in prevention programs for women, and not just condom use.

Questions & Answers about this publication

  • Dianne Morrison-Beedy added an answer in In Depth Interviews:
    What is the best rationale ethically for compensation of research participants?

    I am conducting a study that involves focus group discussions, in depth interviews and developing a testing of an intervention with study participants. This will take most of their free time due to demands of the study. I feel I need to compensate them in monetary form. How best Should I do and explain this to ensure it is ethically acceptable?

    Dianne Morrison-Beedy · University of South Florida

    Compensation is standard in a research studies because it speaks to acknowledgment of human dignity- that those who work should be compensated for time and effort in research in the same manner they are compensated for work within our nation.I have compensated young teens based on the average hourly wage  they might receive babysitting or having a part-time job in a store or restaurant and it was really important to acknowledge that they provide data/information that are criticalto understanding the problem under investigation and need to be compensated just as adults are.

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