Enhancing Evidence-Based HIV/STD Prevention Interventions for African American Youth: Addressing Gaps through Review of the Literature

Background:

Many African American adolescents are at increased risk for negative outcomes due to sexual risk behavior (SRB). Evidence-based behavioral interventions (EBIs) remain the most promising approach for reducing sexual risk behaviors. We examined how aligned, EBI approaches are with risk and protective factors that provide greatest evidence of reductions in risk behaviors among African American adolescents.

Objectives: To describe behavior change constructs most likely to influence African American adolescents engaging in health-promoting behaviors for HIV/STD prevention and to identify which constructs are reflected in current EBIs.

Methods: We conducted a literature review on behavioral determinants for SRB among African American adolescents. Next, we conducted a content analysis of seven packaged EBIs developed for African American youth. We identified constructs from behavior change theories to compare literature review findings and content of the EBIs.

Results:

Although all of the EBIs had activities that operationalized the theoretical constructs, equal time was not devoted to all constructs. Analysis showed that perceived norms and environmental constraints were minimally addressed in the EBIs even though these constructs were most frequently associated with sexual risk reduction in the literature. Conversely, EBIs devoted considerable time to skills and self-efficacy, yet significant associations between these constructs and sexual risk behavior reduction were reported less often in the literature.

Conclusions:

Perceived norms, such as those related to peer sexual behaviors, and environmental constraints such as parental monitoring and communication, frequently associated with sexual risk behaviors in the literature than time dedicated to these constructs in the EBIs.

Implications for Programs, Policy, and/or Research: EBIs may be improved through adding activities that address peer norms or incorporate parent monitoring and communication. Reviewing the concordance of the behavioral determinants with the content of EBIs is an important exercise to ensure both research and practice are continuously improved.