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
Human papillomavirus vaccination among adolescents in Georgia
AbstractUnderwood, N. L., Weiss, P., Gargano, L. M., Seib, K., Rask, K. J., Morfaw, C., Murray, D., DiClemente, R., Hughes, J. M., & Sales, J. M. (n.d.).Publication year
2015Journal title
Human Vaccines and ImmunotherapeuticsVolume
11Issue
7Page(s)
1703-1708AbstractHuman papillomavirus (HPV) vaccination coverage for adolescent females and males remains low in the United States. We conducted a 3-arm randomized controlled trial (RCT) conducted in middle and high schools in eastern Georgia from 2011–2013 to determine the effect of 2 educational interventions used to increase adolescent vaccination coverage for the 4 recommended adolescent vaccines: Tdap, MCV4, HPV and influenza. As part of this RCT, this article focuses on: 1) describing initiation and completion of HPV vaccine series among a diverse population of male and female adolescents; 2) assessing parental attitudes toward HPV vaccine; and 3) examining correlates of HPV vaccine series initiation and completion. Parental attitude score was the strongest predictor of HPV vaccine initiation among adolescents (adjusted odds ratio (aOR): 2.08; 95% confidence interval (CI): 1.80, 2.39). Other correlates that significantly predicted HPV series initiation were gender, study year, and intervention arm. Parental attitudes remained a significant predictor of receipt of 3 doses of HPV vaccine along with gender, race, school type and insurance type. This study demonstrates that positive parental attitudes are important predictors of HPV vaccination and critical to increasing coverage rates. Our findings suggest that more research is needed to understand how parental attitudes are developed and evolve over time.Human papillomavirus vaccine intention among college men : What's oral sex got to do with it?
AbstractCrosby, R. A., DiClemente, R., Salazar, L. F., Nash, R., Younge, S., & Head, S. (n.d.).Publication year
2012Journal title
Journal of American College HealthVolume
60Issue
1Page(s)
8-12AbstractObjective: To identify associations between engaging in oral sex and perceived risk of oral cancer among college men. Also, to identify associations, and their moderating factors, between oral sex and human papillomavirus (HPV) vaccine acceptance. Methods: Young men were recruited from 2 university campuses in the South (N = 150). Men completed an audio computer-assisted self-administered interview. Results: With the exception of receiving fellatio, each measure of oral sex behavior was significantly associated with greater perceived risk of oral cancer. Four oral sex behaviors evidenced significant associations with vaccine acceptance. Men engaging in recent oral sex or reporting oral sex behaviors with more than 2 partners were more likely to indicate vaccine intent. African American/black race, communication with parents about sex-related topics, and HPV-related stigma/shame were identified as moderating factors. Conclusion: Young college men giving or receiving oral sex with multiple partners may be predisposed to HPV vaccination.Identification of strategies for promoting condom use : A prospective analysis of high-risk African American female teens
AbstractCrosby, R. A., DiClemente, R., Wingood, G. M., Salazar, L. F., Harrington, K., Davies, S. L., & Oh, M. K. (n.d.).Publication year
2003Journal title
Prevention ScienceVolume
4Issue
4Page(s)
263-270AbstractCondom promotion strategies for adolescents typically include provision of STD/HIV-associated knowledge, fostering favorable attitudes toward condom use, promoting positive peer norms regarding condom use, improving condom-related communication skills and self-efficacy, and overcoming barriers to condom use. The purpose of this study was to identify which of these constructs were prospectively associated with condom use among a high-risk sample of African American adolescent females reporting sexual activity with a steady male partner. Adolescents, 14-18 years old, were recruited from schools and health clinics. Adolescents completed an in-depth survey and interview at baseline and again 6 months later. Analyses were limited to adolescents with steady partners who reported sexual activity between the baseline and 6-month follow-up assessment periods (N = 179). At baseline, five-scale measures and a single-item measure were used to assess predictive constructs. At follow-up, adolescents were asked about their frequency of condom use over various periods of recall. Multivariate models were created to control for the confounding influence of pregnancy status. The findings were remarkably distinct. The evidence strongly supported the predictive role of perceived barriers toward condom use and peer norms. The measure of sexual communication achieved significance for two of the six assessed outcomes. Alternatively, measures of attitudes toward condom use, condom negotiation self-efficacy, and knowledge about STD/HIV-prevention were consistently nonsignificant. The findings suggest that to improve effectiveness of individual-level STD/HIV prevention programs, designed for this population, program emphasis should be on reducing barriers to condom use, teaching partner communication skills, and fostering positive peer norms relevant to condom use.Identifying psychosocial and social correlates of sexually transmitted diseases among black female teenagers
