A pilot study testing the efficacy of a STD/HIV prevention intervention for pregnant African American adolescents

Background: Unprotected vaginal sex while pregnant places both mother and fetus at risk for STD/HIV and the adverse sequelae associated with these infections. As many adolescents use condoms less frequently during pregnancy, we developed and evaluated an STD/HIV prevention program specifically tailored for newly pregnant African American adolescent females.

Method: A Phase II trials was conducted to assess the efficacy of a pilot culturally-appropriate STD/HIV intervention tailored for sexually active, newly pregnant African American adolescent females (N=87). Data, consisting of sociodemographics, psychosocial mediators, and sexual behaviors, were collected at baseline and 6-months post-intervention. Regression and ANCOVAs, along with post-hoc tests, evaluated differences between the intervention and comparison group at 6-months post-intervention.

Results: Intervention participants significantly increased their condom use behaviors relative to the control group at 6-month follow-up. Specifically, intervention participants, relative to the comparison group, were more likely to use condoms at last intercourse (OR = 3.8) and consistently over the past 30 days (OR = 10.6). Significant group differences favoring the intervention group were also observed for several intervention-targeted mediators: increasing sexual communication frequency (p = .03), enhancing ethnic identity (p = .03), improving ability to refuse sex without a condom (p = .05), and decreasing fear of condom negotiation (p = .06).

Conclusion: Preliminary findings indicate that this culturally-appropriate STD/HIV prevention intervention for African American pregnant adolescents is effective at enhancing STD/HIV preventive behaviors and psychosocial mediators associated with preventive behaviors. A larger trial testing its efficacy and including biological markers is warranted.