Ralph DiClemente
Ralph DiClemente
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Professor of Social and Behavioral Sciences
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Professional overview
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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.
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Education
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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
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Areas of research and study
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Community InterventionsDiabetesHIV/AIDSImplementation scienceInfluenzaPsychology
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Publications
Publications
Targeting STD/HIV prevention interventions for heterosexual male adolescents in North and Central America : A review
AbstractLomotey, M., Brown, J. L., & DiClemente, R. (n.d.).Publication year
2013Journal title
Current Pediatric ReviewsVolume
9Issue
4Page(s)
376-382AbstractBackground: Adolescents experience elevated rates of STDs and HIV. STD/HIV prevention interventions for young men are crucial to decrease their STD/HIV rates and reduce disease transmission to female partners. To advance sexual health promotion interventions for young men, this paper reviewed the efficacy of STD/HIV prevention interventions conducted in North and Central America in the past 20 years. Method: PubMed, Google Scholar, and EBSCO Host databases were used to locate STD/HIV interventions. Eligible interventions were limited to STD/HIV interventions for young men between the ages of 10 and 18. We review 8 STD/HIV prevention interventions targeting heterosexual adolescent males and summarize key intervention components and content, overview intervention efficacy outcome data, and provide directions for future research. Results: The majority of interventions were guided by health behavior change theory. Interventions employed interactive group-based education and behavioral skills training to reduce risky sexual behaviors. All interventions used a randomized controlled trial design with a comparison or control group. Follow-up times varied markedly, ranging from 3 weeks to 36 months. All but one intervention improved at least one behavioral outcome (e.g., increased frequency of condom use). Conclusions: Findings suggest that male adolescent interventions can effectively curtail the STD/HIV epidemic. Major weaknesses of the reviewed studies include the reliance on self-report behavioral measures, lack of biological endpoints, and short follow-ups. Study strengths include use of randomized control trial design and theory-based content. Future research should increase the dissemination of effective sexual risk reduction interventions to decrease STD/HIV among adolescent males and their female partners.The concrete jungle : City stress and substance abuse among young adult African American men
AbstractSeth, P., Murray, C. C., Braxton, N. D., & DiClemente, R. (n.d.).Publication year
2013Journal title
Journal of Urban HealthVolume
90Issue
2Page(s)
307-313AbstractSubstance use is prevalent among African American men living in urban communities. The impact of substance use on the social, psychological, and physical health of African American men has important public health implications for families, communities, and society. Given the adverse consequences of alcohol and drug abuse within communities of color, this study evaluated the relationship between city stress, alcohol consumption, and drug use among African American men. Eighty heterosexual, African American men, 18 to 29 years old, completed psychosocial risk assessments that assessed substance use and city stress. Multiple logistic regression analyses, controlling for age, indicated that participants reporting high levels of urban stress, relative to low levels of urban stress, were more likely to report a history of marijuana use (AOR = 5.19, p =.05), history of ecstasy and/or GHB use (AOR = 3.34, p =.04), having family/friends expressing strong concerns about their illicit drug use (AOR = 4.06, p =.02), and being unable to remember what happened the night before due to drinking (AOR = 4.98, p =.01). African American men living within the confines of a stressful urban environment are at increased risk for exposure to and utilization of illicit substances. Culturally competent public health interventions for substance use/abuse should address psychological factors, such as stress and neighborhood violence.The relationship between ethnic identity and Chlamydia and Gonorrhea infections among low-income detained African American adolescent females
AbstractVoisin, D. R., Salazar, L. F., Crosby, R., & DiClemente, R. (n.d.).Publication year
