Ralph DiClemente
Ralph DiClemente
Scroll
Professor of Social and Behavioral Sciences
-
Professional overview
-
Dr. Ralph DiClemente was trained as a Health Psychologist at the University of California, San Francisco where he received his PhD in 1984 after completing a ScM at the Harvard School of Public Health. He earned his undergraduate degree at the City University of New York.
Dr. DiClemente’s research has four key foci:
- Developing interventions to reduce the risk of HIV/STD among vulnerable populations
- Developing interventions to enhance vaccine uptake among high-risk adolescents and women, such as HPV and influenza vaccine
- Developing implementation science interventions to enhance the uptake, adoption and sustainability of HIV/STD prevention programs in the community
- Developing diabetes screening and behavior change interventions to identify people with diabetes who are unaware of their disease status as well as reduce the risk of diabetes among vulnerable populations.
He has focused on developing intervention packages that blend community and technology-based approaches that are designed to optimize program effectiveness and enhance programmatic sustainability.
Dr. DiClemente is the author of ten CDC-defined, evidence-based interventions for adolescents and young African-American women and men. He is the author of more than 540 peer-review publications, 150 book chapters, and 21 books. He serves as a member of the Office of AIDS Research Advisory Council.
Previously, Dr. DiClemente served as the Charles Howard Candler Professor of Public Health at the Rollins School of Public Health at Emory University. He was also Associate Director of the Center for AIDS Research, and was previously Chair of the Department of Behavioral Sciences and Health Education at the Rollins School of Public Health.
Dr. DiClemente is Past President of the Georgia chapter of the Society for Adolescent Health & Medicine. He previously served as a member of the CDC Board of Scientific Counselors, and the NIMH Advisory Council.
-
Education
-
BA, The City College of the City University of New York (CCNY), New York, NYScM, Behavioral Sciences, Harvard University, Cambridge, MAPhD, Health Psychology, University of California San Francisco Center for Behavioral Sciences, San Francisco, CAPostdoctoral Fellow, University of California, San Francisco, CA
-
Areas of research and study
-
Community InterventionsDiabetesHIV/AIDSImplementation scienceInfluenzaPsychology
-
Publications
Publications
Expanding the scope of HIV prevention for adolescents : Beyond individual-level interventions
AbstractDiClemente, R., DiClemente, R. J., & Wingood, G. M. (n.d.).Publication year
2000Journal title
Journal of Adolescent HealthVolume
26Issue
6Page(s)
377-378Abstract~Explaining racial disparities in HIV incidence in black and white men who have sex with men in Atlanta, GA : A prospective observational cohort study
AbstractSullivan, P. S., Rosenberg, E. S., Sanchez, T. H., Kelley, C. F., Luisi, N., Cooper, H. L., DiClemente, R., Wingood, G. M., Frew, P. M., Salazar, L. F., del Rio, C., Mulligan, M. J., & Peterson, J. L. (n.d.).Publication year
2015Journal title
Annals of EpidemiologyVolume
25Issue
6Page(s)
445-454AbstractPurpose: To describe factors associated with racial disparities in HIV (human immunodeficiency virus) incidence among men who have sex with men (MSM) in the United States. Methods: In a longitudinal cohort of black and white HIV-negative MSM in Atlanta, HIV incidence rates were compared by race. Incidence hazard ratios (HRs) between black and white MSM were estimated with an age-scaled Cox proportional hazards model. A change-in-estimate approach was used to understand mediating time-independent and -dependent factors that accounted for the elevated HR. Results: Thirty-two incident HIV infections occurred among 260 black and 302 white MSM during 843 person-years (PY) of follow-up. HIV incidence was higher among black MSM (6.5/100 PY; 95% confidence interval [CI]: 4.2-9.7) than white MSM (1.7/100 PY; CI: 0.7-3.3) and highest among young (18-24years) black MSM (10.9/100 PY; CI: 6.2-17.6). The unadjusted hazard of HIV infection for black MSM was 2.9 (CI: 1.3-6.4) times that of white MSM; adjustment for health insurance status and partner race explained effectively all of the racial disparity. Conclusions: Relative to white MSM in Atlanta, black MSM, particularly young black MSM, experienced higher HIV incidence that was not attributable to individual risk behaviors. In a setting where partner pool risk is a driver of disparities, it is also important to maximize care and treatment for HIV-positive MSM.Exploring evidence for behavioral risk compensation among participants in an HIV vaccine clinical trial
AbstractPainter, J. E., DiClemente, R., Jimenez, L., Stuart, T., Sales, J. M., & Mulligan, M. J. (n.d.).Publication year
2017Journal title
VaccineVolume
35Issue
28Page(s)
