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
The association between alcohol use and sexual risk behaviors among African American women across three developmental periods : A review
AbstractSales, J. M., Brown, J. L., Vissman, A. T., & DiClemente, R. (n.d.).Publication year
2012Journal title
Current Drug Abuse ReviewsVolume
5Issue
2Page(s)
117-128AbstractBackground: African American women experience increased rates of sexually transmitted diseases and HIV. The use of alcohol may increase sexual risk behaviors among this population. Purpose: This paper provides a review and critique of the literature examining the association etween alcohol use and sexual risk behaviors among African American females including a: (a) synthesis of research findings from adolescent, college-aged/early adulthood, and adult samples; (b) methodological critique of the literature; and (c) guidance for future research. Methods: We reviewed 32 studies examining the association between alcohol use and sexual risk behaviors among African American females across developmental periods. Results: Similar to previous association studies, results suggest that increased use of alcohol is associated with increased sexual risk practices among African American females. Further, even non-abuse levels of drinking among African American females, at all ages, were related to increased sexual risk-taking. Conclusions: Future studies should seek to recruit samples that more fully reflect the diversity of African American women's experiences across the lifespan. Given the association between alcohol use and/or abuse and the prevalence of STI/HIV-associated risk behaviors and adverse biological outcomes (i.e., STIs, including HIV) among African American females across the lifespan, there is a clear need to develop and evaluate prevention research efforts tailored for this subgroup.The mediating role of partner communication frequency on condom use among African American adolescent females participating in an HIV prevention intervention
AbstractSales, J. M., Lang, D. L., DiClemente, R., Latham, T. P., Wingood, G. M., Hardin, J. W., & Rose, E. S. (n.d.).Publication year
2012Journal title
Health PsychologyVolume
31Issue
1Page(s)
63-69AbstractObjective: Although effective HIV prevention interventions have been developed for adolescents, few interventions have explored whether components of the intervention are responsible for the observed changes in behaviors postintervention. This study examined the mediating role of partner communication frequency on African American adolescent females' condom use postparticipation in a demonstrated efficacious HIV risk-reduction intervention. Methods: As part of a randomized controlled trial, African American adolescent females (N = 715), 15-21 years, seeking sexual health services, completed a computerized interview at baseline (prior to intervention) and again 6 and 12 months follow-up post-intervention participation. The interview assessed adolescents' sexual behavior and partner communication skills, among other variables, at each time point. Using generalized estimating equation (GEE) techniques, both logistic and linear regression models were employed to test mediation over the 12-month follow-up period. Additional tests were conducted to assess the significance of the mediated models. Results: Mediation analyses observed that partner communication frequency was a significant partial mediator of both proportion of condom-protected sex acts (p = .001) and consistent condom use (p = .001). Conclusion: Partner communication frequency, an integral component of this HIV intervention, significantly increased as a function of participating in the intervention, partially explaining the change in condom use observed 12 months postintervention. Understanding what intervention components are associated with behavior change is important for future intervention development.The Strong African American Families-Teen Trial : Rationale, Design, Engagement Processes, and Family-Specific Effects
AbstractKogan, S. M., Brody, G. H., Molgaard, V. K., Grange, C. M., Oliver, D. A., Anderson, T. N., DiClemente, R., Wingood, G. M., Chen, Y. f., & Sperr, M. C. (n.d.).Publication year
2012Journal title
Prevention ScienceVolume
13Issue
2Page(s)
206-217AbstractThis study addresses two limitations in the literature on family-centered intervention programs for adolescents: ruling out nonspecific factors that may explain program effects and engaging parents into prevention programs. The Rural African American Families Health project is a randomized, attention-controlled trial evaluating the efficacy of the Strong African American Families-Teen (SAAF-T) program, a family-centered risk-reduction intervention for rural African American adolescents. Rural African American families (n = 502) with a 10th-grade student were assigned randomly to receive SAAF-T or a similarly structured, family-centered program that focused on health and nutrition. Families participated in audio computer-assisted self-interviews at baseline and 6-month follow-up. Program implementation procedures yielded a design with equivalent doses, five sessions of family-centered intervention programming for families in each condition. Of eligible families screened for participation, 76% attended four or five sessions of the program. Consistent with our primary hypotheses, SAAF-T youth, compared to attention-control youth, demonstrated higher levels of protective family management skills, a finding that cannot be attributed to nonspecific factors such as aggregating families in a structured, interactive setting.A randomized controlled trial of a culturally congruent intervention to increase condom use and HIV testing among heterosexually active immigrant latino men
