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Participants completed a self-administered questionnaire and an interview, demonstrated condom application skills, and provided specimens for STD testing.

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Outcome assessments were made at 6- and month follow-up. The intervention emphasized ethnic and gender pride, HIV knowledge, communication, condom use skills, and healthy relationships.

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The comparison condition emphasized exercise and nutrition. Participants in the intervention reported using condoms more consistently in the 6 months preceding the 6-month assessment unadjusted analysis, intervention, Using generalized estimating equation analyses over the month follow-up, adolescents in the Girls Harrington sex were more likely to use a condom at last intercourse, less likely to have a new vaginal sex partner in the past 30 days, and more Housewives looking casual sex IL Fox river grove 60021 to apply condoms to sex partners Girls Harrington sex had better condom application skills, a higher percentage of condom-protected sex acts, fewer unprotected vaginal sex acts, and higher scores Girls Harrington sex measures of mediators.

Promising effects were also observed for chlamydia infections and self-reported pregnancy. Adolescents are acknowledged as a population at increased risk of human immunodeficiency virus HIV infection. A seroepidemiologic study of Job Corps applicants reported that HIV prevalence among African American adolescent girls was significantly higher than among their white or Hispanic female peers 4.

African American adolescent girls in the South had the highest prevalence 6. Recent meta-analyses Girls Harrington sex reviews indicate that theoretically derived and empirically based HIV interventions can successfully promote the adoption of protective sexual behaviors among adolescents.

Overall, while African American adolescent girls are disproportionately affected by the HIV epidemic, no intervention designed specifically for this population has demonstrated efficacy in reducing HIV-associated risk behaviors. To address this health disparity, we evaluated the efficacy of an HIV prevention intervention in reducing risky sexual behaviors and sexually transmitted diseases and enhancing skills and mediators of HIV-preventive behaviors among sexually experienced African American adolescent girls residing in the southern United States.

The study was conducted from September to August From December through April Harrjngton, recruiters screened self-identified African American adolescent girls seeking services at 4 community health agencies. Of these, Eligibility criteria included being African American, female, and 14 to 18 years of age; reporting vaginal intercourse Girls Harrington sex the preceding 6 months; and providing written informed consent.

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Girls Harrington sex consent was waived by the IRB. Thus, adolescents Girrls to participate in Secaucus ms free fuck buddy study, completed baseline assessments, and were randomized to study conditions Figure 1. The study was a randomized controlled trial. Assignment to study conditions was conducted subsequent to baseline assessment using concealment of allocation procedures, defined by protocol and compliant with published recommendations.

As participants completed baseline assessments, sealed opaque envelopes were used to execute Girls Harrington sex assignments. Girls Harrington sex were randomly assigned to either the HIV intervention or a general health promotion condition. The research team collaborated with African American adolescent girls in the community to develop the study conditions.

The HIV intervention consisted of four 4-hour interactive group sessions implemented Harringotn consecutive Saturdays at a family medicine clinic.

Each session had an average of 10 to 12 participants and was implemented by a trained African American female health educator and Girls Harrington sex African American female peer educators.

Peer educators were instrumental in modeling skills and creating group norms supportive of HIV prevention. To Girls Harrington sex the likelihood that the effects of the HIV prevention intervention could be attributed to group interaction or Hawthorne effects, participants randomized to the general health promotion condition also received four 4-hour interactive Easton PA sex dating sessions, 2 sessions emphasizing nutrition and 2 sessions emphasizing exercise, administered on consecutive Saturdays.

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Prior to implementing Girls Harrington sex main trial, both Harrrington were field tested with adolescents from the study population. Social cognitive theory 20 and the theory of gender and power 2122 were complementary theoretical frameworks guiding the design and implementation of the HIV intervention.

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Session 1 emphasized ethnic and Adult want real sex Ferron pride by discussing the joys and challenges of being an African American adolescent female, acknowledging the accomplishments of African American women, reading poetry written by African American women, and framing artwork created by African American women artists. Girls Harrington sex 2 enhanced awareness of HIV risk-reduction strategies such as abstaining from sex, using condoms consistently, and having fewer sex partners.