3558-3563AbstractBackground HIV vaccine trial participants may engage in behavioral risk compensation due to a false sense of protection. We conducted an ancillary study of an HIV Vaccine Trials Network (HVTN) vaccine efficacy trial to explore risk compensation among trial participants compared to persons who were willing to participate but ineligible based on previous exposure to the Ad5 virus (Ad5+) across three timepoints. Methods Participants were drawn from the Atlanta, GA site of the HVTN 505 vaccine trial. From 2011–2013, all persons who met prescreening criteria for the clinical trial and presented for Ad5 antibody testing were invited to participate in the ancillary study. Data were collected from vaccine trial participants (n = 51) and Ad5+ participants (n = 60) via online surveys across three timepoints: baseline, T2 (after trial participants received 2/4 injections) and T3 (after trial participants received 4/4 injections). Data analyses assessed demographic, psychosocial, and behavioral differences at baseline and changes at each timepoint. Results At baseline, Ad5+ participants were less likely to have some college education (p = 0.024) or health insurance (p = 0.008), and were more likely to want to participate in the vaccine trial “to feel safer having unprotected sex” (p = 0.005). Among vaccine trial participants, unprotected anal sex with a casual partner (p = 0.05), HIV transmission worry (p = 0.033), and perceived chance of getting HIV (p = 0.027), decreased across timepoints. Conclusions Study findings suggest that persons with previous exposure to Ad5 may be systematically different from their Ad5-negative peers. Unprotected anal sex with a casual partner significantly decreased among HIV vaccine trial participants, as did HIV worry and perceived chance of getting HIV. Findings did not support evidence of risk compensation among HIV vaccine trial participants compared to Ad5+ participants.Exploring factors associated with nonchange in condom use behavior following participation in an STI/HIV prevention intervention for African-American adolescent females
AbstractSales, J. M., Brown, J. L., DiClemente, R., & Rose, E. (n.d.).Publication year
2012Journal title
AIDS Research and TreatmentVolume
2012AbstractTo enhance future STI/HIV prevention efforts, this study examined factors associated with adolescents' failure to improve their condom use behaviors after participating in an STI/HIV prevention intervention. African-American adolescent females (N=205; M age = 17.9) in an STI/HIV prevention intervention trial completed ACASI interviews and provided self-collected vaginal swabs to assess two prevalent STIs at baseline and 6 months after intervention. Analyses compared those who increased condom use after intervention (change group) to those whose condom use did not increase (nonchange group). 43.4% did not increase their condom use after the intervention and were more likely to have an STI at followup (χ 2 = 4.64, P =. 03). In a multivariate logistic regression model, the nonchange group was more likely to have (a) higher sensation seeking (AOR =.91, P=.023), (b) a boyfriend (AOR =.32, P=.046), and/or (c) a physical abuse history (AOR =.56, P=.057). There were also differences in the extent to which psychosocial mediators changed between the two groups. Findings highlight the need to tailor STI/HIV interventions to adolescents with a greater degree of sensation seeking and address key relationship characteristics and trauma histories to bolster intervention efficacy.Exploring sleep difficulties, alcohol, illicit drugs, and suicidal ideation among adolescents with a history of depression
AbstractRobbins, R., Weaver, M. D., Quan, S. F., Logan, R. W., Czeisler, C. A., & DiClemente, R. (n.d.).Publication year
2024Journal title
Psychiatry ResearchVolume
340AbstractSleep difficulties and misuse of drugs/alcohol have been associated with suicidal ideation in young people. Using cross-sectional representative surveys of adolescents in the United States, we conducted adjusted logistic regression modeling to assess the relationships between sleep difficulties, substance use, and suicidal ideation among adolescents with a history of depression (n = 38,418) between 2015 and 2020. Sleep difficulties were associated with thinking about (aOR=1.6,95%CI:1.3–1.9), planning (aOR=1.8,95%CI:1.2–2.6), or attempting (aOR=1.7,95%CI:1.2–2.5) suicide. In those reporting alcohol abuse/dependence, sleep difficulties were associated with attempting suicide (aOR=3.1,95%CI:1.2–8.5). In those reporting illicit drug abuse/dependence, sleep difficulties were associated with thinking about (aOR=2.1,95%CI:1.1–4.1) and attempting (aOR=2.2,95%CI:1.2–4.1) suicide.Exploring sleep difficulties, alcohol, illicit drugs, and suicidal ideation among adolescents with a history of depression
AbstractDiClemente, R., Robbins, R., Weaver, M., Quan, F., Logan, R., & Czeisler, C. (n.d.).Publication year
2024Volume
Psychiatry Research, Vol 340Abstract~Exploring substance misuse behaviors among black girls in detention : Intersections of trauma, sex, and age
AbstractQuinn, C. R., Boyd, D. T., Menon, S. E., Mitchell, M., Radney, A., Coker, E. J., Lloyd Allen, J., Simmons-Horton, S., Hughley, A., DiClemente, R., & Voisin, D. R. (n.d.).Publication year