AbstractRhodes, S. D., McCoy, T. P., Vissman, A. T., DiClemente, R., Duck, S., Hergenrather, K. C., Foley, K. L., Alonzo, J., Bloom, F. R., & Eng, E. (n.d.).Publication year
2011Journal title
AIDS and BehaviorVolume
15Issue
8Page(s)
1764-1775AbstractThis randomized controlled trial tested the efficacy of an HIV prevention intervention to increase condom use and HIV testing among Spanish-speaking, heterosexually active immigrant Latino men. A community- based participatory research partnership developed the intervention and selected the study design. Following baseline data collection, 142 immigrant Latino men were randomized to the HIV prevention intervention or the cancer education intervention. Three-month follow-up data were collected from 139 participants, for a 98% retention rate. Mean age of participants was 31.6 years and 60% reported being from Mexico. Adjusting for baseline behaviors, relative to their peers in the cancer education comparison, participants in the HIV prevention intervention were more likely to report consistent condom use and receiving an HIV test. Community-based interventions for immigrant Latino men that are built on state of the art prevention science and developed in partnership with community members can greatly enhance preventive behaviors and may reduce HIV infection.Adolescent attitudes toward influenza vaccination and vaccine uptake in a school-based influenza vaccination intervention : A mediation analysis
AbstractPainter, J. E., Sales, J. M., Pazol, K., Wingood, G. M., Windle, M., Orenstein, W. A., & DiClemente, R. (n.d.).Publication year
2011Journal title
Journal of School HealthVolume
81Issue
6Page(s)
304-312AbstractBACKGROUND: School-based vaccination programs may provide an effective strategy to immunize adolescents against influenza. This study examined whether adolescent attitudes toward influenza vaccination mediated the relationship between receipt of a school-based influenza vaccination intervention and vaccine uptake. METHODS: Participants were recruited from 2 counties participating in a school-based influenza vaccination intervention trial in rural Georgia (N = 337). Data were collected from surveys distributed to adolescents at pre- and post-intervention time points and from documents indicating vaccine uptake. Guided by the Health Belief Model and the Integrated Behavioral Model, surveys assessed demographic, behavioral, and psychosocial variables. A mediation analysis was used to test whether changes in psychosocial variables from baseline to follow-up mediated the relationship between study condition and influenza vaccine uptake. RESULTS: Controlling for background variables, step 1 of the mediation analysis revealed a significant relationship between study condition and vaccine uptake (odds ratio = 1.77, p = .038). Step 2 of the mediation analysis revealed a significant relationship between study condition and changes in psychosocial variables from baseline to follow-up. Steps 3 and 4 of the mediation analysis revealed that there was full mediation of the relationship between study condition and receipt of an influenza vaccination by intention to receive an influenza vaccination. CONCLUSION: Findings suggest that the success of our school-based influenza vaccination intervention in increasing vaccine uptake was mediated by adolescents' intention to receive an influenza vaccination. Future influenza vaccination efforts geared toward rural adolescents may benefit from addressing adolescent attitudes toward influenza vaccination, particularly increasing intention to receive a vaccine.African American adolescents and new media : Associations with HIV/STI risk behavior and psychosocial variables
AbstractWhiteley, L. B., Brown, L. K., Swenson, R. R., Romer, D., DiClemente, R., Salazar, L. F., Vanable, P. A., Carey, M. P., & Valois, R. F. (n.d.).Publication year
2011Journal title
Ethnicity and DiseaseVolume
21Issue
2Page(s)
216-222AbstractObjectives: Cell phones and online media are used frequently but we know little about their use among African American adolescents. This study examines the frequency of such use and its relationship to psychosocial variables and STI/HIV risk behavior. Setting/Participants: 1,518 African American, aged 13-18 years, from 2 Northeast US cities (Providence, RI; Syracuse, NY) and 2 Southeast US cities (Columbia, SC; Macon, GA), were assessed from 2008-2009. Design: Participants were assessed on frequency of cell phone and Internet use, psychological constructs (ie, depression, life satisfaction, impulsivity) and HIV/STI risk behaviors (ie, history of intercourse, sexual sensation seeking attitudes, peer sexual risks norms) with reliable scales and measures using an audio computer-assisted self-interview. Results: Over 90% of African American adolescents used cell phones every day or most days and 60% used social networking sites every day or most days (96% used Myspace). Greater frequency of cell phone use was associated with sexual sensation seeking (P=.000), riskier peer sexual norms (P=.000), and impulsivity (P=.016). Greater frequency of Internet use was associated with a history of oral/vaginal/anal sex (OR=1.03, CI=1.0-1.05) and sexual sensation seeking (P=.000). Conclusion: These findings suggest that riskier youth are online and using cell phones frequently. The Internet and cell phones may be useful platforms for targeted health promotion and prevention efforts with AA adolescents.Alcohol Use as a Marker for Risky Sexual Behaviors and Biologically Confirmed Sexually Transmitted Infections Among Young Adult African-American Women
