Ralph DiClemente

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Professor of Social and Behavioral Sciences

Dr. Ralph DiClemente was trained as a Health Psychologist at the University of California, San Francisco where he received his PhD in 1984 after completing a ScM at the Harvard School of Public Health. He earned his undergraduate degree at the City University of New York.

Dr. DiClemente’s research has four key foci:

Developing interventions to reduce the risk of HIV/STD among vulnerable populations
Developing interventions to enhance vaccine uptake among high-risk adolescents and women, such as HPV and influenza vaccine
Developing implementation science interventions to enhance the uptake, adoption and sustainability of HIV/STD prevention programs in the community
Developing diabetes screening and behavior change interventions to identify people with diabetes who are unaware of their disease status as well as reduce the risk of diabetes among vulnerable populations.

He has focused on developing intervention packages that blend community and technology-based approaches that are designed to optimize program effectiveness and enhance programmatic sustainability.

Dr. DiClemente is the author of ten CDC-defined, evidence-based interventions for adolescents and young African-American women and men. He is the author of more than 540 peer-review publications, 150 book chapters, and 21 books. He serves as a member of the Office of AIDS Research Advisory Council.

Previously, Dr. DiClemente served as the Charles Howard Candler Professor of Public Health at the Rollins School of Public Health at Emory University. He was also Associate Director of the Center for AIDS Research, and was previously Chair of the Department of Behavioral Sciences and Health Education at the Rollins School of Public Health.

Dr. DiClemente is Past President of the Georgia chapter of the Society for Adolescent Health & Medicine. He previously served as a member of the CDC Board of Scientific Counselors, and the NIMH Advisory Council.

Education

BA, The City College of the City University of New York (CCNY), New York, NY

ScM, Behavioral Sciences, Harvard University, Cambridge, MA

PhD, Health Psychology, University of California San Francisco Center for Behavioral Sciences, San Francisco, CA

Postdoctoral Fellow, University of California, San Francisco, CA

Areas of research and study

Community Interventions

Diabetes

HIV/AIDS

Implementation science

Influenza

Psychology

Publications

Pregnant African-American teens are less likely than their nonpregnant peers to use condoms

Prevalence and correlates of Chlamydia trachomatis among sexually active African-American adolescent females

Prevention interventions for HIV positive individuals

DiClemente, R. J., Wingood, G. M., Del Rio, C., & Crosby, R. A. (n.d.).

Publication year

2002

Journal title

Sexually transmitted infections

Volume

Issue

Page(s)

393-395

10.1136/sti.78.6.393

Protease inhibitor combination therapy and decreased condom use among gay men

Psychosocial and behavioral correlates of refusing unwanted sex among African-American adolescent females

Psychosocial predictors of pregnancy among low-income African-American adolescent females: A prospective analysis

Crosby, R. A., DiClemente, R. J., Wingood, G. M., DiClemente, R. J., DiClemente, R. J., Crosby, R. A., DiClemente, R. J., Harrington, K., Davies, S., & Davies, S. (n.d.).

Publication year

2002

Journal title

Journal of Pediatric and Adolescent Gynecology

Volume

Issue

Page(s)

293-299

10.1016/S1083-3188(02)00195-X

Abstract

Abstract

Objective: To prospectively identify psychosocial predictors of pregnancy among African-American adolescent females. Methods: African-American females, 14-18 yrs old, were recruited from schools and health clinics in low-income neighborhoods. Adolescents completed an in-depth survey and provided urine specimens for pregnancy testing at baseline and 6-month intervals for 1.5 years. Selected problem behaviors, demographic, and psychosocial variables were tested for bivariate and multivariate significance relative to biologically confirmed pregnancy during the follow-up period. Only adolescents who initially tested negative for pregnancy were included (n = 241). Results: About 26% (n = 63) of the adolescents became pregnant over the follow-up period. Although a broad spectrum of variables achieved bivariate significance, few retained significance in the multivariate model. Multivariate predictors of pregnancy were biologically confirmed marijuana use (adjusted odds ratios [AOR] = 12.4, P = 0.0003) and perceiving that the sex partner desired pregnancy (AOR = 1.27, P = 0.01). A protective effect was observed for adolescents who reported that a family member received welfare benefits; these adolescents were about 60% less likely to become pregnant (AOR = 0.38, P = 0.04). Conclusions: Pediatricians and other health professionals who participate in community efforts to prevent first and subsequent adolescent pregnancies may benefit from recognizing that marijuana use and pregnancy may be co-occurring problems. Adolescents' perceptions of their boyfriends' level of desire for conception may also be an important predictor of pregnancy risk. The findings also suggest a possible protective effect of receiving TANF (Temporary Assistance to Needy Families) benefits; adolescent recipients of these programs may be more vigilant in their pregnancy prevention practices than those who are not recipients.