Session 3, through role-play and cognitive rehearsal, enhanced adolescents' confidence in initiating safer-sex Harringotn, negotiating Girls Harrington sex sex, and refusing unsafe sexual encounters. Additionally, peer educators discussed the importance of abstinence and proper and consistent condom use and modeled condom skills. Session 4 emphasized the importance of healthy relationships. Health educators described Girls Harrington sex unhealthy relationships could make it difficult to practice safer sex.

Data collection occurred at baseline and at 6- and month follow-up. At each assessment, data were obtained from 4 sources. First, participants completed a self-administered questionnaire Harrignton sociodemographics and psychosocial mediators of HIV-preventive behaviors.

Subsequently, a trained African American female interviewer administered an interview assessing Girls Harrington sex behaviors. Next, the interviewer assessed participants' ability to correctly apply condoms using a direct observation of skills assessment protocol.

Finally, participants provided 2 self-collected vaginal swab specimens that were analyzed for sexually transmitted diseases.

Self-reported consistent condom use, the primary outcome, was defined as use of a condom during every episode of vaginal intercourse. Consistent condom use was assessed for the 30 days and the 6 months prior to baseline and at Girls Harrington sex 6- and month assessments.

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This outcome was calculated by dividing the total number of episodes of vaginal intercourse by sez total number of times a male condom was used, with a score of 1 representing consistent condom use. Consistent condom use was selected as a primary outcome based on demonstrated evidence of effectiveness in reducing sexually transmitted HIV infection.

Other self-reported behavioral outcomes included 1 condom use at last vaginal intercourse; 2 percentage of condom-protected Slutty older females Greensboro intercourse acts in the 30 days preceding assessment; 3 percentage of condom-protected vaginal intercourse acts in the 6 months preceding assessment; 4 number of unprotected vaginal intercourse acts in the 30 days preceding assessment; 5 number of unprotected vaginal intercourse acts in the 6 months preceding assessment; 6 whether participants Girls Harrington sex a new vaginal sex Girls Harrington sex in the 30 days preceding assessment; and 7 self-reported pregnancy.

Additionally, a single item assessed the frequency with which Girls Harrington sex applied condoms on their sex partners in the past 6 months. Responses Girls Harrington sex from 1 "never" to 5 "every time". These measures of condom use were included to permit comparison with previous HIV interventions conducted among adolescents.

Several techniques were used to enhance the validity of participants' self-reported sexual behaviors. Participants were asked to report their behaviors over relatively brief time intervals to enhance accurate recall 28 and were provided calendars specifying the reporting intervals of interest. To enhance confidentiality, interviewers assured participants that codes rather sexx names would be used on records.

Sexually transmitted disease STD incidence was defined as a positive laboratory test result for a new chlamydia, gonorrhea, or trichomonas infection Harriington either the 6-month assessment or the month assessment. Given the Girls Harrington sex sample size and limited power to detect differences in STD Girls Harrington sex for each assessment interval, incidence for each STD was determined only for the Sexy couples galleries. month follow-up period.

Specimens were collected after all other assessment procedures were completed. Participants Girls Harrington sex 2 vaginal swabs at each of the 3 assessments. Adolescents testing positive for an STD Girlls provided directly observable single-dose treatment, received appropriate risk-reduction counseling per Centers for Disease Control and Prevention recommendations, and were encouraged to refer sex partners for treatment.

The county health department aex notified of reportable Girls Harrington sex. Psychosocial Mediators of Sexual Behavior. Psychosocial mediators were derived from the underlying theoretical frameworks and a review of the empirical literature.

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Constructs were assessed using scales with satisfactory psychometric properties previously used among African American adolescents. Participants' condom application skills Harrungton rated by interviewers using a structured scoring protocol that ranged from 0 to 6, with higher ratings reflecting greater proficiency at applying condoms.

Analyses were performed Girls Harrington sex on prespecified hypotheses using an intention-to-treat protocol in which participants were analyzed in their original assigned Girls Harrington sex conditions irrespective of the number of sessions attended.

The effectiveness of Girls Harrington sex HIV intervention was analyzed Harringtom the entire month period from baseline to the month assessment. Effectiveness was also investigated for the two 6-month periods from baseline to the 6-month assessment and from the 6-month to the month assessment.

The Girls Harrington sex intervention effects analysis for each of the two 6-month assessment periods used logistic regression to compute adjusted odd ratios ORs for dichotomous outcomes 37 and used linear regression 38 to compute adjusted means and mean differences for Horny Richburg women outcomes.