AbstractKraft, J. M., Whiteman, M. K., Carter, M. W., Snead, M. C., DiClemente, R., Murray, C. C., Hatfield-Timajchy, K., & Kottke, M. (n.d.).Publication year
2015Journal title
Sexually Transmitted DiseasesVolume
42Issue
4Page(s)
192-197AbstractBackground: Black teenagers have relatively high rates of sexually transmitted diseases (STDs), and recent research suggests the role of contextual factors, as well as risk behaviors.We explore the role of 4 categories of risk and protective factors on having a biologically confirmed STD among black, female teenagers. Methods: Black teenage girls (14-19 years old) accessing services at a publicly funded family planning clinic provided a urine specimen for STD testing and completed an audio computer-assisted self-interview that assessed the following: risk behaviors, relationship characteristics, social factors, and psychosocial factors. We examined bivariate associations between each risk and protective factor and having gonorrhea and/or chlamydia, as well as multivariate logistic regression among 339 black female teenagers. Results: More than one-fourth (26.5%) of participants had either gonorrhea and/or chlamydia. In multivariate analyses, having initiated sex before age 15 (adjusted odds ratio [aOR], 1.87) and having concurrent sex partners in the past 6 months (aOR, 1.55) were positively associated with having an STD. Living with her father (aOR, 0.44), believing that an STD is theworst thing that could happen (aOR, 0.50), and believing shewould feel dirty and embarrassed about an STD (aOR, 0.44) were negatively associated with having an STD. Conclusions: Social factors and attitudes toward STDs and select risk behaviors were associated with the risk for STDs, suggesting the need for interventions that address more distal factors. Future studies should investigate how such factors influence safer sexual behaviors and the risk for STDs among black female teenagers.Identifying the prevalence and correlates of stds among women residing in rural domestic violence shelters
AbstractWingood, G. M., DiClemente, R., & Raj, A. (n.d.).Publication year
2000Journal title
Women and HealthVolume
30Issue
4Page(s)
15-26AbstractThe present study uses a cross-sectional study design to assess the prevalence and abuse-related correlates of STDs among women (n = 203) residing in rural and nonurban domestic violence shelters, a venue in which health care providers could intervene by providing STD prevention counseling, diagnosis and treatment. To our knowledge, this is the first study to examine the prevalence and correlates of self-reported STDs among women residing in domestic violence shelters. In this sample, 99% of women reported being physically abused in the prior 2 months, 55% reported being sexually abused and 43% reported being raped. Further, 33% of women reported acquiring an STD during their abusive relationship, 13.3% reported acquiring multiple STDs and 9.2% reported acquiring an STD in the 2 months prior to entering the shelter. In this sample having a history of rape, having an unfaithful partner and fear negotiating condom use were all associated with having an STD history. Coordinating STD services with domestic violence shelters could reach a high-risk population that is not traditionally targeted by STD programs, could increase early detection of STDs, may increase access to and improve the quality of STD-related care, particularly among rural populations, and could be cost-effective.Images of sexual stereotypes in rap videos and the health of African American female adolescents
AbstractPeterson, S. H., Wingood, G. M., DiClemente, R., Harrington, K., & Davies, S. (n.d.).Publication year
2007Journal title
Journal of Women's HealthVolume
16Issue
8Page(s)