AbstractSeth, P., Wingood, G. M., DiClemente, R., & Robinson, L. S. (n.d.).Publication year
2011Journal title
Women's Health IssuesVolume
21Issue
2Page(s)
130-135AbstractIntroduction: Previous research has primarily focused on the relationship between illicit drug use and HIV/sexually transmitted infection (STI) risk behavior among African-American women. Very few studies have solely reviewed the role of alcohol use on risky sexual behavior. The present study examined the relationship between alcohol use at non-abuse levels and risky sexual behaviors and STIs among young adult African-American women. Methods: Eight hundred forty-eight African American women, ages 18 to 29, participated at baseline, with 669 and 673 women at 6 and 12 months follow-up, respectively. Participants completed an Audio Computer Assisted Survey Interview assessing sociodemographics, alcohol use, and risky sexual behaviors. Subsequently, participants provided two vaginal swab specimens for STIs. Results: Multivariate logistic regression analyses were conducted for cross-sectional analyses, with illicit drug use as a covariate. Women who consumed alcohol were more likely to have multiple partners and risky partners. Binary generalized estimating equation models assessed the impact of alcohol use at baseline on risky sexual behavior and STIs over a 12-month period. Illicit drug use, intervention group, and baseline outcome measures were entered as covariates. Alcohol consumption predicted positive results for chlamydia, positive results for any STI, and never using a condom with a casual partner over a 12-month follow-up period. Discussion: Frequency of alcohol use at non-abuse levels was correlated with and predicted risky sexual behaviors and STIs. Prevention programs for African-American women should incorporate education regarding the link between alcohol and HIV/STI risk behaviors and the potential negative health consequences.Application of condoms on male clients by female sex workers in Yerevan, Armenia : Prevalence and correlates
AbstractDarbinyan, N., Lang, D. L., DiClemente, R., Joseph, J. B., & Markosyan, K. (n.d.).Publication year
2011Journal title
Journal of Biosocial ScienceVolume
43Issue
5Page(s)
575-585AbstractThis study sought to assess the prevalence of consistent condom application on male clients by female sex workers (FSWs) in Armenia and its association with demographic, psychosocial and behavioural factors. In this cross-sectional study, 120 street-based FSWs aged 20-52 completed an interviewer-administered questionnaire. The primary outcome measure was consistent application of condoms by FSWs on their male clients. A total of 21.7% of participants reported consistently applying condoms on clients. Logistic regression analysis demonstrated that higher condom use self-efficacy (Adjusted Odds Ratio, AOR=1.1; p=0.01), lower perceived condom use barriers (AOR=0.9; p=0.04) and not using douching as a method to prevent STI/HIV (AOR=4.8; p=0.04) significantly predicted consistent condom application. Higher HIV/AIDS knowledge was a marginally significant predictor of condom application (AOR=1.3; p=0.05). Future interventions should address these modifiable factors to encourage FSWs to apply condoms on clients themselves, which may reduce condom failure and exposure to HIV transmission.Association between sexually transmitted diseases and young adults' self-reported abstinence
AbstractDiClemente, R., Sales, J. M., Danner, F., & Crosby, R. A. (n.d.).Publication year
2011Journal title
PediatricsVolume
127Issue
2Page(s)
208-213AbstractOBJECTIVE: Self-reported behavior has been the cornerstone of sexual health research and clinical practice, yet advances in sexually transmitted disease (STD) screening provide researchers with the opportunity to objectively quantify sexual risk behaviors. However, the extent to which young adults' laboratory-confirmed STD results and selfreported sexual behaviors are consistent has not been assessed in a nationally representative sample. PATIENTS AND METHODS: Data are derived from participants who completed wave 3 in the National Longitudinal Study of Adolescent Health. Young adults (N = 14 012) completed an audio computer-assisted self-interviewing survey and provided a urine specimen to detect the presence of Chlamydia trachomatis and Neisseria gonorrhoeae, and a polymerase chain reaction assay to detect Trichomonas vaginalis. RESULTS: More than 10% of young adults with a laboratory-confirmed positive STD result reported abstaining from sexual intercourse in the 12 months before assessment and STD testing. After controlling for several sociodemographic factors, self-reported sex (versus those who reported abstinence) in the previous 12 months was significantly associated with testing positive, but the odds of testing positive were only slightly more than twofold (adjusted odds ratio: 2.11 [95% confidence interval: 2.097-2.122]). CONCLUSIONS: Findings indicate discrepancy between young adults' positive STD status and self-reported sexual behavior. No significant correlates of discrepant reporting were identified. From a clinical standpoint, the discrepancies between STD positivity and self-reported sexual behavior observed in this nationally representative sample suggest that routine STD screening may be beneficial and necessary to reduce STD morbidity among young adults.Bias in Online recruitment and retention of racial and ethnic minority men who have sex with men
