Title

Relative efficacy of a pregnancy, STI, or HIV prevention-focused intervention on changing sexual risk behavior among young adults

Date of Completion

January 2009

Keywords

Psychology, Social|Health Sciences, General|Health Sciences, Public Health

Degree

Ph.D.

Abstract

Young adults in the U.S. are at an increasing risk for unplanned pregnancy, sexually transmitted infections (STIs), and HIV infection as a result of engaging in unprotected sexual intercourse. Despite efforts to change young adults' sexual risk behavior, perhaps evidence-based interventions developed to date are not as effective as possible because they have focused predominantly on preventing HIV-infection, with fewer interventions focused on preventing unplanned pregnancy or STI infection. Indeed, research indicates that young adults are motivated to use condoms to prevent an unplanned pregnancy or STI, but are relatively less motivated to use condoms to prevent HIV infection. ^ The present study compared the relative efficacy of three brief, theory-based, separately-focused interventions (i.e., pregnancy, STI, or HIV prevention-focused) on increasing condom use behavior and decreasing risky sexual behavior among young adults in a longitudinal, randomized controlled trial. Exposure to one of the three separately-focused interventions was disassociated from collection of the study outcome measures, which were assessed at three time points. A control condition was used as the standard-of-care comparison. Hypothesis 1 predicted that the three separately-focused interventions would be more effective at changing participants' condom use and risky-sexual behavior compared to those in a control condition. Hypothesis 2 predicted that the pregnancy or STI prevention-focused interventions would be more effective at changing participants' condom use and risky-sexual behavior compared to those in the HIV prevention-focused intervention. Inconsistent with Hypothesis 1, participants exposed to one of the three separately-focused interventions (collapsed into a single intervention-group) did not display greater condom use behavior or reduced risky sexual behavior over time compared to those in the control condition. However, consistent with Hypothesis 2, participants exposed to the pregnancy or STI prevention-focused intervention displayed greater condom use behavior and less risky sexual behavior over time compared to those in the HIV prevention-focused intervention. Limitations of the present study, including sample size and those related to the separate-study design, are noted. Implications for future research and public health efforts to design, disseminate, and implement sexual risk-reduction interventions that are most effective at changing young adults' behavior are discussed. ^