1157-1164AbstractObjective: This study sought to determine whether perceiving portrayals of sexual stereotypes in rap music videos was associated with adverse health outcomes among African American adolescent females. Methods: African American female adolescents (n = 522) were recruited from community venues. Adolescents completed a survey consisting of questions on sociodemographic characteristics, rap music video viewing habits, and a scale that assessed the primary predictor variable, portrayal of sexual stereotypes in rap music videos. Adolescents also completed an interview that assessed the health outcomes and provided urine for a marijuana screen. Results: In logistic regression analyses, adolescents who perceived more portrayals of sexual stereotypes in rap music videos were more likely to engage in binge drinking (OR 3.8, 95% CI 1.32-11.04, p = 0.01), test positive for marijuana (OR 3.4, 95% CI 1.19-9.85, p = 0.02), have multiple sexual partners (OR 1.9, 95% CI 1.01-3.71, p = 0.04), and have a negative body image (OR 1.5, 95% CI 1.02-2.26, p = 0.04). This is one of the first studies quantitatively examining the relationship between cultural images of sexual stereotypes in rap music videos and a spectrum of adverse health outcomes in African American female adolescents. Conclusions: Greater attention to this social issue may improve the health of all adolescent females.Impact of a physician recommendation and parental immunization attitudes on receipt or intention to receive adolescent vaccines
AbstractGargano, L. M., Herbert, N. L., Painter, J. E., Sales, J. M., Morfaw, C., Rask, K., Murray, D., DiClemente, R., & Hughes, J. M. (n.d.).Publication year
2013Journal title
Human Vaccines and ImmunotherapeuticsVolume
9Issue
12Page(s)
2627-2633AbstractFour vaccines are recommended by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices for adolescents. Parental attitudes may play a key role in vaccination uptake in this age group. In 2011, we conducted a cross-sectional survey among parents of adolescents in one county in Georgia to identify parental attitudes toward adolescent vaccination, reasons for vaccine acceptance or refusal, and impact of a physician recommendation for vaccination. Physician recommendation was reported as one of the top reasons for receipt or intent to receive any of the vaccines. Physician recommendation of any of the four vaccines was associated with receipt of Tdap (p < 0.001), McV4 (p < 0.001), and hPV (p = 0.03) and intent to receive Tdap (p = 0.05), McV4 (p = 0.005), and hPV (p = 0.05). compared with parents who did not intend to have their adolescent vaccinated with any of the vaccines, parents who did intend reported higher perceived susceptibility (3.12 vs. 2.63, p = 0.03) and severity of disease (3.89 vs. 3.70, p = 0.02) and higher perceived benefit of vaccination (8.48 vs. 7.74, p = 0.02). These findings suggest that future vaccination efforts geared toward parents may benefit from addressing the advantages of vaccination and enhancing social norms. Physicians can play a key role by providing information on the benefits of adolescent vaccination.Impact of abuse history on adolescent African American women's current HIV/STD-associated behaviors and psychosocial mediators of HIV/STD risk
AbstractBrown, J. L., Young, A. M., Sales, J. M., DiClemente, R., Rose, E. S., & Wingood, G. M. (n.d.).Publication year
2014Journal title
Journal of Aggression, Maltreatment and TraumaVolume
23Issue
2Page(s)
151-167AbstractThis study examined if relationship power, sex refusal self-efficacy, or fear of condom negotiation mediated the relationship between abuse history and consistent condom use (CCU) among African American female adolescents (N = 593). Participants with an abuse history (58%) were less likely to report CCU. Women with an abuse history reported less relationship power and self-efficacy for refusing sex and more fear of condom negotiation, none of which independently or jointly mediated the association between abuse and CCU. Notably, history of abuse was associated with CCU across mediator models despite inclusion of psychosocial mediators. This study demonstrates the importance of understanding adolescents'condom use behaviors within the context of their life experiences, especially past abuse history.Impact of COVID-19-related knowledge on protective behaviors : The moderating role of primary sources of information
AbstractKim, S., Capasso, A., Cook, S. H., Ali, S. H., Jones, A. M., Foreman, J., DiClemente, R., & Tozan, Y. (n.d.).Publication year
2021Journal title
PloS oneVolume
16Issue
