Examining the impact of timing and frequency of HIV prevention program implementation during early and middle adolescence on protection knowledge and behavior

Background: The development of sexual behaviors and increased exposure to risk behaviors prevalent throughout adolescence underscore the importance of risk prevention especially among younger populations. Few studies, however, have examined the efficacy of risk prevention programs when implemented before the onset of sexual behaviors compared to later in adolescence. The current study examined the importance of increasing protection knowledge and examined the timing and the frequency of intervention delivery. Methods: 599 Bahamian youth participated in an randomized control trial of a HIV prevention intervention, Focus on Youth in the Caribbean (FOYC) in grade six and the randomized control trial of Bahamian Focus on Older Youth (BFOOY) in grade 10. Four groups were examined, those who received 1) both treatment conditions, FOYC and BFOOY; 2) FOYC in grade six and the control intervention in grade 10; 3) the control condition in grade six and BFOOY in grade 10; and 4) both control conditions. Youth were assessed over 60 months on their sexual behaviors, intentions, perceptions and knowledge of condom-use skills. Results: Results showed that those that received both treatments had the greatest increase in condom-use skills. Youth who received only FOYC in grade six had the greatest increase in condom-use self-efficacy. Differences in behavior and intentions were not observed. Conclusions: These results suggest that youth receive the most protection with early and repeated exposure to interventions. Therefore, findings would suggest that educators should consider implementing HIV prevention and risk reduction programs as a fixed component of education curriculum.