Documente Academic
Documente Profesional
Documente Cultură
HLTH639
Dr. Niya Werts
Fall 2008
Literature Review
According to the Centers for Disease Control and Prevention, about 18.9 million cases of
sexually transmitted diseases/infections occurred in the United States in 2001. Of the sexually
active population, people aged 15-24 years consist of only 25%. However, in 2001, about half of
sexually transmitted diseases/infections cases took place among this young population (2006).
The Centers for Disease Control and Prevention (1990) reported that African American
youth have the highest chance of getting infected with human immunodeficiency virus (HIV). In
a 2005 survey by the Centers for Disease Control and Prevention (2005), 49% of population
infected with HIV, were African Americans. While studies from the National Institutes of Health
(1997) show that interventions can result in a decrease of risky sexual behaviors in adolescents, it
is still uncertain which specific interventions and who the conductors of the intervention need to
be in order for the program to succeed. Since HIV is caused by unprotected sex the interventions
focused on the individual’s behavior and attitudes. The two methods of interventions
implemented in the article included the abstinence approach which focused on reducing the
amount of sexual intercourse and the safe-sex approach which focused on advocating condom
usage. The control group was a health promotion intervention which educated the students on
various health diseases that is prevalent among African Americans such as heart disease, stroke
According to the Archives of Pediatrics and Adolescent Medicine, in 2001, the incidence
rate of acquired immune deficiency syndrome virus (AIDS) in Latino adolescents was 3 times
higher than the non-Hispanic white population. In addition, results from the national Youth Risk
Behavior Surveillance System showed that Latino adolescents started having sexual intercourse
before the age of 13 and have more multiple partners (greater than 4) compared to the non-
Hispanic white population. Also, the reported condom usage among Latino youth was much less
than the non-Hispanic white population (2006). The purpose of this study was to analyze the
efficacy of prevention interventions that focused on reducing sexual risk behaviors among Latino
youth. The study was a randomized controlled trial from April 2000 to March 2003 and took
place in 3 schools of Northeast Philadelphia. The participants were 684 male and female youth
aged 13 to 18 years of which 553 participants were Latino youth. The intervention included two
types of programs which were both 8-hours long and taught over 2 consecutive Saturdays. The
two types of programs in the intervention were the HIV risk-reduction intervention and the
health-promotion intervention program. The HIV risk-reduction program was based on the social
cognitive theory and the theories of reasoned action and planned behavior. The HIV risk-
abstinence and condom use to prevent sexually transmitted diseases/infections, including HIV
(2006). The health-promotion intervention emphasized the importance of healthy behaviors such
as diet, exercise, physical activity, etc. After the interventions, the participants were required to
complete questionnaires at 3, 6, and 12-month intervals. From the results of this study, it
provided proof of efficacy among the participants in the HIV risk-reduction program by self-
reported numbers of decreased sexual activity and increased condom usage among Latino youth
(2006).
immunodeficiency virus (HIV) sexual risk-reduction interventions among youth. This study
summarized the findings of all the educational, psychological, or behavioral interventions that
supported sexual risk reduction for the purpose of preventing HIV (2003). The information was
collected from 44 studies and 56 interventions that were conducted as of January 2, 2001. From
the data obtained by the interventions, the students who participated in behavioral HIV risk-
reduction interventions showed significantly lower HIV risk due to increased information and
In the Journal of the American Medical Association, there was a randomized controlled
trial study that tested the efficacy of individual face-to-face counseling to reduce the risk of
human immunodeficiency virus (HIV) and other sexually transmitted diseases (STD’s). The
program was called “Project RESPECT” and each participant was designated to 1 of 3
counseling interventions. The interventions took place at five public STD clinics (Baltimore,
MD; Denver, CO; Long Beach, CA; Newark, NJ; and San Francisco, CA) and the participants
included 5758 heterosexual, HIV-negative patients who came into the clinics for STD exams.