2023Journal title
Addictive BehaviorsVolume
143AbstractHigh risk substance misuse, trauma and gang involvement are prevalent in adolescents and often occur with youth involved with the youth punishment system. Evidence suggests that system involvement is related to trauma histories, substance misuse, as well as gang involvement. This study investigated the associations between individual and peer factors and their relationship to problem drug and alcohol use among Black girls involved with the youth punishment system. Data were collected from 188 Black girls in detention at baseline, as well as 3 and 6 month follow up periods. Measures assessed were abuse history, trauma history, sex while using drugs and alcohol, age, government assistance, and drug use. Significant findings from the multiple regression analyses indicated that younger girls were more likely to have a higher prevalence of having a drug problem than older girls at baseline. Having sex while on drugs and alcohol at the 3 month follow up period was correlated with drug use. These findings highlight how individual and peer factors can influence problem substance misuse, their behavior and peer relationships among Black girls in detention.Exploring the mediating mechanism between gender-based violence and biologically confirmed chlamydia among detained adolescent girls
AbstractSalazar, L. F., Crosby, R. A., & DiClemente, R. (n.d.).Publication year
2009Journal title
Violence Against WomenVolume
15Issue
3Page(s)
258-275AbstractThe study examined several behavioral mechanisms that link gender-based violence (GBV) to STD among detained, sexually active adolescent girls. Girls (N = 198) were recruited from eight youth detention facilities. Measures were assessed using audiocomputerĝ€"assisted self-interviewing. DNA amplification was conducted to assess for chlamydia. Thirty-one percent had experienced GBV and 15% tested positive for chlamydia. GBV was related to chlamydia directly and indirectly through condom failures and through having sexual intercourse while high on drugs and/or alcohol. The study found that sexual risk reduction programs may benefit this population by addressing the role of GBV and its association with STD-associated behaviors.Exploring why young African American women do not change condom-use behavior following participation in an STI/HIV prevention intervention
AbstractDiClemente, R., Sales, J. M., Diclemente, R. J., Davis, T. P., & Sullivan, S. (n.d.).Publication year
2012Journal title
Health Education ResearchVolume
27Issue
6Page(s)
1091-1101AbstractHuman immunodeficiency virus (HIV) interventions can significantly reduce risky sexual behaviors among vulnerable populations. However, not everyone exposed to an intervention will reduce their sexual risk behavior. This qualitative study sought to identify factors associated with young African American females' lack of increase in condom use post-participation in an HIV prevention intervention. Semi-structured interviews were conducted with 50 young African American women (18-23 years; approximately half were mothers) after participating in a demonstrated effective HIV prevention intervention; 24 did not increase condom use post-intervention. Interviews were thematically coded for barriers to condom-use post-intervention. Although nearly all young women reported partner-associated challenges to using condoms, there were relational differences observed among those who changed their condom use versus those who did not. Many 'non-changers' were engaged in non-stable 'on and off' relationships, with high rates of infidelity, often with the father of their child, in which they were fearful of requesting condom use. 'Non-changers' also reported more substance use, feeling incapable of change and not thinking about condom use. Thus, future HIV prevention efforts may benefit from incorporating strategies on how young mothers can maintain a non-sexual relationship with their child's father, as well as elaborating on the intersection of substance use and risky sexual decision-making.Exposure to alcohol problems and its association with sexual behaviour and biologically confirmed Trichomonas vaginalis among women living with HIV
AbstractDiClemente, R., Seth, P., Wingood, G. M., & DiClemente, R. J. (n.d.).Publication year
2008Journal title
Sexually transmitted infectionsVolume
84Issue
5Page(s)
