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A Randomized Controlled Pilot Study of an HIV Risk-Reduction Intervention for Sub-Saharan African University Students

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Abstract

This pilot study used a randomized controlled trial to test the efficacy of an HIV risk-reduction intervention for university students in Eastern Cape Province, South Africa. Randomly selected second-year students were randomized to one of two interventions based on social cognitive theory and qualitative research: HIV risk-reduction, targeting sexual-risk behaviors; health-promotion control, targeting health behaviors unrelated to sexual risks. Participants completed behavioral assessments via audio computer-assisted self-interviewing pre-intervention, 6, and 12 months post intervention, with 97.2% retained at 12-month follow-up. Averaged over the 2 follow-ups, HIV risk-reduction intervention participants reported less unprotected vaginal intercourse and more frequent condom use than control participants, with greater efficacy in non-South Africans than South Africans. Positive changes were also observed on theoretical mediators of condom use that the intervention targeted. Interventions based on social cognitive theory integrated with qualitative information from the population may reduce sexual risk behaviors among university students in sub-Saharan Africa.

Resumen

Este estudio piloto se utilizó una prueba controlada aleatoria para probar la eficacia de la intervención para reducir el riesgo de VIH entre estudiantes universitarios en la Provincia Oriental del Cabo, Sudáfrica. Estudiantes de segundo año seleccionados al azar fueron asignados a una de dos intervenciones basadas en teoría cognoscitiva social e investigación cualitativa: reducción de riesgo para VIH con atención a conductas de riesgo sexual; promoción de la salud con atención a conductas no relacionas a riesgos sexuales. Los participantes completaron encuestas por medio del uso de computadoras con audio, pre-intervención y 6 y 12 meses post-intervención, con un 97.2% de retención al darse seguimiento 12 meses después. Promediada sobre los 2 seguimientos, participantes de intervención de reducción del riesgo de VIH reportó menos relaciones sexuales sin protección y uso de preservativos más frecuentemente que los participantes de control, con una mayor efectos en aquellos que no eran sudafricano en comparación con los sudafricanos. Cambios positivos fueron también observados en mediadores teóricos del uso del condón. Las intervenciones basadas en la teoría cognitiva social integrada con información cualitativa de la población pueden reducir los comportamientos sexuales de riesgo entre los estudiantes universitarios en el África subsahariana.

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Acknowledgments

The research reported in this article was supported, in part, by grant R34 MH078803 from the National Institute of Mental Health. The authors gratefully acknowledge the assistance of Lynette Gueits, MS, and Jillian Baker, PhD, in developing the interventions, Mandisa Magwa, MS, Phyllis Moore, MSW, Xoliswa Mtose, PhD, and Marcia Penn, MS, in training of facilitators, Janet Hsu, BS, in management of data and data collector training, and Raymond Chiruka, MSc, Jessica Batidzirai, MSc, Arnold Gwaze, MSc, and Show Marange, MSc, in data collection, recruitment, and retention.

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Authors and Affiliations

  1. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 520, Philadelphia, PA, 19104-3309, USA

    G. Anita Heeren & John B. Jemmott III

  2. Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA

    John B. Jemmott III

  3. Department of Anthropology, Haverford College, Haverford, PA, USA

    Zolani Ngwane

  4. Department of Statistics, University of Fort Hare, Alice, South Africa

    Andrew Mandeya & Joanne C. Tyler

Authors
  1. G. Anita Heeren
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  2. John B. Jemmott III
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  3. Zolani Ngwane
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  4. Andrew Mandeya
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  5. Joanne C. Tyler
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Corresponding author

Correspondence to John B. Jemmott III.

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Heeren, G.A., Jemmott III, J.B., Ngwane, Z. et al. A Randomized Controlled Pilot Study of an HIV Risk-Reduction Intervention for Sub-Saharan African University Students. AIDS Behav 17, 1105–1115 (2013). https://doi.org/10.1007/s10461-011-0129-2

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  • DOI: https://doi.org/10.1007/s10461-011-0129-2

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