Original articleA Human Immunodeficiency Virus Risk Reduction Intervention for Incarcerated Youth: A Randomized Controlled Trial
Section snippets
Methods
In this randomized controlled trial, secure custody facilities were selected to reflect two incarceration systems for young offenders in Ontario, separating youth by age: 12–15 years and 16–18 years. Inclusion criteria were as follows: residence in a young offender secure custody facility during the time of the education program; age 12–18 upon recruitment; no current enrollment in other in-depth HIV education program(s) apart from previously established school health curricula; and ability to
Characteristics of the sample
Study recruitment took place between January 2000 and December 2003. Of the 260 participants eligible for the education program, 85% received that intervention. The retention rate postintervention was 71.6% at 3 months and 59.6% at 6 months. Of the 391 participants, 289 were male and 102 were female, reflecting the proportion of male and female youth in custody in Ontario. Demographics are presented in Table 1.
Baseline demographics, behavioral characteristics, and outcome measures for
Discussion
Baseline data confirm that risk behaviors in the study sample are dramatically different from community norms. Research [39] indicates that among Canadian Grade 11 students (average age 16), 40% of males and 46% of females had engaged in sexual intercourse, compared to more than 90% in our study sample. Similarly, the incarcerated youth in this study reported a younger age at first intercourse, 13.0 years for males and 13.7 years for females, as compared to a mean of 14.1 years for males and
Conclusions and Future Directions
This challenging group of adolescents is clearly at elevated risk for HIV infection and in urgent need of effective prevention programs. Our intervention was effective in improving several areas of HIV knowledge, prevention attitudes, and condom use attitudes, and supports the utility of intensive education interventions incorporating a strong attitudinal and skills-building component. Booster sessions were also shown to sustain effects in certain of the areas of HIV knowledge and prevention
Acknowledgments
The authors thank Catherine Moravac for her important contributions to this study, as well as all the interviewers, other staff, institutions and youth who participated in the study. Funding was provided by the Ontario HIV Treatment Network (OHTN). This study was conducted under the auspices of the Divisions of Adolescent Medicine and Infectious Diseases in the Department of Pediatrics at The Hospital for Sick Children and University of Toronto, and the Department of Public Health Sciences,
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