390-392AbstractObjectives: Only a small number of studies have examined the association between alcohol use and risky sexual behaviour among women living with HIV, particularly African-American women. The present study examined the association between alcohol problems, sexual behaviour and biologically confirmed sexually transmitted infections (STI) among a sample of predominantly African-American women living with HIV. Methods: A sample of 366 women living with HIV between the ages of 18 and 50 years participated in the study. The majority of women were African-American (84.2%). Participants completed a face-to-face interview assessing sociodemographics, sexual behaviour, other substance use and alcohol problems using the CAGE (Cut down, Annoyed, Guilty, Eye opener), a screening measure for alcohol abuse. Participants also provided self-collected vaginal swab specimens that were assayed for STI. Results: The prevalence of high scores on the CAGE was 54.5% and 15% of women tested positive for Trichomonas vagínalis. Multivariate logistic regression analyses, with age and other substance use as covariates, indicated that women who scored higher on the CAGE, relative to those who scored lower, were more likely to test positive for T vaginalis, have sex with their spouse or steady partner when only they had been drinking and have sex with their spouse or steady partner when they had both been drinking. Conclusions: These findings suggest that alcohol assessment should be included in regular healthcare maintenance among women living with HIV. Intervention programmes should be tailored to address alcohol use/ abuse among African-American women living with HIV.Exposure to High-Risk Genital Human Papillomavirus and Its Association with Risky Sexual Practices and Laboratory-Confirmed Chlamydia Among African-American Women
AbstractSeth, P., Wingood, G. M., Robinson, L. S., & DiClemente, R. (n.d.).Publication year
2009Journal title
Women's Health IssuesVolume
19Issue
5Page(s)
344-351AbstractBackground: Genital human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States and African-American women have the highest prevalence of high-risk HPV. This study examined exposure to high-risk HPV in African-American women and its relation to risky sexual practices and laboratory-confirmed chlamydia. Methods: A sample of 665 African-American women between 18 and 29 years old, recruited from October 2002 to March 2006 in Atlanta, Georgia, completed an Audio Computer-Assisted Survey Interview assessing sociodemographics, health practices, and risky sexual practices. Participants also provided vaginal swab specimens assayed for STIs and high-risk HPV. Results: The overall prevalence of high-risk HPV was 38.9%. Among women 18 to 24 years old, it was 42.4%; it was 31% among women 25 to 29 years old. Age-stratified logistic regression analyses indicated that women between the ages of 18 and 29 and 18 and 24 who had multiple male sexual partners did not use a condom during their last casual sexual encounter and tested positive for chlamydia were significantly more likely to test positive for high-risk HPV. Women 18 to 24 years old who reported having a casual or risky sexual partner were significantly more likely to test positive for high-risk HPV. No significant correlates were identified among women 25 to 29 years old. Conclusions: Programs should aim to educate, decrease risky sexual practices, and increase screening and treatment for STIs among women with high-risk HPV infections. HPV vaccination recommendations for young adult African-American women warrant special consideration.Exposure to tobacco on the internet : Content analysis of adolescents' internet use
AbstractJenssen, B. P., Klein, J. D., Salazar, L. F., Daluga, N. A., & DiClemente, R. (n.d.).Publication year
2009Journal title
PediatricsVolume
124Issue
2Page(s)
e180-e186AbstractOBJECTIVE: We performed a content analysis of all Web pages viewed by a random sample of adolescents to describe exposure to tobaccoand smoking-related text and images. METHODS: Adolescents (14-17 years of age) with home Internet access were recruited. Internet-tracking software was installed on home computers used by 346 eligible consenting participants. All Web pages viewed by adolescent participants were captured during a 30-day period for each subject. Keywords on smoking and tobacco were used to identify tobacco images or text. RESULTS: The 346 participants viewed 1.2 million Web pages, of which 8702 (0.72%) contained tobacco or smoking content. Exposure to tobacco content did not vary according to smoking status. Content was protobacco on 1916 pages, antitobacco on 1572, and complex or unclear on 5055. Social networking sites, mainly MySpace, represented 53% of pages (n = 4612) on which tobacco content was found. All pages with smoking content contained references in text, and 256 (3%) contained images. Many (43%) of the adolescents were exposed to protobacco imagery (median: 3 pages per month). Cigarettes were mentioned on 20% of pages. Tobacco products were sold on 50 pages, and 242 pages contained links to tobacco products sold on other pages. On social networking sites, 4121 pages included a mention of smoking status in the authors' individual profiles, with 23% of authors identifying themselves as smokers. CONCLUSIONS: Many adolescents are consistently exposed to tobacco content on the Internet, but the volume of exposure is limited and not all content represents protobacco content.Exposure to X-rated movies and adolescents' sexual and contraceptive-related attitudes and behaviors
AbstractWingood, G. M., DiClemente, R., Harrington, K., Davies, S., Hook, E. W., & Oh, M. K. (n.d.).Publication year
2001Journal title
PediatricsVolume
107Issue
5Page(s)