AbstractSullivan, P. S., Khosropour, C. M., Luisi, N., Amsden, M., Coggia, T., Wingood, G. M., & DiClemente, R. (n.d.).Publication year
2011Journal title
Journal of medical Internet researchVolume
13Issue
2Page(s)
e38AbstractBackground: The Internet has become an increasingly popular venue for men who have sex with men (MSM) to meet potential sex partners. Given this rapid increase in online sex-seeking among MSM, Internet-based interventions represent an important HIV (human immunodeficiency virus) prevention strategy. Unfortunately, black and Hispanic MSM, who are disproportionately impacted by the HIV epidemic in the United States, have been underrepresented in online research studies. Objective: Our objective was to examine and quantify factors associated with underrecruitment and underretention of MSM of color in an online HIVbehavioral risk research study of MSM recruited from an online social networking site. Methods: Internet-using MSM were recruited through banner advertisements on MySpace.com targeted at men who reported in their MySpace profile their age as at least 18 and their sexual orientation as gay, bisexual, or unsure. Multivariable logistic regression models were used to estimate the odds stratified by race and ethnicity of the MySpace user clickingthrough the banner advertisement. To characterize survey retention, Kaplan-Meier survivalcurves and multivariable Cox proportional hazards models identified factors associated with survey dropout. Results: Over 30,000 MySpace users clicked on the study banner advertisements (click-through rate of 0.37%, or 30,599 clicks from 8,257,271 impressions). Black (0.36% or 6474 clicks from 1,785,088 impressions) and Hispanic (0.35% or 8873 clicks from 2,510,434 impressions) MySpace users had a lower click-through rate compared with white (0.48% or 6995 clicks from 1,464,262 impressions) MySpace users. However, black men had increased odds of click-through for advertisements displaying a black model versus a white model (adjusted odds ratio [OR] = 1.83, 95% confidence interval [CI] 1.72 - 1.95), and Hispanic participants had increased odds of click-through when shown an advertisement displaying an Asian model versus a white model (adjusted OR = 1.70, 95% CI 1.62 - 1.79). Of the 9005 men who consented to participate, 6258 (69%) completed the entire survey. Among participants reporting only male sex partners, black non-Hispanic and Hispanic participants were significantly more likely to drop out of the survey relative to white non-Hispanic participants (hazard ratio [HR] = 1.6, 95% CI 1.4 - 1.8 and HR = 1.3, 95% CI 1.1 - 1.4, respectively). Men with a college-level of education were more likely to complete the survey than those with a high-school level of education (HR = 0.8, 95% CI 0.7 - 0.9), while men who self-identified as heterosexual were more likely to drop out of the survey compared with men who self-identified as gay (HR = 2.1, 95% CI 1.1 - 3.7).Conclusions: This analysis identified several factors associated with recruitment and retention of MSM in an online survey. Differential click-through rates and increased survey dropout by MSM of color indicate that methods to recruit and retain black and Hispanic MSM in Internet-based research studies are paramount. Although targeting banner advertisements to MSM of color by changing the racial/ethnic composition of the advertisements may increase click-through, decreasing attrition of these study participants once they are engaged in the survey remains a challenge.Challenges in addressing depression in HIV research : Assessment, cultural context, and methods
AbstractSimoni, J. M., Safren, S. A., Manhart, L. E., Lyda, K., Grossman, C. I., Rao, D., Mimiaga, M. J., Wong, F. Y., Catz, S. L., Blank, M. B., DiClemente, R., & Wilson, I. B. (n.d.).Publication year
2011Journal title
AIDS and BehaviorVolume
15Issue
2Page(s)
376-388AbstractDepression is one of the most common co-morbidities of HIV infection. It negatively impacts self-care, quality of life, and biomedical outcomes among people living with HIV (PLWH) and may interfere with their ability to benefit from health promotion interventions. State-of-the-science research among PLWH, therefore, must address depression. To guide researchers, we describe the main diagnostic, screening, and symptom-rating measures of depression, offering suggestions for selecting the most appropriate instrument. We also address cultural considerations in the assessment of depression among PLWH, emphasizing the need to consider measurement equivalence and offering strategies for developing measures that are valid cross-culturally. Finally, acknowledging the high prevalence of depression among PLWH, we provide guidance to researchers on incorporating depression into the theoretical framework of their studies and employing procedures that account for participants with depression.Condom Use Among Young Women : Modeling the Theory of Gender and Power
AbstractDepadilla, L., Windle, M., Wingood, G., Cooper, H., & DiClemente, R. (n.d.).Publication year
2011Journal title
Health PsychologyVolume
30Issue
3Page(s)