2013Journal title
Psychology, Health and MedicineVolume
18Issue
3Page(s)
355-362AbstractThis study explored the relationship between ethnic identity and Chlamydia and Gonorrhea infections among detained African American female adolescents. A cross-sectional survey was conducted among 123 African American female adolescents within eight detention facilities in Georgia. Using audio-computer assisted self-interviewing technology, data were collected on demographics, ethnic identity, laboratory-confirmed Chlamydia and Gonorrhea, and other known correlates for sexually transmitted infections (STIs), such as socioeconomic status, parental monitoring, and risky sexual behaviors. Rates of Chlamydia and Gonorrhea testing yielded incidence rates of 22.6% and 4.3%, respectively. Findings indicated that, controlling for STI correlates, participants who indicated high ethnic identity were 4.3 times more likely to test positive for an STI compared to those scoring low on the measure of ethnic identity.The social and behavioral sciences research network : Translational research to reduce disparities in HIV
AbstractBlank, M. B., Metzger, D. S., Wingood, G. M., & DiClemente, R. (n.d.).Publication year
2013Journal title
Journal of Acquired Immune Deficiency SyndromesVolume
63Issue
SUPPL. 1Page(s)
S1-S3Abstract~Turning the Corner on the HIV Epidemic Among Adolescents : Prioritizing Directions for Future Prevention Research
AbstractDiClemente, R. (n.d.).Publication year
2013Journal title
Journal of HIV/AIDS and Social ServicesVolume
12Issue
3-4Page(s)
258-265Abstract~Understanding reasons for participating in a school-based influenza vaccination program and decision-making dynamics among adolescents and parents
AbstractHerbert, N. L., Gargano, L. M., Painter, J. E., Sales, J. M., Morfaw, C., Murray, D., DiClemente, R., & Hughes, J. M. (n.d.).Publication year
2013Journal title
Health Education ResearchVolume
28Issue
4Page(s)
663-672AbstractInfluenza remains a significant cause of morbidity and mortality in the United States. Vaccinating school-aged children has been demonstrated to be beneficial to the child and in reducing viral transmission to vulnerable groups such as the elderly. This qualitative study sought to identify reasons parents and students participated in a school-based influenza vaccination clinic and to characterize the decision- making process for vaccination. Eight focus groups were conducted with parents and students. Parents and students who participated in the influenza vaccination clinic stated the educational brochure mailed to their home influenced participation in the program. Parents of non-participating students mentioned barriers, such as the lengthy and complicated consent process and suspicions about the vaccine clinic, as contributing to their decision not to vaccinate their child. Vaccinated students reported initiating influenza vaccine discussion with their parents. Parental attitudes and the educational material influenced parents' decision to allow their child to receive influenza vaccine. This novel study explored reasons for participating in a school-based vaccination clinic and the decision-making process between parents and child(ren). Persons running future school-based vaccination clinics may consider hosting an 'information session with a question and answer session' to address parental concerns and assist with the consent process.What girls won't do for love : Human immunodeficiency virus/sexually transmitted infections risk among young african-american women driven by a relationship imperative
AbstractRaiford, J. L., Seth, P., & DiClemente, R. (n.d.).Publication year
2013Journal title
Journal of Adolescent HealthVolume
52Issue
5Page(s)
566-571AbstractPurpose: Rates of Human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) continue to increase among African-American youth. Adolescents who have a stronger identity in relation to others (relational identity) rather than to themselves (self-identity) may view intimate relationships as imperative to a positive self-concept, which may lead to risky sexual behavior and abuse. Therefore, the present study assessed the associations among a relationship imperative and HIV/STI-related risk factors and behaviors. Methods: Participants were 715 African-American adolescent females, aged 15 to 21 years. They completed measures that assessed how important a relationship was to them and HIV-related risk factors and behaviors. Participants also provided vaginal swab specimens for STI testing. Results: Multivariate logistic regression analyses, controlling for covariates, were conducted. Females who endorsed a relationship imperative (29%), compared to those who did not, were more likely to report: unprotected sex, less power in their relationships, perceived inability