Lessons learned from adapting an evidence-based intervention for detained African American adolescent girls

Issues: Adolescent girls in juvenile detention have an elevated risk for STDs compared to non-incarcerated peers, yet there remains a deficit of evidence-based interventions for incarcerated girls. Description: To address this disparity, a best-evidence HIV risk-reduction intervention (Horizons) was adapted for use among detained African American adolescent girls aged 13 to 17 years. The adapted intervention (IMARA) was pilot tested with incarcerated girls (N=145) prior to being tested in a randomized controlled trial (RCT) (N=188). Three sources of data were analyzed for this study: 1) qualitative facilitator notes from one-on-one participant sessions, 2) qualitative and quantitative participant evaluations of sessions (RCT), and 3) qualitative exit interviews (n=15) upon study completion (RCT). Data were coded using NVivo for qualitative and SPSS for quantitative data. Presented are: 1) challenges during the pilot intervention with intervention uptake and STD re-infection, 2) solutions incorporated into the RCT intervention addressing those challenges, and 3) participant feedback about main trial intervention components. Lessons Learned: Solutions incorporated into the RCT were adjusting the delivery from one group session to three one-on-one sessions, incorporating computer-based interactive intervention activities, four prevention maintenance counseling sessions delivered by telephone between sessions, and expedited partner therapy for girls diagnosed with STDs. Adjustments implemented in the RCT maintained core elements of intervention content outlined in the original adaptation of IMARA. Session evaluations indicated highly favorable ratings of session content and facilitators. Recommendations: Future programs should intervene both pre- and post-release, helping girls better navigate sexual decision-making once integrated back into their sexual networks.