Intervention dose effects on outcomes of a group-level HIV prevention intervention for adjudicated adolescents

BACKGROUND: PALMS is a theater-based HIV prevention intervention for minority adolescents aged 12 to 18 that uses peer actors to model appropriate behavior and facilitates problem-solving and skill-building for protective behaviors. The 3-session group intervention was delivered in juvenile justice and drug treatment facilities. Some youth did not attend all 3 sessions due to court-mandated changes in treatment. Thus attrition from the intervention was not due to participant choice.

METHODS: PALMS was evaluated by non-randomly assigning adolescent males (79% African American, 8% Latino) to intervention and control conditions. Evaluation data were collected at baseline and 6-month follow-up (80% retention). Previously reported findings documented intervention effects on increased HIV knowledge and condom-use knowledge for the whole sample, and on decreased number of sexual partners for participants ages 15-18 not living in facilities at follow-up. We used repeated measures ANOVA to examine differences in outcomes for participants who attended all three sessions (completers) and those who did not (non-completers).

RESULTS: Of 192 adolescents assigned to the intervention, 72% were completers. Completers and non-completers did not differ in age, race, or baseline sex and drug behaviors. Completers had significantly greater increases than non-completers from baseline to follow-up on HIV knowledge (p<.03) and condom-use knowledge (p<.01). Among those not in facilities at follow-up, completers decreased their number of sex partners from 4.2 at baseline to 2.3 at follow-up, versus 3.8 to 3.9 for non-completers (p<.02).

CONCLUSIONS: Multiple group sessions are essential to reinforce HIV knowledge and protective behavior skills-building, particularly with high-risk adolescents.