Each Girls Harrington sex these approaches Sexy women want sex tonight Wilmington the corresponding baseline measure for the specific outcome as a covariate in the analysis. To assess HIV intervention effects for the sdx month follow-up period, logistic and linear generalized estimating equation GEE regression models were designed specifically to control for Girls Harrington sex within-subject measurements.

This technique allows for a differential number of observations on study participants over the longitudinal course of observation. These Harrinngton included a time-independent variable study condition as well as time-dependent variables covariates and outcomes.

The models were adjusted for the corresponding baseline measure for each outcome and other covariates to obtain adjusted ORs to assess the effect of the intervention on dichotomous Harringtpn and adjusted mean differences to assess the effect of the Girls Harrington sex on continuous outcomes.

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Additionally, an indicator for the time period was included in the model to capture any unaccounted temporal effects. Fitted GEE parameters can be interpreted as the odds in logistic models or mean difference in linear regression models over the sfx month period for an "average" participant. To obtain adjusted means and mean differences, models were repeatedly estimated from the bootstrap samples where samples were drawn with replacement at the level of the participant.

For each model, adjusted means were calculated and standard errors Girls Harrington sex then calculated from the collection of bootstrap results. Percentage of relative change provides Girls Harrington sex common measure of the magnitude of change across different scale measures relative to the baseline measure.

Of the participants randomized, were allocated Girls Harrington sex the HIV intervention and to the general health promotion condition.

At baseline, significant differences were observed for several variables associated with HIV sexual behaviors and were included as covariates in subsequent analyses. Trained monitors Harringhon all study sessions Girls Harrington sex rated the fidelity of implementation to assess quality assurance.

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Participants' attendance in each condition was high; Wives wants sex Hebo Additionally, participants' confidential ratings of their satisfaction with the delivery and content of each session, assessed using a 5-point scale, indicated comparably high ratings between the HIV intervention ssex [SD], 4.

Of the Girls Harrington sex allocated to the general health promotion condition, Additionally, no differences between study conditions for sociodemographic characteristics were observed at either the 6- or month assessment. Finally, no differences were observed in baseline variables for either study condition in participants retained in the Girls Harrington sex compared with those unavailable for follow-up.

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Hsrrington of the intervention on the primary outcome, consistent condom use, and other dichotomous outcomes Girls Harrington sex presented in Table 2. These analyses were performed separately at the 6-month assessment baseline to 6-month assessmentat the month assessment 6- to month assessmentand over the entire month period baseline to month assessment.

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Relative to participants in the general health promotion condition, participants in the HIV intervention were more likely to report Harington condoms consistently in the 30 Harringron preceding the 6-month assessment unadjusted analysis, intervention, Likewise, participants in the HIV intervention were more likely to report using condoms consistently during the 6 months prior to Girls Harrington sex 6-month assessment unadjusted analysis, intervention, Additionally, participants in the HIV intervention were more likely to report using Housewives wants sex Webbville condom at last vaginal sexual intercourse, less likely to self-report a pregnancy, and less likely to report having a new vaginal sex partner in the 30 days prior to assessments.

The effects of the HIV intervention on other measures of self-reported sexual behavior sdx presented in Table 3 and Table 4. Participants in the HIV intervention were more Really is there any real woman in Lowell Massachusetts to report a significantly higher percentage of condom-protected srx acts in the 30 days and in the 6 months preceding the 6- and the month assessments and over the entire month period.

Additionally, participants in Girls Harrington sex HIV intervention reported significantly fewer unprotected vaginal intercourse episodes in the 30 days and in the 6 months preceding the 6- and Girls Harrington sex month assessments and over the entire month period.

Furthermore, participants in the HIV intervention reported a higher frequency of putting condoms on their partners at Girls Harrington sex 6- and month assessments and over the entire month period.

The crude Grils incidence, by condition, was calculated for chlamydia intervention, 2.

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Girls Harrington sex Results of GEE STD-specific analyses Girls Harrington sex the entire month follow-up period, adjusting for the corresponding baseline variable and covariates, suggest a treatment advantage in reducing chlamydia infections OR, 0.

Intervention effects were not observed for trichomonas OR, 0. The intervention effects reflect adjusted analyses. These findings may result from the relatively small number of incident STDs and missing data for some covariates, which affect the precision and stability of effect estimates.