11AbstractThis study assessed the modifying role of primary source of COVID-19 information in the association between knowledge and protective behaviors related to COVID-19 among adults living in the United States (US). Data was collected from 6,518 US adults through an online cross-sectional self-administered survey via social media platforms in April 2020. Linear regression was performed on COVID-19 knowledge and behavior scores, adjusted for sociodemographic factors. An interaction term between knowledge score and primary information source was included to observe effect modification by primary information source. Higher levels of knowledge were associated with increased self-reported engagement with protective behaviors against COVID-19. The primary information source significantly moderated the association between knowledge and behavior, and analyses of simple slopes revealed significant differences by primary information source. This study shows the important role of COVID-19 information sources in affecting people's engagement in recommended protective behaviors. Governments and health agencies should monitor the use of various information sources to effectively engage the public and translate knowledge into behavior change during an evolving public health crisis like COVID-19.Improving health outcomes for IPV-exposed women living with HIV
AbstractWingood, G. M., DiClemente, R., & Seth, P. (n.d.).Publication year
2013Journal title
Journal of Acquired Immune Deficiency SyndromesVolume
64Issue
1Page(s)
1-2Abstract~Improving HPV vaccination uptake among adolescents in low resource settings: Sociocultural and socioeconomic barriers and facilitators
AbstractDiClemente, R., Xu, M., Choi, J., & Capasso, A. (n.d.).Publication year
2024Volume
Adolesc Health, Med, Therapeutics, 15Abstract~Improving HPV vaccination uptake among adolescents in low-resource settings: Sociocultural barriers and facilitators
AbstractDiClemente, R., Xu, M., Choi, J., & Capasso, A. (n.d.). (Adolescent Health, Medicine, and Therapeutics).Publication year
2025AbstractXu MA, Choi J, Capasso A, DiClemente R. Enhancing vaccine uptake among boys and girls: the importance of targeting both genders for optimal HPV vaccine coverage in LMICs. Vaccines.Improving the validity of self-reported sexual behavior : No easy answers
AbstractDiClemente, R., Swartzendruber, A. L., & Brown, J. L. (n.d.).Publication year
2013Journal title
Sexually Transmitted DiseasesVolume
40Issue
2Page(s)
111-112Abstract~In their own words : Romantic relationships and the sexual health of young African American women
AbstractMurray, C. C., Hatfield-Timajchy, K., Kraft, J. M., Bergdall, A. R., Habel, M. A., Kottke, M., & DiClemente, R. (n.d.).Publication year
2013Journal title
Public Health ReportsVolume
128Issue
SUPPL. 1Page(s)
33-42AbstractObjective. We assessed young African American women's understanding of "dual protection" (DP) (i.e., strategies that simultaneously protect against unintended pregnancies and sexually transmitted diseases [STDs]) and how relationship factors influence their use of DP methods. Methods. We conducted 10 focus groups with African American women (n551) aged 15-24 years in Atlanta, Georgia, to identify barriers to and facilitators of their DP use. Focus group participants also completed a brief self-administered questionnaire that assessed demographics and sexual behaviors. We analyzed focus group data by theme: relationships, planning for sex, pregnancy intentions, STD worries, the trade-off between pregnancy and STDs, attitudes toward condoms and contraceptives, and understanding of DP. Results. From the questionnaire, 51% of participants reported that an STD would be the "worst thing that could happen," and 26% reported that being pregnant would be "terrible." Focus group data suggested that most participants understood what DP was but thought it was not always feasible. Relationship factors (e.g., trust, intimacy, length of relationship, and centrality) affected pregnancy intentions, STD concerns, and use of DP. Social influences (e.g., parents) and pregnancy and STD history also affected attitudes about pregnancy, STDs, and relationships. Conclusions. Although participants identified risks associated with sex, a complex web of social and relationship factors influenced the extent to which they engaged in protective behavior. The extent to which relationship factors influence DP may reflect developmental tasks of adolescence and should be considered in any program promoting sexual health among young African American women.Incentivizing drug-using women's long-term contraceptive use : Some answers, more questions
AbstractDiClemente, R., & Young, A. (n.d.).Publication year
2012Journal title
AddictionVolume
107Issue
6Page(s)
1042-1043Abstract~Incorporating Communication into the Theory of Planned Behavior to Predict Condom Use Among African American Women
AbstractGuan, M., Coles, V. B., Samp, J. A., Sales, J. M., DiClemente, R., & Monahan, J. L. (n.d.).Publication year
2016Journal title
Journal of Health CommunicationVolume
21Issue
9Page(s)
