Do Community HIV Mentors Trained in Evidence-Based, Youth-Focused HIV Prevention Program Have An Effect On Youth Outcomes?
Today, nearly 12 million adolescents and young adults are living with HIV accounting for more than 50% of new infections each year (Gopalan et al., in press). HIV is also the health problem with the largest racial disparity where 80% of all new diagnoses are among African Americans and Latinos (Gopalan et al., in press). Further, a disproportionate number of African American and Latino young adults are diagnosed in their 20s, suggesting infection during adolescence (NYCDOH, 2010). Key barriers for HIV prevention among adolescents at risk of infection include stigma, knowledge about HIV and prevention, and attitudes towards sex. HIV prevention programs have significant difficulties reaching African American and Latino youth within inner-city communities, encounter serious obstacles related to school and community endorsement and find few existing resources for delivery of prevention programs (see McKay & Paikoff, 2007). These barriers are most unfortunate given that prevention scientists have developed and tested a number of sexual risk reduction programs targeting urban minority youth. However, efforts to transport empirically supported prevention programs has been slow. The estimated 17-year “science to service” gap has been attributed to the prioritization of establishment of efficacy using RCTs without consideration for mechanisms for widespread implementation following the completion of the research study (Bruns et al., 2008; Proctor et al., 2011). As a result, the CHAMPions project was designed to addresses this gap. The purpose of this research study was to examine the effect of parent HIV educators trained in evidence-based practices on youth outcomes at post- and follow up, specifically 6 domains including stigma, HIV knowledge, and attitudes about sex.
Methods
A sample of 300 urban parents in New York City were recruited and randomly assigned to train in one of three evidence-based, youth-focused HIV prevention programs co-led by existing community-based mentors and university-trained research staff (n=100 parent HIV educators nested within 4 Bronx middle/early high schools). Following the training in each of the three study conditions, parent HIV educators were assigned to a middle/high school site. Parent HIV educators delivered the program to 600 youth, ages 11 to 16 years.
Results
Quantitative data analysis was conducted using MANOVA tests resulting in statistically significant findings in youths’ outcomes at post-test as well as 18 month follow-up across all three prevention programs (p<.001). Results indicated that youth showed decreases in stigmatization, greater increases in HIV knowledge, and more positive attitudes about sex in all three programs.
Implications
This research suggests that the implementation of three evidence-based, youth-focused HIV prevention programs delivered by trained community members yielded effective results. This study has strong implications for identifying mechanisms for implementing evidence-based programs in real-world settings, specifically those targeting adolescents and young adults at risk for HIV infections.