to refuse sex, anal sex, sex while their partner was high on alcohol/drugs, and partner abuse. Furthermore, participants with less power, recent partner abuse, and a perceived ability to refuse sex were more likely to test STI positive. Conclusion: These results indicate that if African-American adolescent females believe a relationship is imperative, they are more likely to engage in riskier sexual behaviors. Additionally, less perceived power and partner abuse increases their risk for STIs. HIV/STI prevention programs should target males and females and address healthy relationships, sense of self-worth, self-esteem and the gender power imbalance that may persist in the community along with HIV/STI risk.Young adult women and correlates of potential adoption of pre-exposure prophylaxis (PrEP) : Results of a national survey
AbstractRubtsov, A., Wingood, G. M., Dunkle, K., Camp, C., & DiClemente, R. (n.d.).Publication year
2013Journal title
Current HIV ResearchVolume
11Issue
7Page(s)
543-548AbstractWe examine potential use of pre-exposure prophylaxis (PrEP) among young adult women, based on nationally representative random-digit dial telephone household survey of 1,453 US African-American and white women. The hypotheses were generated based on Health Belief Model. Our analyses showed that, as compared to women of 30-45 years old, young women of 20-29 years old experienced stronger social influences on PrEP uptake. However, as compared to older women, young women did not report higher potential PrEP uptake or adherence, despite their greater risk of HIV. For PrEP to be an effective method of prevention for young adult women, interventions are needed to increase HIV risk awareness.Acceptability of medical male circumcision and improved instrument sanitation among a traditionally circumcising group in East Africa
AbstractSiegler, A. J., Mbwambo, J. K., & DiClemente, R. (n.d.).Publication year
2012Journal title
AIDS and BehaviorVolume
16Issue
7Page(s)
1846-1852AbstractBy removing the foreskin, medical male circumcision (MMC) reduces female to male heterosexual HIV transmission by approximately 60 %. Traditional circumcision has higher rates of complications than MMC, and reports indicate unsanitized instruments are sometimes shared across groups of circumcision initiates. A geographically stratified, cluster survey of acceptability of MMC and improved instrument sanitation was conducted among 368 eligible Maasai participants in two Northern Districts of Tanzania. Most respondents had been circumcised in groups, with 56 % circumcised with a shared knife rinsed in water between initiates and 16 % circumcised with a knife not cleaned between initiates. Contrasting practice, 88 % preferred use of medical supplies for their sons' circumcisions. Willingness to provide MMC to sons was 28 %; however, provided the contingency of traditional leadership support for MMC, this rose to 84 %. Future interventions to address circumcision safety, including traditional circumciser training and expansion of access to MMC, are discussed.African american adolescents meeting sex partners online : Closing the digital research divide in STI/HIV prevention
AbstractDiClemente, R., Whiteley, L. B., Brown, L. K., Swenson, R. R., Valois, R. F., Vanable, P. A., Carey, M. P., Di Clemente, R., Salazar, L. F., & Romer, D. (n.d.).Publication year
2012Journal title
Journal of Primary PreventionVolume
33Issue
1Page(s)
13-18AbstractMinority adolescents are affected disproportionately by HIV and STIs, and the Internet is a popular venue to meet sex partners. Little is known about the risks of this behavior for minority adolescents. The majority of studies that have examined sexual risk behavior online or STI/HIV prevention programs online have been among adult MSM. In this study, data from 1,045 African American youth found that 6% met sex partners online and in chat rooms. Odds ratios, adjusting for gender, found this behavior was associated with alcohol (AOR = 2.33, 95% CI [1.1, 4.7]) and drug use (AOR = 3.45, 95% CI [1.9, 6.1]), unprotected vaginal (AOR = 4.71, 95% CI [1.9, 8.4]) and anal sex (AOR = 4.77, 95% CI [1.3,17.1]) in the last 90 days, more lifetime vaginal (AOR = 3.65, 95% CI [2.0, 6.8]) and anal sex (AOR = 2.74, 95% CI [1.5, 4.8]), greater sexual sensation seeking (AOR = 2.92, 95% CI [1.5, 5.7]) and greater depression (AOR = 2.06, 95% CI [1.2, 3.6]. A final multiple logistic regression analyses found that male gender (AOR = 3.13, 95% CI [1.7, 5.8]), drug use at last sex (AOR = 2.41, 95% CI [1.3, 4.5]), lifetime history of vaginal (AOR = 2.90, 95% CI [1.5, 5.5]) and anal sex (AOR = 2.09, 95% CI [1.2, 3.6]), and cocaine use (AOR = 8.53, 95% CI [2.7, 27.3]) were independently associated with having sex with a partner met online. Meeting sex partners online is associated with a variety of risks among African American youth; however, the Internet may be an opportunity for intervention.Age differences in STDs, sexual behaviors, and correlates of risky sex among sexually experienced adolescent African-American females