1116-1119AbstractObjectives. To examine the association between exposure to X-rated movies and teens' contraceptive attitudes and behaviors. Methods. Black females, 14 to 18 years old (n = 522) were recruited from adolescent medicine clinics, health departments, and school health clinics. Results. Exposure to X-rated movies was reported by 29.7% of adolescents. Exposure to X-rated movies was associated with being more likely to have negative attitudes toward using condoms (odds ratio [OR]: 1.4), to have multiple sex partners (OR: 2.0), to have sex more frequently (OR: 1.8), to not have not used contraception during the last intercourse (OR: 1.5), to have not used contraception in the past 6 months (OR: 2.2), to have a strong desire to conceive (OR: 2.3), and to test positive for chlamydia (OR: 1.7). Conclusions. Additional research is needed to understand the impact of X-rated movies on adolescents' sexual and contraceptive health.Factors Associated with HIV Testing among African American Female Adolescents in Juvenile Detention Centers
AbstractSeth, P., Raiford, J., & DiClemente, R. (n.d.).Publication year
2016Journal title
AIDS and BehaviorVolume
20Issue
9Page(s)
2010-2013AbstractBackground: Little is known about sexual and psychosocial factors associated with HIV testing among detained African American female adolescents—an understudied group at risk for HIV. Methods: 188 detained African American female adolescents completed assessments on HIV testing, sexual risk behaviors, and psychosocial factors. Results: Unprotected vaginal sex, history of STI-positivity or pregnancy, higher STI knowledge, and lower partner availability were associated with a higher likelihood of ever being tested for HIV. Discussion: HIV testing is the gateway to important services for high-risk HIV-positive and HIV-negative adolescents. More research is needed to address barriers and to inform programmatic changes to increase testing among youth.Factors associated with multiple sex partners among junior high school students
AbstractDurbin, M., DiClemente, R., Siegel, D., Krasnovsky, F., Lazarus, N., & Camacho, T. (n.d.).Publication year
1993Journal title
Journal of Adolescent HealthVolume
14Issue
3Page(s)
202-207AbstractTwenty-one percent of a sample of inner-city junior high school students were found to be sexually active (n = 403). Only 31% of them reported a single lifetime sexual partner, 25% reported two partners, and 43% reported three or more partners. Logistic regression analysis evaluated the influence of demographic, psychosocial, and behavioral factors on the adolescents' lifetime number of sex partners. Respondents whose sexual debut occurred before age 13 years were nine times more likely to report three or more sex partners compared with those whose first sexual intercourse was at age 15 or 16 years, blacks were four times more likely than non-Hispanic whites to report three or more sex partners; and males were four times as likely as females to report this number of sexual partners. Factors not independently associated with the number of sex partners included: age, Asian or Hispanic ethnicity, human immunodeficiency virus (HIV) knowledge, self-efficacy (belief that one can protect oneself from the virus), condom use, and alcohol and drug use. We conclude that a significant proportion of school-based middle adolescents are sexually active and that most of these are at risk for contracting HIV because of behaviors such as having multiple sexual partners. Topics often stressed in school-based HIV education, such as factual knowledge about HIV, avoiding drugs and alcohol, and condom use are not associated with adolescents' choice about their number of sex partners. Intervention programs will have to identify and then target each specific HIV risk behavior and its motivations in order to reduce adolescents' risks of contracting and transmitting the disease.Factors associated with phosphatidylethanol (PEth) sensitivity for detecting unhealthy alcohol use : An individual patient data meta-analysis
AbstractHahn, J. A., Murnane, P. M., Vittinghoff, E., Muyindike, W. R., Emenyonu, N. I., Fatch, R., Chamie, G., Haberer, J. E., Francis, J. M., Kapiga, S., Jacobson, K., Myers, B., Couture, M. C., DiClemente, R., Brown, J. L., So-Armah, K., Sulkowski, M., Marcus, G. M., Woolf-King, S., … Saitz, R. (n.d.).Publication year
2021Journal title
Alcoholism: Clinical and Experimental ResearchVolume
45Issue
6Page(s)
