Efficacy of Theory-Based HIV Behavioral Prevention Among Rural-to-Urban Migrants in China: A Randomized Controlled Trial

Abstract

Our objective was to evaluate the efficacy of a cultural adaptation of a social cognitive theory-based HIV behavioral prevention program among young rural-to-urban migrants in China. The intervention design and assessment were guided by the Protection Motivation Theory (PMT). The intervention was evaluated through a randomized controlled trial with 6-month and 12-month follow-ups. The primary behavioral outcome was the use of condoms. Other outcome measures include HIV knowledge, condom use knowledge, HIV-related perceptions (PMT constructs), and intention to use condom. The mixed-effects regression models for condom use with regular partners indicated that overall frequency of condom use, condom use in last three sexual acts and proper condom use increased over time for the participants but the increases were significantly greater among the intervention group than the control group at 6-month and 12-month follow-ups. The mixed-effects models for HIV-related perceptions indicated that extrinsic rewards, intrinsic rewards, and response costs decreased while vulnerability, severity, response efficacy, and self-efficacy increased over time for the intervention group. The increases in HIV knowledge, condom use knowledge, and intention to use condom were also significantly greater among the intervention group than the control group. The data in the current study suggested efficacy of a social cognitive theory-based behavioral intervention in increasing condom use among young migrants in China. The intervention also increased protective perceptions and decreased risk perception posited by the theory (i.e., PMT).

The Impact of a Sexual and Reproductive Health Intervention for American Indian Adolescents on Predictors of Condom Use Intention

“…This study adds to the growing body of work directly addressing these deficits [34, 36–39, 40]. Our findings illustrate the importance of developing interventions specific to an American Indian context and which incorporate theoretical components predictive of behavior-change intentions among Native adolescents.…”

“…Adolescents with higher condom use self-efficacy are likely equipped with better communication, and problem-solving skills [34–36]. The increase in condom use self-efficacy among RCL participants is likely attributable to several communication and problem-solving skill-building activities, including role playing communication styles, use of a problem solving tool, and negotiating sexual decision making.…”

Mobility among youth in Rakai, Uganda: Trends, characteristics, and associations with behavioural risk factors for HIV

“…Understanding patterns and characteristics of mobile youth can inform future HIV prevention and treatment interventions in this area. Such interventions should address the unique HIV risks of mobile youth by using an integrated, multi-level approach to acknowledge mobility and its associated risk as products of both the individual and the social context (Camlin et al, 2014; Li et al, 2014; Organista, Carrillo, & Ayala, 2004). As suggested by Deane et al (2010), future work in this area must ‘embrace a more targeted approach to enhance our understandings of the link between mobility and the spread of HIV... and to enable the design of new and more location-specific interventions to mitigate risk enhancement.’ Additionally, HIV risk among mobile populations may not be due to the movement itself, but rather to the unique set of conditions and behaviours that accompany mobility and adaptation to new environments (UNAIDS, 2001).…”

Loneliness and Self‐Esteem in Children and Adolescents Affected by Parental HIV: A 3‐Year Longitudinal Study

“…It is worth noting that many interventions have successfully improved self-efficacy among people living with HIV/AIDS (e.g. Fillipas, Oldmeadow, Bailey, & Cherry, 2006;Li et al, 2014). Self-efficacy is closely related to self-esteem (Judge, Erez, Bono, & Thoresen, 2002).…”

“…Self-efficacy is closely related to self-esteem (Judge, Erez, Bono, & Thoresen, 2002). However, these interventions focused on the change of selfefficacy (Fillipas et al, 2006) or the effect of self-efficacy on behavioral change (Li et al, 2014) and provided little information on the effect of self-esteem on loneliness.…”