Moderation and mediation of an effective HIV risk-reduction intervention for South African adolescents

Ann Behav Med. 2012 Oct;44(2):181-91. doi: 10.1007/s12160-012-9375-4.

Abstract

Background: "Let Us Protect Our Future" is a sexual risk-reduction intervention for sixth-grade adolescents in South Africa. Tested in a cluster-randomized controlled trial, the intervention significantly reduced self-reported intercourse and unprotected intercourse during a 12-month follow-up period.

Purpose: The present analyses were conducted to identify moderators of the intervention's efficacy as well as, which theory-based variables mediated the intervention's effects.

Methods: Intervention efficacy over the 3-, 6-, and 12-month follow-up was tested using generalized estimating equation models.

Results: Living with their father in the home, parental strictness, and religiosity moderated the efficacy of the intervention in reducing unprotected intercourse. Self-efficacy to avoid risky situations and expected parental disapproval of their having intercourse, derived from Social Cognitive Theory, significantly mediated the intervention's effect on abstinence.

Conclusions: This is the first study to demonstrate that Social Cognitive variables mediate the efficacy of a sexual risk-reduction intervention among South African adolescents.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology*
  • Female
  • HIV Infections / prevention & control*
  • Health Promotion*
  • Humans
  • Male
  • Risk Reduction Behavior*
  • Self Efficacy
  • Sexual Behavior / psychology*
  • South Africa