AIDS 2010 - Vienna 18-23 July 2010 - XVIII International AIDS Conference

Preventive Interventions Among Youth	WEAC02

Type:

Oral Abstract Session

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Location:

SR 7

Schedule:

16:30 - 18:00, 21.07.2010

Code:

WEAC02

Chairs:

Frances Cowan, Zimbabwe
Andrew Forsyth, United States

Presentations in this session:

16:30
WEAC0201
Abstract
Slides with audio HIV prevention in young people in Sub-Saharan Africa: a systematic review and update of the evidence evidence
Presented by Aoife M Doyle, United Kingdom
A.M. Doyle, S. Napierala Mavedzenge, D.A. Ross
London School of Hygiene & Tropical Medicine, Epidemiology and Population Health, London, United Kingdom

16:45
WEAC0202
Slides with audio Incentivising behaviour change
Presented by Charlotte Watts, United Kingdom

17:00
WEAC0203
Abstract
Slides with audio An innovative multi-level intervention for HIV prevention in young South African women: pilot of a randomized controlled trial
Presented by Helen Rees, South Africa
C.L. MacPhail¹, A. Pettifor², M. Adato³, K. Kahn⁴, A. Selin⁵, H. Rees⁶, The CCT Working Group
¹Reproductive Health & HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa, ²University of North Carolina - Chapel Hill, Gillings School of Global Public Health, Chapel Hill, United States, ³IFPRI, Washington, United States, ⁴Agincourt Health & Population Unit, University of the Witwatersrand, Johannesburg, South Africa, ⁵University of North Carolina - Chapel Hill, Carolina Population Center, Chapel Hill, United States, ⁶Reproductive Health & HIV Research Unit, Johannesburg, South Africa

17:15
WEAC0204
Abstract
Slides with audio Brief cellphone-delivered counseling as a novel strategy to enhance the maintenance of HIV behavioral intervention efficacy: results from a supplemental treatment effectiveness trial
Presented by Ralph DiClemente, United States
R. DiClemente¹, G. Wingood², E. Rose², J. Sales², T. Latham², J. Hardin³, A. Caliendo⁴
¹Rollins School of Public Health, Emory University, Center for AIDS Research, Atlanta, United States, ²Rollins School of Public Health, Emory University, Atlanta, United States, ³University of South Carolina, Epidemiology & Biostatistics, Columbia, United States, ⁴Emory University School of Medicine, Pathology, Atlanta, United States

17:30
WEAC0205
Abstract
Slides with audio Preventing HIV among juvenile offenders: evidence from randomized and quasi-randomized controlled trials
Presented by Kristen Ann Underhill, United States
K.A. Underhill, D. Operario
Brown University, Department of Community Health, Providence, United States

Rapporteur reports

Track C report by Anne BUVÉ

In this session three reviews were presented of different types of interventions targeting young people.

In 2005 WHO published a review of interventions targeting young people in general and proposed a methodology to formulate recommendations for implementation that did take into account not only strength of evidence, but also cost, acceptability, feasibility and risk of negative effects (Technical report series 938). This review was updated and 23 additional studies were identified that were published between 2005 and 2008 (WEAC0201). Since 2005 there was an increase in studies with a strong design. There was growing evidence for effectiveness of community based intervention under certain conditions.

Incentive based interventions are being implemented for a variety of health problems but so far there is limited experience with this type of interventions for HIV prevention. Five trials were identified that had a reproductive health outcome, including prevalence of sexually transmitted infections; uptake of HIV test result; HIV infection; and intimate partner violence (WEAC0202). One of these trials conducted in Malawi, was presented at this conference in a special session on Sunday 18^th July (SUSA22). The intervention consisted of a cash transfer program for schoolgirls (and young women who had recently dropped out of school) to stay in (and return to) school. At 18 months prevalence of HIV infection and of HSV-2 infection was significantly lower in the intervention group than in the control group. A trial of cash transfers conditional on schooling of young girls is being planned in South Africa (WEAC0203). Main outcome measure will be HIV infection. The trial has a factorial design and will also assess the effects of a community based intervention targeting men aged 18-35.

The third review was on interventions for juvenile offenders (WEAC0205). Eleven studies were identified that had a strong design, i.e. were randomized trials or quasi randomized trials. All studies were from North America. Some interventions were promising suggesting that reducing HIV risk in juvenile offenders is feasible.

Sustaining behavior change after an intervention is a major challenge. In this session an RCT was presented evaluating the effects of a supplemental intervention for Afro-American young women who had been exposed to HORIZONS, an evidence-based behavioral intervention (WEAC0204). The intervention consisted of follow up cell phone contacts. The intervention had an effect on condom use over the whole period of follow-up.

Youth report by Onikepe Oluwadamilola OWOLABI

Youth Session summary

WEAC02

Prevention interventions among youth.

Numerous research studies were presented by the panelists showing the analyzing numerous intervention methods on mainly high risk sexual behavior. Studies were carried out in Africa, one on an African American community in the US and the last on juvenile offenders and 3 of the 5 studies focused on females. They assessed interventions such as conditional cash transfers to increase school attendance and reduce debut age of sex, promote condom use, maintain HIV negative status, undergo voluntary counseling and testing. Also phone call counseling sessions and their effect on sustaining an already present change in behavior, curriculum based interventions (comparing those led by adults, peers and health providers), community led interventions with indices for assessing impact of each of the interventions.

After discussing the studies, some points which clearly stood out include; that the results of behavioral interventions are short lived after the intervention is concluded, and often need some form of follow up or reinforcement to sustain the effects. Also poverty and reduced stay in school is an important risk factor for high risk sexual behavior and HIV in young females, and poor social conditions such as incarceration on the sexual behavior of young males.

Numerous interventions have the potential to have high impact on young people’s behavior, but need more evaluation to determine the strengths and weaknesses of each program and programs need to be adapted to their social context of the affected population. Also multi level interventions are very effective, involving different providers and methods and follow up is essential to see long lasting results [owo].