1046-1054AbstractThe present research extends the theory of planned behavior (TPB) to investigate how communication-related variables influence condom use intention and behavior among African American women. According to the TPB, attitudes, subjective norms, and self-efficacy are associated with behavioral intent, which predicts behavior. For women, it was argued that condom negotiation self-efficacy was more important than condom use self-efficacy in predicting consistent condom use. Moreover, an important environmental factor that affects condom use for African American women is fear or worry when negotiating condom use because the sex partners might leave, threaten, or abuse them. Fears associated with negotiating condom use were predicted to be negatively associated with attitudes, subjective norms, and self-efficacy. African American women (N = 560; M age = 20.58) completed assessments of TPB variables at baseline and condom use 3 months later. Condom negotiation self-efficacy was a significant indicator of behavioral intent, while condom use self-efficacy was not. Fear of condom negotiation was negatively associated with all TPB components, which was in turn significantly associated with behavioral intent and condom use. Implications for the TPB, safer sex literature, and sexually transmitted infection prevention intervention design are discussed.Increased alcohol use during the COVID-19 pandemic : The effect of mental health and age in a cross-sectional sample of social media users in the U.S.
AbstractCapasso, A., Jones, A. M., Ali, S. H., Foreman, J., Tozan, Y., & DiClemente, R. (n.d.).Publication year
2021Journal title
Preventive MedicineVolume
145AbstractThe COVID-19 pandemic has triggered a public health crisis of unprecedented scale. Increased alcohol use has been extensively documented during other crises, particularly among persons with anxiety and depression. Despite COVID-19's differential impact by age, the association of age, mental health and alcohol use during the pandemic has not been explored. This study aimed to examine whether age modified the association of anxiety and depressive symptoms with alcohol use during the COVID-19 pandemic. Two online surveys were administered to U.S. adult social media users in March and April 2020. Generalized linear models were conducted in 2020 among 5850 respondents (52.9% female; 22.0% aged 18–39 years, 47.0% aged 40–59 years, and 31.0% aged ≥60 years) to examine if age modified the association of anxiety and depression symptomatology and alcohol use. Overall, 29% of respondents reported increased alcohol use. Adjusted odds ratios of reporting increased alcohol use were 1.41 (95% CI = 1.20–1.66) among respondents with anxiety symptoms and 1.64 (95% CI = 1.21–2.23) among those with depressive symptoms compared to those without such symptoms. Whereas respondents aged 18–39 years had the highest probability of reporting increased alcohol use, the probability of older persons (40–59 and ≥60 years) reporting increased drinking was much greater among those with symptoms of anxiety and depression, compared to those without symptoms. These findings warrant age-differentiated public health messaging on the risks of excessive alcohol use and scale-up of substance use services for middle-aged and older adults with symptoms of depression and anxiety.Individual- and Community-Level Factors in the STD Status of Justice-Involved Youth : Multi-Group, Exploratory Two-Level Analysis
AbstractDembo, R., Faber, J., Cristiano, J., Wareham, J., Krupa, J., Schmeidler, J., Terminello, A., & DiClemente, R. (n.d.).Publication year
2019Journal title
Archives of Sexual BehaviorVolume
48Issue
7Page(s)
2171-2186AbstractJustice-involved youth display higher prevalence rates of sexually transmitted diseases (STDs), in comparison with youth in the general population, highlighting a critical public health concern. Individual factors are important predictors of STDs, but only provide a partial understanding of this public health issue. Communities experiencing higher levels of disorder and lower levels of cohesion tend to have fewer institutional resources available, which may impact sexual risk behavior and STDs. However, few studies have examined the association between community characteristics and STD prevalence among adolescents. The current study examined community-level (n = 106) characteristics and individual-level attributes in explaining STDs among justice-involved youth (n = 1233: n = 515 female; n = 718 male). At the individual level, results showed older males and those with more drug-related problems were more likely to be STD positive, while females with more sexual partners and those with less drug-related problems were more likely to be STD positive. At the community level, females residing in areas with fewer educated residents were more likely to be STD positive. These gender differences were significant, suggesting a gendered perspective is important for understanding STD infection. The justice system represents a critical opportunity in the treatment and prevention of STDs for youth.Influence of sexual arousability on partner communication mediators of condom use among African American female adolescents