AbstractSales, J. M., Brown, J. L., DiClemente, R., Davis, T. L., Kottke, M. J., & Rose, E. S. (n.d.).Publication year
2012Journal title
Journal of pediatric psychologyVolume
37Issue
1Page(s)
33-42AbstractObjective To explore age differences in factors associated with positive sexually transmitted diseases (STD) status among a sample of African-American adolescent females. Methods Data were collected via ACASI from 701 African-American adolescent females (14-20 years) seeking services at reproductive health clinics. Adolescents provided self-collected vaginal swabs assayed using NAAT to assess the prevalence of three STDs. Results Younger adolescents (14-17 years) had significantly higher rates of STDs than older adolescents (18-20 years), but older adolescents had significantly higher levels of STD-associated risk behavior. In controlled analysis, having a casual sex partner was the only variable significantly associated with a positive STD test for younger adolescents, and prior history of STD and higher impulsivity were significantly associated with testing STD positive among older adolescents. Conclusions These findings suggest that developmentally tailored STD/HIV prevention interventions are needed for younger and older subgroups of adolescent females to help reduce their risk of infection.Blocking the benefit of group-based HIV-prevention efforts during adolescence : The problem of HIV-related stigma
AbstractBarker, D. H., Swenson, R. R., Brown, L. K., Stanton, B. F., Vanable, P. A., Carey, M. P., Valois, R. F., DiClemente, R., Salazar, L. F., & Romer, D. (n.d.).Publication year
2012Journal title
AIDS and BehaviorVolume
16Issue
3Page(s)
571-577AbstractHIV-related stigma has been shown to impede HIV-antibody testing and safer sexual practices in adults. Less is known about its effects on prevention programs among at-risk youth. This study examined the longitudinal relationships between HIV-stigma and HIV-knowledge following completion of a validated group-based intervention. Data were provided by 1,654 African-American adolescents who participated in a large multi-city prevention trial (Project iMPACCS). Participants were randomly assigned to an empirically-validated skill-based intervention or a general health promotion control group. Both stigma and knowledge were assessed at baseline and post-intervention. Results suggested that adolescents participating in the intervention showed improvements in knowledge and decreases in stigma when compared to controls. Improvements in stigma appeared to be partly driven by improvements in knowledge. Higher baseline stigma was shown to reduce gains in knowledge in both the treatment and control groups. Results suggest that HIV-stigma can interfere with how youth identify with and internalize messages from group-based prevention trials.Build it and they will come. or will they? Overcoming barriers to optimizing delivery of seasonal influenza vaccine to US adolescents
AbstractDiClemente, R., Painter, J. E., Sales, J. M., & Gargano, L. M. (n.d.).Publication year
2012Journal title
Expert Review of VaccinesVolume
11Issue
4Page(s)
387-389Abstract~Cash, cars, and condoms : Economic factors in disadvantaged adolescent women's condom use
AbstractRosenbaum, J., Zenilman, J., Rose, E., Wingood, G., & DiClemente, R. (n.d.).Publication year
2012Journal title
Journal of Adolescent HealthVolume
51Issue
3Page(s)
233-241AbstractEvaluate whether adolescent women who received economic benefits from their boyfriends were more likely never to use condoms. Data are obtained from a longitudinal HIV prevention intervention study with 715 African American adolescent women in urban Atlanta surveyed at baseline, 6 months, and 12 months. The primary outcome was never using condoms in the past 14 and 60 days at 6 and 12 months. The primary predictor was having a boyfriend as primary spending money source at baseline. Analysis minimized confounding using propensity weighting to balance respondents on 81 variables. A boyfriend was the primary spending money source for 24% of respondents, who did not differ in neighborhood or family context but had lower education, more abuse history, riskier sex, and more sexually transmitted infections. After propensity score weighting, no statistically significant differences for 81 evaluated covariates remained, including age distributions. Women whose boyfriend was their primary spending money source were 50% more likely never to use condoms at 6 and 12 months and less likely to respond to the intervention at 12 months. Women whose boyfriend had been their primary spending money source but found another spending money source were more likely to start using condoms than women who continued. Women whose boyfriends owned cars were more likely never to use condoms. Receiving spending money from a boyfriend is common among adolescent women in populations targeted by pregnancy and sexually transmitted infection prevention interventions, and may undermine interventions' effectiveness. Clinicians and reproductive health interventions need to address females' economic circumstances.Characteristics of African American adolescent females who perceive their current boyfriends have concurrent sexual partners