310-319AbstractObjective: This study sought to articulate pathways between constructs from the theory of gender and power and their associations with sexual behavior. Design: The data were collected preintervention during a randomized controlled HIV prevention trial. Participants were 701 sexually active, unmarried African American females, aged 14-20, who were not pregnant, and were recruited from three health clinics in a southeastern US city. Structural equation modeling was used for the analyses. Main Outcome Measure: Self-reported condom use. Results: Theoretical associations yielded a well-fitting structural model across initial and cross-validation samples. A significant amount of variance was explained for the variables of condom use (R2 = .31, .18), partner communication (R2 = .30, .26), substance use during sex (R2 = .32, .51), and negative personal affect (R2 = .36, .48). Partner communication (.35, .38) was the strongest predictor of condom use, negative personal affect (-41, -37) was the strongest predictor of partner communication, and physical risk (.54, .54) was the strongest predictor of negative personal affect. Conclusion: This model provides evidence to support both direct and indirect associations between social and behavioral risk factors and condom use. Associations between theory of gender and power constructs and condom use can facilitate future development and analyses of interventions based on this theory.Correlates of 2009 H1N1 influenza vaccine acceptability among parents and their adolescent children
AbstractPainter, J. E., Gargano, L. M., Sales, J. M., Morfaw, C., Jones, L. M., Murray, D., DiClemente, R., & Hughes, J. M. (n.d.).Publication year
2011Journal title
Health Education ResearchVolume
26Issue
5Page(s)
751-760AbstractSchool-aged children were a priority group for receipt of the pandemic (2009) H1N1 influenza vaccine. Both parental and adolescent attitudes likely influence vaccination behaviors. Data were collected from surveys distributed to middle- and high-school students and their parents in two counties in rural Georgia. Multivariable logistic regression analyses were conducted to assess correlates of parental acceptance of H1N1 influenza vaccination for their children and adolescents' acceptance of vaccination for themselves. Concordance analyses were conducted to assess agreement between parent-adolescent dyads regarding H1N1 influenza vaccine acceptance. Parental acceptance of H1N1 influenza vaccination for their children was associated with acceptance of the vaccine for themselves and feeling motivated by the H1N1 influenza pandemic to get a seasonal influenza vaccine for their child. Adolescents' acceptance was associated with receipt of a seasonal influenza vaccine in the past year, fear of getting H1N1 influenza, feeling comfortable getting the vaccine and parental acceptance of H1N1 influenza vaccine. Half (50%) of parent-adolescent pairs included both a parent and child who expressed H1N1 influenza vaccine acceptance, and 19% of pairs would not accept the vaccine. This research highlights the need for interventions that target factors associated with H1N1 influenza vaccine acceptance among both parents and adolescents.Correlates of 2009 pandemic H1N1 influenza vaccine acceptance among middle and high school teachers in rural Georgia
AbstractGargano, L. M., Painter, J. E., Sales, J. M., Morfaw, C., Jones, L. M., Weiss, P., Murray, D., DiClemente, R., & Hughes, J. M. (n.d.).Publication year
2011Journal title
Journal of School HealthVolume
81Issue
6Page(s)
297-303AbstractBACKGROUND: Teachers play an essential role in the school community, and H1N1 vaccination of teachers is critical to protect not only themselves but also adolescents they come in contact within the classroom through herd immunity. School-aged children have a greater risk of developing H1N1 disease than seasonal influenza. The goal of this study was to assess the relationship between attitudes toward H1N1 vaccination and vaccine acceptance among middle and high school teachers in rural Georgia. METHODS: Participants were recruited from 2 counties participating in a school-based influenza vaccination intervention in rural Georgia. Data were collected from surveys distributed to middle and high school teachers in participating counties in September 2009 prior to implementing the interventions to increase vaccination against seasonal influenza. Multivariate logistic regression was used to assess the association between teachers' attitudes toward H1N1 vaccination and H1N1 vaccine acceptance, controlling for demographic variables. RESULTS: Among participants, 52.9% indicated that they would get the H1N1 vaccine. In multivariate analyses, H1N1 vaccine acceptance was associated with male gender (odds ratio[OR] = 3.67, p = .016), fear of contracting H1N1 (OR = 3.18, p = .025), and receipt of a seasonal influenza vaccine in the past year (OR = 3.07, p = .031). H1N1 vaccine acceptance was not significantly associated with age, race, perceived severity of H1N1, belief that the H1N1 vaccine would cause illness, or talking about H1N1 with friends. CONCLUSIONS: Teachers may play a pivotal role in school-based H1N1 vaccinations. Understanding and addressing teachers' attitudes toward H1N1 vaccination may assist in future immunization efforts.Determinants of multimethod contraceptive use in a sample of adolescent women diagnosed with psychological disorders
AbstractLang, D. L., Sales, J. M., Salazar, L. F., DiClemente, R., Crosby, R. A., Brown, L. K., & Donenberg, G. R. (n.d.).Publication year
2011Journal title
Infectious Diseases in Obstetrics and GynecologyVolume