AbstractSwartzendurber, A., Murray, S. H., Sales, J. M., Milhausen, R. R., Sanders, S. A., Graham, C. A., DiClemente, R., & Wingood, G. M. (n.d.).Publication year
2015Journal title
Sexual HealthVolume
12Issue
4Page(s)
322-327AbstractBackground Ample evidence shows that partner sexual communication is related to condom use. Although communication about safer sex may often occur when sexual arousal is high, no studies have examined arousability, one's propensity for sexual arousal and partner sexual communication. The purpose of this study was to examine associations between sexual arousability and partner-related mediators of condom use among African American female adolescents, who have disproportionate risk for HIV and sexually transmissible infections (STIs). Methods: The study analysed self-reported baseline data from 701 African American females aged 14-20 years participating in a HIV/STI trial. Linear regression models examined associations between arousability and partner-related mediators of condom use (partner sexual communication self-efficacy, partner sexual communication frequency, sex refusal self-efficacy and condom use self-efficacy), controlling for age, impulsivity and relationship power. Results: Greater arousability was significantly associated with reduced levels of each partner communication outcome assessed (partner sexual communication self-efficacy, partner sexual communication frequency and sex refusal self-efficacy) but was not associated with condom use self-efficacy. Conclusions: Arousal and other positive aspects of sex have largely been ignored by HIV/STI prevention efforts, which primarily focus on individual behaviour. A population-level sexual health approach focusing on sexual wellbeing may reduce stigma, facilitate partner sexual communication and be more effective at reducing HIV/STI rates than traditional approaches.Influence of sexual sensation-seeking on factors associated with risky sexual behaviour among African-American female adolescents
AbstractRitchwood, T. D., Penn, D. C., DiClemente, R., Rose, E. S., & Sales, J. M. (n.d.).Publication year
2014Journal title
Sexual HealthVolume
11Issue
6Page(s)
540-546AbstractBackground The identification of antecedents to sexual risk among youth is critical to the development and dissemination of multilevel interventions. Therefore, the aim of the present study was to examine the effect of sexual sensation-seeking on partner age, partner communication, and the sexual attitudes and behaviours of African-American female youth. Methods: This study examined survey data collected by audio computer-assisted self-interviews from 701 young African-American females between 14 and 20 years of age. The survey consisted of items designed to measure adolescents' sexual risk and preventive behaviours. Results: The results of this study suggest that sexual sensation-seeking is associated with condom use among adolescent African-American females. For adolescents who reported greater sexual sensation-seeking, lower levels of sexual happiness were associated with a decreased likelihood of condom use at last intercourse (β≤1.01, P≤0.05). For those reporting lower levels of sexual sensation-seeking, greater sexual enjoyment was associated with a greater likelihood of condom use at last intercourse (β≤0.93, P≤0.01). Adolescents with younger sexual partners and lower levels of sexual sensation-seeking reported a higher proportion of condom use in the past 6 months (β≤0.70, P≤0.01). Higher partner communication self-efficacy and decreasing levels of sexual sensation-seeking were associated with fewer lifetime sexual partners (β≤-0.54, P≤0.05). Conclusions: Future research should address the impact of these variables on adolescent relationship dynamics and sexual decision-making.Influence of sources of information about influenza vaccine on parental attitudes and adolescent vaccine receipt
AbstractGargano, L. M., Underwood, N. L., Sales, J. M., Seib, K., Morfaw, C., Murray, D., DiClemente, R., & Hughes, J. M. (n.d.).Publication year
2015Journal title
Human Vaccines and ImmunotherapeuticsVolume
11Issue
7Page(s)