AbstractBrown, J. L., Sales, J. M., DiClemente, R., Latham Davis, T. P., & Rose, E. S. (n.d.).Publication year
2012Journal title
Journal of Adolescent HealthVolume
50Issue
4Page(s)
377-382AbstractPurpose: Perceived partner concurrency, reporting that a current sexual partner has other sexual partners, may pose sexual health risks to adolescents. We examined the contextual characteristics of African American female adolescents who reported their current boyfriend was having concurrent sexual relationships. Methods: Participants were African American adolescent females (N = 511; mean age = 17.6) recruited from sexual health clinics. Before participating in an STD/HIV prevention trial, the participants completed audio computer-assisted self-interviews with measures of perceived partner concurrency and individual- (e.g., depression, substance use), interpersonal- (e.g., social support, interpersonal stress), and community-level factors (i.e., neighborhood quality). Results: Twenty-seven percent of participants reported their belief that their current boyfriend had concurrent sexual partners during their relationship. In a logistic regression analysis, participants endorsing perceived partner concurrency reported less relational power (adjusted odds ratio [AOR] =.94, 95% confidence interval [CI] =.89.98, pCollege Graduation Reduces Vulnerability to STIs/HIV among African-American Young Adult Women
AbstractPainter, J. E., Wingood, G. M., DiClemente, R., DePadilla, L. M., & Simpson-Robinson, L. S. (n.d.).Publication year
2012Journal title
Women's Health IssuesVolume
22Issue
3Page(s)
e303-e310AbstractAfrican-American women are disproportionately affected by sexually transmitted infections (STIs), including HIV. The Theory of Gender and Power (TGP) posits that socioeconomic exposures, including educational attainment, place women at increased risk for STIs/HIV. This study examined the association between educational attainment and vulnerability to STIs/HIV, as well as potential TGP-driven mediators of this association, among African-American women. Baseline data were assessed from an STI/HIV prevention intervention for African-American women (n = 848) aged 18 to 29 recruited from three Kaiser Permanente Centers in Atlanta, Georgia. Data collection included a survey of demographic, psychosocial, and behavioral measures and self-collected, laboratory-confirmed vaginal swabs for STIs (trichomoniasis, chlamydia, gonorrhea, and human papillomavirus). Multiple regression analyses and multivariate mediation analyses were used to examine the association between educational attainment with a laboratory-confirmed STI and potential TGP mediators. Controlling for age and receipt of public assistance, the odds of an STI diagnosis were 73% lower among participants with a college degree or greater compared with participants who had not completed high school. There were also significant associations between educational attainment and multiple TGP mediators from the sexual division of power and the structure of cathexis. TGP constructs did not mediate the association between educational attainment and laboratory-confirmed STI. The current study suggests that graduating from college may lead to a beneficial reduction in vulnerability to STIs/HIV among African-American women. Findings from this study support expanding structural-level interventions, emphasizing both high school and college graduation, as a means of reducing vulnerability to STIs/HIV among African-American women.Condoms "contain worms" and "cause HIV" in Tanzania : Negative Condom Beliefs Scale development and implications for HIV prevention
AbstractSiegler, A. J., Mbwambo, J. K., McCarty, F. A., & DiClemente, R. (n.d.).Publication year
2012Journal title
Social Science and MedicineVolume
75Issue
9Page(s)
