New program tackles HIV prevention among Latino adolescents

An HIV prevention program emphasizing both abstinence and condom use may help decrease risky sexual behavior among Latino adolescents, according to a report in the August issue of Archives of Pediatrics & Adolescent Medicine.

HIV and AIDS disproportionately affect Latino youth; the incidence of AIDS was more than three times higher among Latinos than non-Hispanic white teens and adults in 2001, according to background information in the article.

Most Latino adolescents with HIV contract the disease through heterosexual contact. Latino youth are more likely than non-Hispanic white youth to have sexual intercourse before age 13 years and to have more than four sexual partners, and may also be less likely to use condoms than white or African American teens. However, few studies have been conducted to determine effective ways to prevent HIV among Latino youth.

Antonia M. Villarruel, Ph.D., R.N., School of Nursing, University of Michigan, Ann Arbor, and colleagues evaluated the effect of a program designed specifically for Latino youth in 553 adolescents (249 males and 304 females, average age 14.9 years). Between 2000 and 2003, the teens were recruited from high schools and community-based organizations in northeast Philadelphia and then randomly assigned to complete one of two eight-hour programs, one focusing exclusively on HIV prevention and the other a general health-promotion course. Both programs were offered in English and Spanish and included small-group discussions, videos, and interactive and skill-building activities. The HIV prevention program incorporated aspects of Latino culture--such as the importance of family--into sexual health education messages. Participants were surveyed before and immediately after completing the intervention and again three, six and twelve months later.

At the end of the study, participants in the HIV intervention group were significantly less likely to report having sex at all in the previous three months, were less likely to have multiple partners, reported fewer days of unprotected sex and were more likely to say they used condoms consistently than those in the health promotion group. Gender did not affect teens' responses to the program but sexual experience level and primary language did. Among those who were sexually inexperienced at the beginning of the study, those in the HIV prevention group reported fewer days of unprotected sex; those who participated in the Spanish HIV course were five times more likely than those in the Spanish health promotion course to have used a condom the last time they had intercourse and also had a greater proportion of protected vs. unprotected sex.

"Results of this study demonstrate the efficacy of a safer sex intervention in decreasing sexual intercourse and increasing condom use," the authors conclude. "It is an important effort in providing practitioners an evidence base from which to guide and support adolescents in sexual decision making. Much more research is needed with Latino adolescents to address the health disparity in HIV and AIDS."