2011AbstractObjective. Despite recommendations for concurrent use of contraceptives and condoms to prevent unintended pregnancy and STIs, multimethod contraceptive use among women is poor. This study examined individual-, interpersonal-, and environmental-level factors that predict multimethod use among sexually active adolescent women diagnosed with psychological disorders. Methods. This multisite study analyzed data from 288 sexually active adolescent women who provided sociodemographic, psychosocial, and behavioral data related to birth control and condom use. Results. 34.7% of the participants reported multimethod use in the past three months. Controlling for empirically and theoretically relevant covariates, a multivariable logistic regression identified self-efficacy, multiple partners, pregnancy history, parental communication, parental norms about sex, and neighborhood cohesion as significant predictors of multimethod use. Conclusions. While continued targeted messages about multi-method contraceptive use are imperative at the individual level, an uptake in messages targeting interpersonal- and environmental-level factors such as adolescents' parents and the broader community is urgently needed.Differences between African-American adolescent females with and without human papillomavirus infection
AbstractSeth, P., Wingood, G. M., DiClemente, R., Crosby, R. A., Salazar, L. F., Rose, E. S., & Sales, J. M. (n.d.).Publication year
2011Journal title
Sexual HealthVolume
8Issue
1Page(s)
125-127AbstractBackground: An important policy question is whether high-risk populations can be identified and prioritised for human papillomavirus (HPV) immunisation. Methods: Data collection included an audio computer-assisted survey interview and testing of Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, and HPV among 295 African-American adolescent females. Results: The results indicated that 43.1% tested positive for HPV. Logistic regression analyses indicated that HPV prevalence was not associated with other sexually transmissible infections (prevalence ratio (PR)=0.85, 95% confidence interval (CI)=0.51-1.41), unprotected vaginal sex (PR=1.04, 95% CI=0.56-1.92), having sex with an older male partner (PR=1.12, 95% CI=0.64-1.96), and having a casual partner (PR=0.89, 95% CI=0.54-1.48). Additionally, t-tests indicated that HPV prevalence was not associated with frequency of vaginal sex (t=0.17, P=0.87), protected sex (t=0.16, P=0.87), number of recent (t=0.40, P=0.69) or lifetime (t=1.45, P=0.15) sexual partners. However, those testing positive for HPV were younger (t=1.97, P=0.05) and reported current use of birth control pills (PR=2.38, 95% CI=1.00-5.63). Conclusions: It may not be possible to identify those with elevated risk of HPV acquisition. Thus, HPV vaccination, regardless of risk indicators, may be the most efficacious public health strategy.Efficacy of a health educator-delivered HIV prevention intervention for Latina women : A randomized controlled trial
AbstractWingood, G. M., Di Clemente, R. J., Villamizar, K., Er, D. L., De Varona, M., Taveras, J., Painter, T. M., Lang, D. L., Hardin, J. W., Ullah, E., Stallworth, J., Purcell, D. W., Jean, R., & DiClemente, R. (n.d.).Publication year
2011Journal title
American journal of public healthVolume
101Issue
12Page(s)
2245-2252AbstractObjectives: We developed and assessed AMIGAS (Amigas, Mujeres Latinas, Inform andonos, Gui andonos, y Apoy andonos contra el SIDA [friends, Latina women, informing each other, guiding each other, and supporting each other against AIDS]), a culturally congruent HIV prevention intervention for Latina women adapted from SiSTA (Sistas Informing Sistas about Topics on AIDS), an intervention for African American women. Methods: We recruited 252 Latina women aged 18 to 35 years in Miami, Florida, in 2008 to 2009 and randomized them to the 4-session AMIGAS intervention or a 1-session health intervention. Participants completed audio computer-assisted self-interviews at baseline and follow-up. Results: Over the 6-month follow-up, AMIGAS participants reported more consistent condom use during the past 90 (adjusted odds ratio [AOR]=4.81; PErratum : Associations between sexually transmitted diseases and young adults' self-reported abstinence (Pediatrics (2011) 127, 2, (208-213) DOI:10.1542/peds.2009-0892)
AbstractDiClemente, R. J., & DiClemente, R. (n.d.).Publication year
2011Journal title
PediatricsVolume
127Issue
4Page(s)
805Abstract~Examining the relationship between psychotropic medication use and testing positive for Chlamydia and Gonorrhea among detained adolescents
AbstractVoisin, D. R., Harris, T. T., Crosby, R. A., Salazar, L. F., & DiClemente, R. (n.d.).Publication year
2011Journal title
Children and Youth Services ReviewVolume
33Issue
9Page(s)
1527-1530AbstractObjective: We examined whether psychotropic medication (PTM) use was related to testing positive for Chlamydia and Gonorrhea among detained adolescents. Methods: A convenience sample of 550 detained adolescents ages 14-18. years were recruited from eight youth detention centers in Georgia. Using A-CASI technology, data was collected on demographic factors, use of PTM, and sexual risk behaviors. Chlamydia and Gonorrhea diagnoses were assessed by laboratory testing. Results: Thirteen percent (13.1%) of adolescents not using PTMs tested positive for STIs compared to only 4.9% of those reporting PTM use. PTM users had a 62% smaller odds ratio for testing positive for Chlamydia or Gonorrhea. Conclusion: Findings suggest that use of psychotropic medication, if deemed useful by detained youth, may be a protective factor against engaging in behaviors which may culminate in contracting some STDs. The practice implications are discussed within the context of these findings.Gardasil for guys : Correlates of intent to be vaccinated