1685-1691AbstractCondom promotion remains a key component of HIV prevention programs, complimenting recent successes in biomedical HIV prevention. Although condom use has increased in much of East Africa, it remains substantially below optimal levels. Negative rumors about condoms have been documented in East Africa, yet the prevalence and effects of belief in the negative rumors have not been explored. This study evaluated levels of belief in negative rumors about condoms, developed a Negative Condom Beliefs Scale, and assessed its accuracy in predicting willingness to use condoms. A cross-sectional, cluster survey (n = 370) was conducted representing adults in two rural districts in Northern Tanzania in 2008. Item agreement ranged from 35 to 53% for the following rumors regarding condoms: causing cancer, having holes, containing HIV, having worms, and the worms causing HIV. Items loaded on a single latent factor and had high internal consistency and convergent validity. In a multivariate model, negative condom score (AOR = 0.67, 95% CI = 0.6, 0.8) was the strongest single predictor of willingness to use condoms, followed by greater perceived anonymity in acquiring condoms (AOR = 4.36, 95% CI = 2.2, 8.6) and higher condom self-efficacy (AOR = 4.24, 95% CI = 2.0, 8.9). Our findings indicate high levels of subscription to negative beliefs about condoms, with two out of three respondents affirming belief in at least one negative condom rumor. This study highlights the relation between condom rumor beliefs and willingness to use condoms, and indicates avenues for future research and means for improving the design of HIV prevention programs.Correlates of sexually transmitted infection prevention knowledge among African American girls
AbstractVoisin, D. R., Tan, K., Salazar, L. F., Crosby, R., & DiClemente, R. (n.d.).Publication year
2012Journal title
Journal of Adolescent HealthVolume
51Issue
2Page(s)
197-199AbstractPurpose: To identify significant factors that distinguish African American girls who have high sexually transmitted infection (STI) prevention knowledge from those lacking such knowledge. Methods: We recruited a sample of 715 African American girls from three public health clinics in downtown Atlanta. Using audio computer-assisted self-interviewing (A-CASI) technology, we assessed for age, self-mastery, employment status, attendance at sex education classes, socioeconomic status, and STI prevention knowledge. Results: Slightly more than one-third of the girls did not know that females are more susceptible to STI infections than males; and that having an STI increases the risk of contracting HIV. Almost half of the girls did not know if a man has an STI he will not have noticeable symptoms; and that most people who have AIDS look healthy. Logistic regression findings indicated that being older, having greater self-mastery, and being employed significantly predicted high STI knowledge. Conclusions: Health educators may especially target African American girls who are younger, unemployed, and experiencing low self-mastery for more tailored STI heath education.Dating Violence Victimization and Unprotected Sex Acts Among Adolescents in Mental Health Treatment
AbstractRizzo, C. J., Hunter, H. L., Lang, D. L., Oliveira, C., Donenberg, G., DiClemente, R., & Brown, L. K. (n.d.).Publication year
2012Journal title
Journal of Child and Family StudiesVolume
21Issue
5Page(s)
825-832AbstractThe objective of this study was to explore the relationship between dating violence victimization and unprotected sex acts among youth in mental health treatment. Sexually-active adolescents (n = 261; ages 13-18) enrolled in mental health treatment completed an audio-assisted computerized self-interview (ACASI) to assess recent dating violence victimization, unprotected sex acts, depression symptoms, and recent alcohol use. Path analysis revealed that dating violence victimization was related to unprotected sex acts both directly and indirectly via its association with depression and condom use self-efficacy. These findings suggest that in order to reduce HIV-related risk behaviors among dating violence victims, treatment providers should consider depressive symptomatology and associated affect around sexual situations.Dual protection use to prevent STIs and unintended pregnancy
AbstractSales, J. M., Whiteman, M. K., Kottke, M. J., Madden, T., & DiClemente, R. (n.d.).Publication year
2012Journal title
Infectious Diseases in Obstetrics and GynecologyVolume
2012Abstract~Employing a teen advisory board to adapt an evidence-based HIV/STD intervention for incarcerated African-American adolescent women
AbstractLatham, T. P., Sales, J. M., Renfro, T. L., Boyce, L. S., Rose, E., Murray, C. C., Wingood, G. M., & DiClemente, R. (n.d.).Publication year
2012Journal title
Health Education ResearchVolume
27Issue
5Page(s)
