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Compendium of Evidence-Based Interventions and
Best Practices for HIV Prevention

Be Proud! Be Responsible!

BEST-EVIDENCE

Intervention Description

Target Population
Inner-city African American male adolescents

Goals of Intervention

  • Increase knowledge and reduce positive attitudes and intentions regarding risky sexual behavior
  • Eliminate or reduce sex risk behaviors

Brief Description

Be Proud! Be Responsible! is a small group skills building and motivational intervention to increase knowledge of AIDS and sexually transmitted diseases (STDs) and to reduce positive attitudes and intentions toward risky sexual behaviors among African-American male adolescents. The intervention consists of one 5-hour session delivered to groups of 5-6 males. The intervention includes facts about HIV/AIDS and risks associated with intravenous drug use and sex behaviors; clarifies myths about HIV; and helps adolescents realize their vulnerability to AIDS and STDs. Videos, games, exercises, and other culturally and developmentally appropriate materials are used to reinforce learning and build a sense of pride and responsibility in reducing HIV risk. Adolescents also engage in role-playing situations to practice implementing abstinence and other safer sex practices, including practicing condom use skills.

Theoretic Basis

  • Social Cognitive Theory
  • Theory of Reasoned Action
  • Theory of Planned Behavior

Intervention Duration
One 5-hour session

Intervention Settings
Local community building

Deliverer
African-American men and women with backgrounds in human sexuality, education, nursing, social work, and small group facilitation. All facilitators had at least a 4-year college degree.

Delivery Methods

  • Exercises
  • Games
  • Group Discussion
  • Lectures
  • Practice
  • Role play
  • Video

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Intervention Package Information

An intervention package is currently available from Select Media

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Evaluation Study and Results

The original evaluation was conducted in Philadelphia, PA between 1988 and 1989.

Key Intervention Effects

  • Reduced risky sex
  • Reduced number of sex partners
  • Reduced unprotected sex
  • Reduced anal sex
  • Increased condom use

Study Sample
The baseline study sample of 157 adolescents is characterized by:

  • 100% African American
  • 100% Male
  • 98% heterosexual, 2% homosexual/bisexual
  • Mean age of 15 years
  • 97% enrolled in high school

Recruitment Settings
Local outpatient medical clinic, high school, and YMCA

Eligibility Criteria
Participants were eligible if they were African-American male adolescents

Assignment Method
Adolescents (N = 157) were randomly assigned to 1 of 2 groups: Be Proud! Be Responsible! (n = 85) or Career-opportunities comparison (n = 72).

Comparison Group
The career-opportunities comparison intervention addressed career planning and opportunities. This intervention was delivered in a single 5-hour session; included small group discussions, exercises, games, and videos; and was facilitated by African-American adults.

Relevant Outcomes Measured and Follow-up Time

  • Sex behaviors during past 3 months (including number of days respondent had sex, number of sex partners, number of sex partners involved with other men, and occurrence of anal sex) were measured at the 3-month follow-up. A risky sexual behavior scale was calculated by combining all sexual risk behavior measures.
  • Condom use during past 3 months (including frequency of condom use scale and number of days of not using a condom during coitus) were measured at the 3-month follow-up.

Participant Retention

  • Be Proud! Be Responsible!
    98% retained at 3 months
  • Career-opportunities comparison:
    93% retained at 3 months

Significant Findings

  • At the 3-month follow-up, adolescents in the intervention group reported significantly less risky sexual behavior (using the combined scale, p < .01) and fewer number of female sex partners (p < .003) than adolescents in the comparison group.
  • At the 3-month follow-up, adolescents in the intervention group reported a significantly fewer days of having sex (p < .008), fewer female sex partners involved with other men (p < .05), and fewer days not using a condom during sex (p < .003). In addition, adolescents in the intervention group were significantly less likely to report engaging in heterosexual anal sex (p < .02) than adolescents in the comparison group at the 3-month follow-up. (While the above findings meet best evidence, these findings meet the GOOD-EVIDENCE criteria.)

Considerations

  • The adolescents in the intervention group reported significantly higher rates of condom use than those in the comparison group at the 3-month follow-up, however, the sample size was too small for this outcome to meet best-evidence or GOOD-EVIDENCE criteria.
  • The 3-month follow-up data revealed that the intervention effect was greater with a female facilitator than a male facilitator for four of the six outcomes reported above (all p’s < .05).

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References and Contact Information

  • Jemmott, J.B. III, Jemmott, L.S., & Fong, G.T. (1992). Reductions in HIV risk-associated sexual behaviors among Black male adolescents: Effects of an AIDS prevention intervention. American Journal of Public Health, 82, 372-377.
  • Jemmott, J.B. III, & Jemmott, L.S. (1996). Strategies to reduce the risk of HIV infection, sexually transmitted diseases, and pregnancy among African American adolescents. In Resnick, R. J. & Rozensky, R. H. (Eds.), Health psychology through the life span: Practice and research opportunities (pp. 395-422). Washington DC: American Psychological Association.

Researcher: Dr. John B. Jemmott III
University of Pennsylvania
Annenberg School for Communication
3535 Market Street, Suite 520
Philadelphia, PA 19104-3309
email: jjemmott@asc.upenn.edu

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