AbstractCrosby, R. A., DiClemente, R., Salazar, L. F., Nash, R., & Younge, S. (n.d.).Publication year
2011Journal title
Journal of Men's HealthVolume
8Issue
2Page(s)
119-125AbstractBackground: The lack of post Food and Drug Administration (FDA)-approval acceptance studies among males aged 18-26 years is problematic relative to the design of human papillomavirus (HPV) vaccine promotion programs designed to target males. Accordingly this study identified correlates of intention to receive the HPV vaccine among young men. Methods: Young men (n= 150) were recruited from two university campuses in the southern United States. Men completed an audio computer-assisted self administered interview assessing their beliefs, attitudes, and intent to receive the vaccine, newly approved for males. Bivariate associations between various measures and men's intent to be vaccinated in the next 12 months were assessed using t-tests. Measures achieving bivariate significance were entered into a regression model. Results: In the regression model, those reporting oral-genital sex were more likely to have positive intent (β = 0.32, t= 4.20, P= 0.0001). Those classified as having a relatively higher perceived susceptibility to HPV were more likely to have positive intent (β = 0.19, t= 2.53, P= 0.013). Finally, intent was associated with agreement/disagreement to the statement that " the HPV vaccine is so new that I should wait awhile before deciding about getting vaccinated" (β = 0.19, t= 2.49, P= 0.014). Those not agreeing were more likely to have positive intent. Conclusion: Young men who have had oral-genital sex and those with greater perceptions of susceptibility to HPV may have greater intent to receive the HPV vaccine. A barrier reducing their intention for vaccination may be the relatively new introduction of this vaccine to the male population.Is male intent to be vaccinated against HPV a function of the promotion message?
AbstractDiClemente, R. J., Crosby, R. A., Salazar, L. F., Nash, R., Younge, S., & DiClemente, R. (n.d.).Publication year
2011Journal title
International Journal of STD and AIDSVolume
22Issue
6Page(s)
332-334AbstractWe aimed to determine whether the type of outcome expectation, stemming from HPV vaccination, would have any effect on young men's HPV vaccine intent. We recruited young men (18-24 years of age) from two university campuses (n = 150). After answering a series of questions they were randomly assigned to one of three information conditions (all delivered by computer): (1) how women may benefit from men's HPV vaccination, (2) preventing genital warts and (3) preventing head and neck cancers. Intent to be vaccinated against HPV in the next 12 months was assessed before and after receiving the informational session corresponding to the assigned condition. A repeated-measures t-test indicated that a significant increase in young men's intent to be vaccinated after they received the assigned information (t = 9.48, [147], P = 0.0001). However, the increase in intent to be vaccinated did not vary by group assignment as there were no significant differences in mean intent scores between the three groups (F = 0.59, [2/144], P = 0.56). Information that promotes the outcome expectations of protecting women from cervical cancer, preventing genital warts for men and preventing head and neck cancers for men may be equally effective in promoting increased intent for HPV vaccine acceptance among young university men.Long term effects of community-based STI screening and mass media HIV prevention messages on sexual risk behaviors of African American adolescents
AbstractSznitman, S., Stanton, B. F., Vanable, P. A., Carey, M. P., Valois, R. F., Brown, L. K., DiClemente, R., Hennessy, M., Salazar, L. F., & Romer, D. (n.d.).Publication year
2011Journal title
AIDS and BehaviorVolume
15Issue
8Page(s)
1755-1763AbstractWe examined the long-term effects of two interventions designed to reduce sexual risk behavior among African American adolescents. African American adolescents (N = 1383, ages 14-17) were recruited from community-based organizations over a period of 16 months in two northeastern and two southeastern midsized U.S. cities with high rates of sexually transmitted infection (STI). Participants were screened for three STIs (gonorrhea, chlamydia, and trichomoniasis) and completed an audio computer-assisted attitude, intention, and behavior self-interview. Youth who tested positive for an STI (8.3%) received treatment and risk reduction counseling. In addition, television and radio HIV-prevention messages were delivered during the recruitment period and 18 months of follow-up in one randomly selected city in each region. Analyses determined effects of the media program for those receiving a positive versus negative STI test result on number of sexual partners and occurrence of unprotected sex. Adolescents who tested STI-positive reduced their number of vaginal sex partners and the probability of unprotected sex over the first 6 months. However, in the absence of the mass media program, adolescents returned to their previously high levels of sexual risk behavior after 6 months. Adolescents who tested STI-positive and received the mass media program showed more stable reductions in unprotected sex. Community- based STI treatment and counseling can achieve significant, but short-lived reductions in sexual risk behavior among STI-positive youth. A culturally sensitive mass media program has the potential to achieve more stable reductions in sexual risk behavior and can help to optimize the effects of community-based STI screening.Longitudinal examination of alcohol use : A predictor of risky sexual behavior and trichomonas vaginalis among African-American female adolescents