1166-1187AbstractBackground: Objective measurement of alcohol consumption is important for clinical care and research. Adjusting for self-reported alcohol use, we conducted an individual participant data (IPD) meta-analysis to examine factors associated with the sensitivity of phosphatidylethanol (PEth), an alcohol metabolite, among persons self-reporting unhealthy alcohol consumption. Methods: We identified 21 eligible studies and obtained 4073 observations from 3085 participants with Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) positive scores (≥3 for women and ≥4 for men) and PEth measurements. We conducted 1-step IPD meta-analysis using mixed effects models with random intercepts for study site. We examined the associations between demographic (sex, race/ethnicity, and age) and biologic (body mass index—BMI, hemoglobin, HIV status, liver fibrosis, and venous versus finger-prick blood collection) variables with PEth sensitivity (PEth≥8 ng/ml), adjusting for the level of self-reported alcohol use using the AUDIT-C score. Results: One third (31%) of participants were women, 32% were African, 28% African American, 28% White, and 12% other race/ethnicity. PEth sensitivity (i.e., ≥8 ng/ml) was 81.8%. After adjusting for AUDIT-C, we found no associations of sex, age, race/ethnicity, or method of blood collection with PEth sensitivity. In models that additionally included biologic variables, those with higher hemoglobin and indeterminate and advanced liver fibrosis had significantly higher odds of PEth sensitivity; those with higher BMI and those living with HIV had significantly lower odds of PEth sensitivity. African Americans and Africans had higher odds of PEth sensitivity than whites in models that included biologic variables. Conclusions: Among people reporting unhealthy alcohol use, several biological factors (hemoglobin, BMI, liver fibrosis, and HIV status) were associated with PEth sensitivity. Race/ethnicity was associated with PEth sensitivity in some models but age, sex, and method of blood collection were not. Clinicians should be aware of these factors, and researchers should consider adjusting analyses for these characteristics where possible.Factors associated with school nurses’ HPV vaccine attitudes for school-aged youth
AbstractRosen, B. L., DiClemente, R., Shepard, A. L., Wilson, K. L., & Fehr, S. K. (n.d.).Publication year
2017Journal title
Psychology, Health and MedicineVolume
22Issue
5Page(s)
535-545AbstractSchool nurses are at the intersection of the healthcare and school communities, thus, they can be considered opinion leaders in providing health advice–including information about the human papillomavirus (HPV) vaccine–to parents and students. This study examined school nurses’ attitudes toward the HPV vaccine based on age, years as a school nurse, geographic location, urban vs. rural work setting, HPV and vaccine knowledge, perception of role as opinion leaders, and school district support in providing health education. Participants (n = 413) were systematically sampled from the National Association of School Nurses’ membership and completed a web-based survey. Multiple regression was used to predict positive HPV vaccine attitudes. The model was statistically significant accounting for 50.8% of the variance (F [9, 400] = 45.96, pFactors associated with sexual arousal, sexual sensation seeking and sexual satisfaction among female African American adolescents
AbstractSales, J. M., Smearman, E. L., Brody, G. H., Milhausen, R., Philibert, R. A., & DiClemente, R. (n.d.).Publication year
2013Journal title
Sexual HealthVolume
10Issue
6Page(s)
512-521AbstractBackground: Sexuality-related constructs, such as sexual arousal, sexual sensation seeking (SSS) and sexual satisfaction, have been related to sexual behaviours that place one at risk of adverse consequences, such as sexually transmissible infections, HIV and unintended pregnancy. The biopsychosocial model posits an array of factors, ranging from social environmental factors to biological and psychological predispositions, that may be associated with these sexuality constructs in adolescents. Methods: Female African Americans aged 14-20 years were recruited from reproductive health clinics for an HIV intervention. Baseline survey and follow-up DNA data (n=304) were used to assess biological, psychological and social environmental associations with the sexuality constructs of arousal, SSS and sexual satisfaction. Results: Multivariate linear regression analysis revealed that a higher depressive symptom rating was associated with higher arousability, whereas short serotonin transporter gene allele(s) status was associated with lower arousability. Impulsivity and perceived peer norms supportive of unsafe sexual behaviours were associated with increased SSS, whereas short serotonin transporter gene allele(s) status was associated with lower SSS. Higher social support was associated with higher levels of sexual satisfaction, whereas short serotonin transporter gene allele(s) status was associated with lower satisfaction. The sexuality constructs were also significantly related to the number of sex partners, the frequency of vaginal sex and the number of unprotected vaginal sex acts in the past 6 months. Conclusions: The findings emphasise the importance of understanding biopsychosocial factors, including the role of serotonin as an indicator of natural variations in sexual inclination and behaviours, that influence sexuality constructs, which, in turn, are associated with sexual behaviours, to allow further refinement of sexual health clinical services and programs and promote the development of healthy sexuality. Journal compilationFactors associated with testing for hepatitis C in an internet-recruited sample of men who have sex with men
