Alcohol use as a moderator of HIV prevention intervention efficacy in an African American adolescent female sample

Background: Alcohol use may impair sexual decision-making leading to unprotected sexual intercourse, even in individuals who have participated in an HIV intervention. However, little research has explored alcohol use as moderating HIV intervention efficacy. Thus, we examined the moderating effect of alcohol use on condom use of African American adolescent females completing an HIV intervention program.

Methods: Data were collected via ACASI from 439 African American female adolescents (15-21 years) seeking services at an urban health department prior to and again 6- and 12-months post intervention participation. Alcohol use, psychosocial correlates of risk, and self-reported sexual behaviors were collected. MANCOVAs, controlling for baseline data, were conducted, along with post-hoc follow-up tests.

Results: We observed significant interactions between condition (intervention versus comparison) and alcohol use for proportion of condom-protected sexual episodes in the past 14 days and past 60 days at 12 month follow-up. Specifically, in the past 14 and 60 days, low alcohol users in the intervention group used condoms more consistently (63% and 58%, respectively) than low alcohol users in the control group (41% and 43%, respectively). However, there were no significant differences in the proportion of condom use in the past 14 and 60 days between high alcohol users in the intervention (50% and 52%, respectively) vs. the control group (48% and 47%, respectively).

Conclusion: Findings suggest that intervention efficacy was adversely affected by alcohol use. Thus, to develop more effective HIV interventions for alcohol-using adolescent females requires also directly addressing the important role of alcohol use.