Cognitive-Behavioral Intervention to Reduce African American Adolescents' Risk for RIV Infection

Two hundred fort y-six African American adolescents were randomly assigned to an educational program or an 8-week intervention that combined education with behavior skills training including correct condom use, sexual assertion, refusal, information provision, self-management, problem solving, and risk recognition. Skill-trained participants (a) reduced unprotected intercourse, (b) increased condom-protected intercourse, and (c) displayed increased behavioral skills to agreater extent than participants who received information alone. The pattems of change diff'ered by gender. Risk reduction was maintained 1 year later for skill-trained youths. It was found that 31.1 % ofyouths in the education program who were abstinent at baseline had initiated sexual activity 1 year later, whereas only 11.5% of skills training participants were sexually active. The results indicate that youths who were equipped with information and specific skilIs lowered their risk to agreater degree, maintained risk reduction changes better, and deferred the onset of sexual activity to agreater extent than youths who received information alone. Although adolescents represent fewer than l % of diagnosed AIDS cases in the United States (Centers for Disease Controi [CDC], 1993), the long latency between initial infection and the later appearance of AIDS means that many AIDS cases di­ agn osed among individuals in their 20s probably reflect adoles­ cent-acquired HIV infection. Heterosexual contact now ac­ counts for the largest increase in reported AIDS cases, and rates