AbstractRhodes, S. D., DiClemente, R., Yee, L. J., & Hergenrather, K. C. (n.d.).Publication year
2001Journal title
Sexually Transmitted DiseasesVolume
28Issue
9Page(s)
515-520AbstractBackground: Nearly 4 million individuals in the United States (1.8%) have been infected with hepatitis C virus, yet few are aware of their infection. Goal: To identify correlates associated with hepatitis C virus testing among a sample of men who have sex with men. Study Design: Internet communications were used for solicitation and collection of data, using a 31-question survey. Results: When the study was restricted to men who have sex with men in the United States (n = 381), 95% of the respondents (n - 361) reported at least one risk factor for hepatitis C virus transmission, 39% of these respondents (n = 140) reported having been tested for hepatitis C virus. Testing was associated with a history of nonsexual risk behavior, increased knowledge of the hepatitis C virus, and health care provider communication. Conclusion: A significant proportion of at-risk respondents had not been tested. Interventions are needed to increase hepatitis C virus knowledge in the community of men who have sex with men, and to encourage providers to communicate about hepatitis to the men in this group who screen as high risk on the basis of their risk behaviors.Factors related to patient delay in seeking medical attention for cutaneous malignant melanoma
AbstractTemoshok, L., DiClemente, R., Sweet, D. M., Blois, M. S., & Sagebiel, R. W. (n.d.).Publication year
1984Journal title
CancerVolume
54Issue
12Page(s)
3048-3053AbstractThis study investigated the relationship between patient delay in seeking medical attention and prognostic indicators, tumor characteristics, and demographic and behavioral factors in 106 patients with cutaneous malignant melanoma. Patients with less readily apparent lesions, particularly on the back, had longer delays in seeking treatment, as might be expected. The prognostically unfavorable nodular melanomas were detected more frequently by patients themselves than they were found during visits to physicians for unrelated problems. In terms of behavioral variables, patients with less knowledge of melanoma or its appropriate treatment had significantly longer delays. Patients who minimized the seriousness of their condition were more likely to seek treatment sooner, perhaps because this reduced fear and anxiety about the disease or its treatment. For superficial spreading melanoma, delay was significantly and positively correlated with Clark's level of invasion, and also with tumor thickness when only noncoincidentally diagnosed patients were included; whereas for the nodular type, delay was significantly and positively associated with tuomr thickness, whether the patient was coincidentally diagnosed or not. The significance of these findings for early detection, and hence improved prognosis of malignant melanoma, is discussed.Family connectedness and sexual minority Asian Americans' eating behavior regulation
AbstractLe, T. P., Ali, S. H., Atkin, A. L., Ching, T. H., Csizmadia, A., Tran, N. K., & DiClemente, R. (n.d.).Publication year
2023Journal title
Eating BehaviorsVolume
51AbstractTo date, psychosocial and interpersonal protective factors such as family connectedness have received little attention in studies of eating behaviors among sexual minority Asian Americans. Therefore, we investigated associations of family connectedness and two types of eating behavior regulation motives and the moderating role of individualism in these associations among 134 sexual minority Asian American young adults. Linear regression models assessed the main and interaction effects of family connectedness and individualism on introjected and identified eating behavior regulation motives. We observed a significant interaction effect between family connectedness and individualism only on introjected regulation. For participants with low levels of individualism, those who reported high levels of family connectedness had lower scores for introjected regulation of eating behavior. The findings of this study highlight the importance of examining strengths related to sexual minority Asian Americans by demonstrating the important role family connectedness plays in eating behavior regulation motives, particularly for those with lower individualism.Family influences and biologically confirmed sexually transmitted infections among detained adolescents
AbstractCrosby, R., Voisin, D., Salazar, L. F., DiClemente, R., Yarber, W. L., & Caliendo, A. M. (n.d.).Publication year
2006Journal title
American Journal of OrthopsychiatryVolume
76Issue
3Page(s)