1641-1647AbstractIn 2011–2012, only 34% of 13–17 years olds in the United States (US) received seasonal influenza vaccine. Little is known about the link between parents' sources of health information, their vaccine-related attitudes, and vaccination of their adolescent against influenza. This study seeks to determine the relationship between number of sources of information on influenza vaccine, parental attitudes toward influenza vaccine, and influenza vaccine uptake in adolescents. We conducted a telephone and web-based survey among US parents of students enrolled in 6 middle and 5 high schools in Georgia. Bivariate and multivariable analyses were conducted to examine associations between the number of information sources about influenza vaccine and vaccine receipt and whether parent vaccine-related attitudes act as a mediator. The most commonly reported sources of information were: a physician/medical professional (95.0%), a family member or friend (80.6%), and television (77.2%). Parents who had higher attitude scores toward influenza vaccine were 5 times as likely to report their adolescent had ever received influenza vaccine compared to parents who had lower attitude scores (adjusted odds ratio (aOR) 5.1; 95% confidence intervals (CI) 3.1–8.4; P < 0.01). Parent vaccine-related attitudes were a significant mediator of the relationship between sources of information and vaccine receipt. In light of the low response rate and participation in an adolescent vaccination intervention, findings may not be generalizable to other populations. This study shows the importance of multiple sources of information in influencing parental decision-making about influenza vaccine for adolescents. Harnessing the power of mass media and family members and friends as health advocates for influenza vaccination can potentially help increase vaccination coverage of adolescents.Infrequent parental monitoring predicts sexually transmitted infections among low-income African American female adolescents
AbstractCrosby, R. A., DiClemente, R., Wingood, G. M., Lang, D. L., & Harrington, K. (n.d.).Publication year
2003Journal title
Archives of Pediatrics and Adolescent MedicineVolume
157Issue
2Page(s)
169-173AbstractObjective: To prospectively determine (using an 18-month follow-up period) the association between African American female adolescents' perceptions of parental monitoring and their acquisition of biologically confirmed infection with Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Design: A prospective cohort study of 217 African American female adolescents enrolled in the control arm of a randomized trial of a human immunodeficiency virus prevention intervention program. Setting and Participants: A volunteer sample of adolescents (aged 14-18 years) recruited from low-income neighborhoods characterized by high rates of unemployment, substance abuse, violence, and sexually transmitted diseases. Main Outcome Measures: Adolescents provided 2 self-collected vaginal swab specimens. One was tested for C trachomatis and N gonorrhoeae DNA with ligase chain reaction. The other was used to inoculate culture medium for T vaginalis. Identical assay procedures were repeated at the 6-month, 12-month, and 18-month follow-up intervals. Results: Adjusted odds ratios indicated that adolescents who perceived infrequent parental monitoring at baseline were 1.8 (95% confidence interval, 1.01-3.21) and 2.4 (95% confidence interval, 1.22-4.87) times more likely to acquire chlamydia or trichomoniasis, respectively, compared with their counterparts who perceived greater levels of monitoring. Similarly, adolescents who perceived infrequent parental monitoring were 2.1 (95% confidence interval, 1.16-3.74) times more likely to test positive for a sexually transmitted infection during the course of the 18-month follow-up period. Conclusions: Adolescents' perceptions of their parental-monitoring levels predicted subsequent acquisition of biologically confirmed chlamydia and trichomoniasis infections. These findings suggest that expanded efforts leading toward effective clinic- and community-based sexually transmitted infection intervention programs involving parents may be warranted.Integrating condom skills into family-centered prevention : Efficacy of the strong african american families-teen program
AbstractKogan, S. M., Yu, T., Brody, G. H., Chen, Y. F., DiClemente, R., Wingood, G. M., & Corso, P. S. (n.d.).Publication year
2012Journal title
Journal of Adolescent HealthVolume
51Issue
2Page(s)