intervals. The results from this study concluded that individualized face-to-face interventions can
increase condom use and prevent the incidence of new STD’s when incorporating a personalized
risk reduction plan. Also, this study proved that individual-based counseling can be effective and
trachomatis. This sexually transmitted disease is the most reported infection in the United States
with 3 to 4 million incidents per year (2002). Among female adolescents, the rate of infection is
6 times higher than the national average for all women. The Health Plan Employer Data and
Information Set (HEDIS) made Chlamydia trachomatis screening a measure of the quality of
services delivered by health maintenance organizations (HMO’s) (2002). The purpose of this
intervention was to increase Chlamydia trachomatis screening among sexually active female
adolescents during their routine check-ups at the clinics. The intervention took place at 10
pediatric Kaiser Permanente clinics located in northern California. The participants were
adolescent females aged 14 to 18 years and the data was collected from April 2000 through
March 2002. Of the 10 clinics, 5 random clinics were chosen to provide usual routine check-up
care and the other 5 clinics provided the intervention of Chlamydia trachomatis screening. From
the results of this intervention, it significantly increased the number of Chlamydia trachomatis
screening among sexually active female adolescents receiving routine check-ups at these clinics.
Of the five articles discussed, only one article specifically identified the type of models
and theories the intervention was based upon. The article, “Abstinence and Safer Sex HIV Risk-
Reduction Interventions for African American Adolescents” was based on social cognitive
theory, theory of reasoned action, and theory of planned behavior. Although the article, “Effect
Girls” does not state the foundational theories within the article, it follows the same model and
intervention strategy as the HIV risk-reduction intervention for African American adolescents.
The three other articles, “A Randomized Controlled Trial Testing an HIV Prevention Intervention
for Latino Youth”, “Interventions to Reduce Sexual Risk for the Human Immunodeficiency Virus
Immunodeficiency Virus and Sexually Transmitted Diseases” contained interventions that were
based mostly on the theory of efficacy. Since the theory of efficacy is derived from the Social
Cognitive Theory, all five articles share the theoretical foundations and framework of the
interventions. The most effective and ideal intervention would be to incorporate as many
different theories as possible to obtain accurate evidence and to propose the best solutions.
References:
Jemmott, J., Jemmott, L., & Fong, G. (1998). Abstinence and Safer Sex HIV Risk-Reduction
Interventions for African American Adolescents. Journal of American Medical Association, 279
(19), 1529-1536. Retrieved October 1, 2008, from
http://jama.ama-
assn.org/cgi/content/full/279/19/1529?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&
fulltext=health+intervention&searchid=1&FIRSTINDEX=30&resourcetype=HWCIT
Villarruel, A., Jemmott, J., & Jemmott, L. (2006). A Randomized Controlled Intervention for
Latino Youth. Archives of Pediatrics & Adolescent Medicine, 160 (8), 772-777. Retrieved
October 20, 2008 from
http://archpedi.ama-
assn.org/cgi/content/full/160/8/772?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&ful
ltext=adolescent+std+intervention&searchid=1&FIRSTINDEX=10&resourcetype=HWCIT
Johnson, B., Carey, M., & Marsh, K. et al. (2003). Intervention to Reduce Sexual Risk for the
Human Immunodeficiency Virus in Adolescents, 1985-2000. Archives of Pediatrics &
Adolescent Medicine. 157 (4),
381-388. Retrieved October 20, 2008 from
http://archpedi.ama-
assn.org/cgi/content/full/157/4/381?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&ful
ltext=adolescent+std+intervention&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
Kamb, M., Fishbein, M., & Douglas, J. et al. (1998). Efficacy of Risk-Reduction Counseling to
Prevent Human Immunodeficiency Virus and Sexually Transmitted Diseases. Journal of
American Medical Association, 280 (13), 1161-1167. Retrieved October 20, 2008 from
http://jama.ama-
assn.org/cgi/content/full/280/13/1161?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&
fulltext=adolescents+std+interventions&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
Shafer, M., Tebb, K., & Pantell, R. et al (2002). Effect of a Clinical Pratice Improvement
Intervention on Chlmydial Screening Among Adolescent Girls.
Journal of Americal Medical Association. 288 (22), 2846-2852. Retrieved on October 20, 2008
from
http://jama.ama-
assn.org/cgi/content/full/288/22/2846?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&
fulltext=adolescents+std+interventions&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
Centers for Disease Control and Prevention (2006). STD-Prevention Counseling Practices and
Human Papillomavirus Opinions Among Clinicians with Adolescent Patients. 55 (41), 1117-
1120. Retrieved October 20, 2008 from
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5541a1.htm
National Institute of Allergy & Infections Diseases (2006). HIV Infection in Adolescents and
Young Adults in the U.S. Retrieved October 20, 2008 from
http://www.niaid.nih.gov/factsheets/hivadolescent.htm