389-394AbstractData from a convenience sample of 476 detained adolescents were used to examine the relationship between family influences and biologically confirmed sexually transmitted diseases (STDs). Results indicated that frequent parental monitoring was negatively associated with STD infection and that this relationship was modified by age, gender, and race. Findings suggest that STD prevention efforts for detained adolescents (particularly high-risk minority females older than age 16) might focus on increasing monitoring by a parent or parental figure.Family influences on adolescents' sexual health : Synthesis of the research and implications for clinical practice
AbstractDiClemente, R., Crosby, R. A., & Salazar, L. F. (n.d.).Publication year
2006Journal title
Current Pediatric ReviewsVolume
2Issue
4Page(s)
369-373AbstractEmerging empirical evidence indicates that parenting strategies can have a substantial impact on their adolescents' sexual health. Three critical parenting strategies: monitoring their adolescents, engaging them in frequent communication about sex, and, providing familial support may afford protection against their adolescents engaging in sexual risk behaviors, and consequently, reducing adolescents' risk of adverse sexual health outcomes such as unintended pregnancy and sexually transmitted diseases including human immunodeficiency virus infection. Family-based interventions can successfully enhance the adoption of all of these protective strategies; however, pediatricians routinely come into contact with parents and their adolescents. Pediatricians can therefore serve as an authoritative source of information and motivation by encouraging parents to monitor their children more closely, enhance parent-adolescent communication about sexual health and encourage a more supportive family environment to enhance the likelihood that adolescents will adopt and maintain sexual health promotion practices. In addition, pediatricians can provide parents with an information prescription (IP) to assist them in acquiring information via the Internet on adolescent sexual health and risks, and on the three critical parenting protective strategies. Thus, pediatricians represent an important and, perhaps, cost-effective intervention point with parents who in turn can protect the sexual health of their adolescents.Family-centered program deters substance use, conduct problems, and depressive symptoms in black adolescents
AbstractBrody, G. H., Chen, Y. F., Kogan, S. M., Yu, T., Molgaard, V. K., DiClemente, R., & Wingood, G. M. (n.d.).Publication year
2012Journal title
PediatricsVolume
129Issue
1Page(s)
108-115AbstractOBJECTIVES: The present research addressed the following important question in pediatricmedicine: Can participation in a new family-centered preventive intervention, the Strong African American Families-Teen (SAAF-T) program, deter conduct problems, substance use, substance use problems, and depressive symptoms among rural black adolescents across 22 months? METHODS: Data were collected from 502 black families in rural Georgia, assigned randomly to SAAF-T or an attention control condition. The prevention condition consisted of 5 consecutive meetings at community facilities with separate, concurrent sessions for caregivers and adolescents followed by a caregiver-adolescent session in which families practiced skills they learned in the separate sessions. Adolescents self-reported conduct problem behaviors, substance use, substance use problems, and depressive symptoms at ages 16 years (pretest) and 17 years 10 months (long-term assessment). RESULTS: Adolescents who participated in SAAF-T evinced lower increases in conduct problem behavior, substance use, substance use problems, and depressive symptom frequencies than did adolescents in the attention control condition across the 22 months between pretest and long-term assessment. CONCLUSIONS: This is the first study to demonstrate efficacy in a prevention program designed to deter conduct problems, substance use, substance use problems, and depressive symptoms among rural black adolescents. Because SAAF-T is a manualized, structured program, it can be easily disseminated to public health agencies, schools, churches, boys' and girls' clubs, and other community organizations.Family-related correlates of sexually transmitted disease and barriers to care : A pilot study of pregnant African American adolescents
AbstractCrosby, R. A., Wingood, G. M., DiClemente, R., & Rose, E. S. (n.d.).Publication year
2002Journal title
Family and Community HealthVolume
25Issue
2Page(s)
16-27AbstractThis study explored associations between family-related measures and sexually transmitted disease (STD) history among 170 pregnant African American adolescent females, 14 to 20 years of age, attending prenatal care clinics in a large urban area of the South. Measures of low family support and infrequent mother-daughter communication were significant bivariate correlates of having at least one STD. Mother-daughter communication about preventing acquired immune deficiency syndrome remained significant in a multivariate model. The study also explored barriers to STD care-seeking behavior and found that few adolescents perceived access or financial issues as reasons to delay entry into the medical system. Low perceived family support was marginally associated with greater perceived barriers to STD care.