895-903AbstractThis manuscript assesses priorities and challenges of adolescent females by conducting a meeting with teen advisory board (TAB) members to collect information regarding their lives and experiences pre-, during and post-incarceration in a juvenile detention facility. Multiple themes emerged regarding the impact of incarceration on young African-American females, including experiencing a loss of personal liberties, the importance of making money upon release, unfaithfulness by partners on the 'outside', substance use and lack of control over their environment upon release, including parents, peers and male sexual partners. Based on feedback from TAB members, unique barriers and challenges were identified that suggested areas where adaptations to an evidenced-based HIV/sexually transmitted disease (STD) intervention would be justified to more adequately meet the needs of this particular subgroup of young African-American women. Adaptations to the evidence-based interventions included enhancing activities related to goal setting, emotion regulation skills, decision-making, recognizing and utilizing support networks and addressing the relationship between substance use and risky sexual behavior. Future health education efforts focusing on either the creation of new HIV/STD interventions or adaptations to existing interventions should consider utilizing advisory boards with members of the priority population at the earliest stages of intervention planning.Examining interest in secondary abstinence among young African American females at risk for HIV or STIs
AbstractBradley, E. L., Sales, J. M., Murray, C. C., & DiClemente, R. (n.d.).Publication year
2012Journal title
Health Education ResearchVolume
27Issue
6Page(s)
1120-1128AbstractSexually active African American females are at increased risk for acquiring HIV or STIs. However, some reduce their risk by abstaining from sex for various periods of time following initiation, a practice known as secondary abstinence. Although this may be a valuable mechanism for reducing HIV or STI rates in this population, little is known about those interested in secondary abstinence. Baseline data were obtained from a sample of African American adolescent females, ages 14-20 years, prior to participation in an HIV-risk reduction intervention trial (N = 701). Differences in individual-level and interpersonal-level factors, as well as sociodemographic variables were examined between participants who reported strong interest in secondary abstinence and those who did not. 144 (20.5%) participants reported strong interest in secondary abstinence. Young women with strong interest in abstinence had higher odds of reporting a history of STIs and feeling negative emotions following sex because of their religious beliefs. They also had higher odds of believing their partner may be interested in abstaining and being less invested in their relationship with their main partner. Additionally, adolescents reported less interpersonal stress and more social support. African American females who are interested in practicing secondary abstinence and those who are not differ in their sexual health education needs. Findings from this study characterizing young women interested in secondary abstinence can help researchers provide more targeted health education by identifying those who may be more responsive to abstinence-promoting messages.Examining Parental Monitoring as a Pathway From Community Violence Exposure to Drug Use, Risky Sex, and Recidivism Among Detained Youth
AbstractVoisin, D. R., Tan, K., Tack, A. C., Wade, D., & DiClemente, R. (n.d.).Publication year
2012Journal title
Journal of Social Service ResearchVolume
38Issue
5Page(s)
699-711AbstractThis study examined whether parental monitoring mediated the relationship between community violence exposure and a spectrum of behaviors such as recidivism, risky sex, and drug use among youth with a history of being detained. It also explored whether risk pathways differed by gender. Adolescents (n = 550) who were detained or previously detained were recruited from eight regional detention facilities in Georgia. Audio computer-assisted self-interviewing technology was used to assess demographic factors (i.e., age, race, and socioeconomic status), risky sex, drug use, and recidivism prior to being detained. Major findings indicated direct relationships between community violence exposures and risky sex and drug use in the 2 months prior to being detained. Findings also indicated that parental monitoring mediated these relationships for both adolescent males and females. These findings document that parental monitoring is an important element even for troubled youth across a broad spectrum of risk factors. Consequently, it is recommended that intervention programs examine the differential effects of monitoring behaviors by a variety of groups such as parental figures, teachers, and peer mentors.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 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.