164-170AbstractPurpose: The Strong African American Families-Teen (SAAF-T) program, a family-centered preventive intervention that included an optional condom skills unit, was evaluated to determine whether it prevented unprotected intercourse and increased condom efficacy among rural African American adolescents. Ancillary analyses were conducted to identify factors that predicted youth attendance of the condom skills unit. Methods: Sixteen-year-old African American youths (N = 502) and their primary caregivers were randomly assigned to SAAF-T (n = 252) or an attention control (n = 250) intervention. SAAF-T families participated in a 5-week family skills training program that included an optional condom skills unit. All families completed in-home pretest, posttest, and long-term follow-up interviews during which adolescents reported on their sexual behavior, condom use, and condom efficacy. Because condom use was addressed only in an optional unit that required caregiver consent, we analyzed efficacy using complier average causal effect analyses. Results: Attendance in both SAAF-T and the attention control intervention averaged 4 of 5 sessions; 70% of SAAF-T youth attended the condom skills unit. Complier average causal effect models indicated that SAAF-T was efficacious in reducing unprotected intercourse and increasing condom efficacy among rural African American high school students. Exploratory analyses indicated that religious caregivers were more likely than nonreligious caregivers to have their youth attend the condom skills unit. Conclusions: Results suggest that brief condom skills educational modules in the context of a family-centered program are feasible and reduce risk for sexually transmitted infections and unplanned pregnancies.Interaction Between 5-HTTLPR Polymorphism and Abuse History on Adolescent African-American Females' Condom Use Behavior Following Participation in an HIV Prevention Intervention
AbstractSales, J. M., DiClemente, R., Brody, G. H., Philibert, R. A., & Rose, E. (n.d.).Publication year
2014Journal title
Prevention ScienceVolume
15Issue
3Page(s)
257-267AbstractNot everyone exposed to an efficacious human immunodeficiency virus (HIV) intervention will reduce sexual risk behaviors, yet little is known about factors associated with "failure to change" high-risk sexual behaviors post-intervention. History of abuse and polymorphisms in the serotonin transporter gene (5-HTT) may be associated with non-change. The current study sought to identify genetic, life history, and psychosocial factors associated with adolescents' failure to change condom use behaviors post-participation in an HIV prevention intervention. A sub-set of participants from a clinic-based sample of adolescent African-American females (N = 254) enrolled in a randomized trial of an HIV-prevention was utilized for the current study. Forty-four percent did not increase their condom use from baseline levels 6 months after participating in the sexually transmitted infection (STI)/HIV prevention intervention. In multivariable logistic regression analysis, an interaction between abuse and 5-HTTLPR group was significantly associated with non-change status, along with partner communication frequency scores at follow-up. Follow-up tests found that having a history of abuse was significantly associated with greater odds of non-change in condom use post-intervention for only those with the s allele. For those with ll allele, participants with higher partner communication frequency scores were at decreased odds of non-change in condom use post-intervention. Thus, STI/HIV interventions for adolescent females may consider providing a more in-depth discussion and instruction on how to manage and overcome fear or anxiety related to being assertive in sexual decisions or sexual situations. Doing so may improve the efficacy of STI/HIV prevention programs for adolescent women who have experienced abuse in their lifetime.Interest in an Ebola vaccine among a U.S. national sample during the height of the 2014–2016 Ebola outbreak in West Africa
AbstractPainter, J. E., DiClemente, R., & von Fricken, M. E. (n.d.).Publication year
2017Journal title
VaccineVolume
35Issue
4Page(s)
508-512AbstractTo better understand the association between Ebola-related attitudes and interest in receiving an Ebola virus vaccine, a survey was administered to a U.S. national sample using GfK's KnowledgePanel®. Among participants (N = 1417), 34.1% expressed interest in an Ebola vaccine for themselves. In the subset of participants with children aged 0–17 (N = 410), 38.1% expressed interest in an Ebola vaccine for their child. In multivariable analyses, vaccine interest for oneself was associated with perceived susceptibility to Ebola (p = 0.009), beliefs that the U.S. government should spend money to control Ebola (p = 0.002), and beliefs Ebola posed a national threat (p = 0.007). Vaccine interest for one's child was associated with perceived severity of Ebola (p = 0.018) and beliefs that the U.S. government should spend money to control Ebola (p = 0.003). Findings highlight the influence of personal and national threat beliefs on vaccine interest. Understanding the impact of threat beliefs may benefit vaccine campaign development during future pandemic threats.