AbstractSeth, P., Sales, J. M., DiClemente, R., Wingood, G. M., Rose, E., & Patel, S. N. (n.d.).Publication year
2011Journal title
Sexually Transmitted DiseasesVolume
38Issue
2Page(s)
96-101AbstractBackground: Alcohol use has been linked to risky sexual practices among adolescents. However, limited research on alcohol use and risky sexual behavior has been conducted on African-American female adolescents. This study examined high quantity of alcohol as a longitudinal predictor of risky sexual behavior and sexually transmitted diseases (STDs) among African-American female adolescents, a high-risk population for STDs. Methods: Three hundred ninety-three adolescent females, 15 to 21 years, were assessed on sociodemographics, alcohol use, and risky sexual behaviors. Participants also provided 2 swab specimens that were assayed for STDs. High quantity of alcohol use was defined as 3 drinks in 1 sitting. Results: Binary generalized estimating equation models were conducted assessing the impact of alcohol use at baseline on risky sexual behavior and STDs over a 12-month period. Age, intervention group, and baseline outcome measures were entered as covariates. The results indicated that high quantity of alcohol use predicted positive TV test results, inconsistent condom use, high sexual sensation seeking, multiple sexual partners, sex while high on alcohol or drugs, and having anal sex over a 12-month follow-up period. Conclusions: These findings suggest that HIV/STD-related behavioral interventions for African-American adolescents should discuss the link between alcohol and HIV/STD-risk behavior. A deeper understanding is paramount to the development of efficacious prevention programs at individual and community levels.Monitoring Challenges : A Closer Look at Parental Monitoring, Maternal Psychopathology, and Adolescent Sexual Risk
AbstractHadley, W., Hunter, H. L., Tolou-Shams, M., Lescano, C., Thompson, A., Donenberg, G., DiClemente, R., & Brown, L. K. (n.d.).Publication year
2011Journal title
Journal of Family PsychologyVolume
25Issue
2Page(s)
319-323AbstractThe present study sought to examine associations between maternal psychopathology, parental monitoring, and adolescent sexual activity among adolescents in mental health treatment. Seven hundred ninety mother-adolescent dyads recruited from adolescent mental health treatment settings completed audio computer-assisted structured interview assessments examining parent psychiatric symptoms, parental monitoring, and adolescent sexual risk behavior. Path analysis was used to examine the associations between variables of interest. Maternal caregivers who reported more mental health symptoms were more likely to have adolescents who reported recent sex and this relationship was mediated by less parental monitoring. These findings suggest that maternal caregivers with mental health symptoms may need specific interventions that provide assistance and support in monitoring their teens in order to reduce sexual risk taking among adolescents in mental health treatment.Multicomponent interventions to enhance influenza vaccine delivery to adolescents
AbstractGargano, L. M., Pazol, K., Sales, J. M., Painter, J. E., Morfaw, C., Jones, L. D., Weiss, P., Buehler, J. W., Murray, D. L., Wingood, G. M., Orenstein, W. A., DiClemente, R., & Hughes, J. M. (n.d.).Publication year
2011Journal title
PediatricsVolume
128Issue
5Page(s)
e1092-e1099AbstractOBJECTIVE: To compare school- versus provider-based approaches to improving influenza vaccination coverage among adolescents in rural Georgia. METHODS: We used a nonrandomized, 3-armed design: (1) a middle-and high school-based influenza vaccination intervention in 1 county; (2) a provider-based influenza vaccination intervention in a second county; and (3) a standard-of-care condition in a third county. Interventions also included distribution of an educational brochure, school presentations, and community-based outreach to enhance vaccine knowledge and awareness among adolescents and their parents. RESULTS: During the 2008-2009 influenza season, 70 (19%) of 370 students were vaccinated in the school-based county and 110 (15%) of 736 students were vaccinated in the provider-based county, compared with 71 (8%) of 889 students in the standard-of-care county (risk ratio [RR] school: 2.4 [95% confidence interval (CI): 1.7-3.2]; RR provider: 1.9 [95% CI: 1.4 -2.5]). During 2009 -2010, seasonal influenza vaccination coverage was 114 (30.4%) of 375 of students in the school-based county, 122 (16.9%) of 663 of students in the provider-based county, and 131 (15.2%) of 861 students in the standard-of-care county (RR school: 2.3 [95% CI: 1.9 -2.9]; RR provider: 1.2 [95% CI: 0.97-1.5]). CONCLUSIONS: Special efforts to promote influenza vaccination among rural, predominantly black students were associated with increased vaccination coverage. The school-based influenza vaccination intervention was associated with the highest levels of vaccination coverage. This study revealed the efficacy of school-based influenza education to improve vaccination rates among adolescents.