Risk among men who have sex with men in the united states: A comparison of an Internet sample and a conventional outreach sample

Selected risk and protective factors associated with two or more lifetime sexual intercourse partners and non-condom use during last coitus among U.S rural high school students

Sexual risk behaviors associated with having older sex partners: A study of black adolescent females

DiClemente, R. J., Wingood, G. M., Crosby, R. A., Sionean, C., Cobb, B. K., Harrington, K., Davies, S. L., Hook, E. W., & Oh, M. K. (n.d.).

Publication year

2002

Journal title

Sexually Transmitted Diseases

Volume

Issue

Page(s)

20-24

10.1097/00007435-200201000-00004

Abstract

Abstract

Background: Volunteer black adolescent females from neighborhoods characterized by high rates of unemployment, substance abuse, violence, and sexually transmitted disease were studied to determine the frequency of condom use and unprotected vaginal sex with steady, older partners during various time periods over the previous 6 months. Goal: To examine associations between having male sex partners who were typically older (by at least 2 years) and adolescent females' sexually transmitted disease (STD)/HIV-associated sexual risk behaviors. Study Design: In this cross-sectional study, 522 sexually active black adolescent females completed a questionnaire and a structured interview, of which a portion assessed the age difference between the adolescents and their typical sex partners. The adolescents' ages, length of relationship and their use of hormonal contraception were identified as covariates. Adjusted odds ratios (AOR), their 95% confidence intervals, and respective P values were calculated to detect significant associations. Results: Sixty-two percent of the adolescents reported their typical sex partners were at least 2 years older. These adolescents were more likely to report never using condoms during the most recent sexual encounter (AOR = 2.0), during the last five sexual encounters (AOR = 2.0), and during the past month (AOR = 2.2). Similarly, having older partners was associated with greater odds of reporting any unprotected vaginal sex in the past 30 days (AOR = 1.7) or the past 6 months (AOR = 1.5). Conclusion: Our findings suggest that many adolescent females have sex partners who are at least 2 years older and that their relationship dynamics do not favor the adoption and maintenance of behavior protective against STD or HIV infection. Prevention programs could include training designed to help adolescent females overcome barriers to safer sex with older male partners.

A prospective study of psychological distress and sexual risk behavior among black adolescent females.

DiClemente, R. J., Wingood, G. M., Crosby, R. A., Sionean, C., Brown, L. K., Rothbaum, B., Zimand, E., Cobb, B. K., Harrington, K., & Davies, S. (n.d.).

Publication year

2001

Journal title

Pediatrics

Volume

108

Issue

Page(s)

E85

10.1542/peds.108.5.e85

Abstract

Abstract

OBJECTIVE: The purpose of the study was to examine the association between adolescents' psychological distress and their sexually transmitted disease/human immunodeficiency virus (STD/HIV)-associated sexual behaviors and attitudes. METHOD: Sexually active black adolescent females (N = 522) completed, at baseline and again 6 months later, a self-administered questionnaire that assessed sexual health attitudes and emotional distress symptoms (using standardized measures, alpha =.84), a structured interview that assessed STD/HIV-associated sexual risk behaviors, and a urine screen for pregnancy. RESULTS: In multivariate analyses, controlling for observed covariates, adolescents with significant distress at baseline were more likely than their peers, after 6 months, to be pregnant (adjusted odds ratio [AOR]: = 2.0), have had unprotected vaginal sex (AOR = 2.1), have nonmonogamous sex partners (AOR = 1.7), and not use any form of contraception (AOR = 1.5). Additionally, they were also more likely to: perceive barriers to condom use (AOR = 2.2), be fearful of the adverse consequences of negotiating condom use (AOR = 2.0), perceive less control in their relationship (AOR = 2.0), have experienced dating violence (AOR = 2.4), feel less efficacious in negotiating condom use with a new sex partner (AOR = 1.6), and have norms nonsupportive of a healthy sexual relationship (AOR = 1.7). DISCUSSION: The findings suggest that psychological distress is predictive over a 6-month period of a spectrum of STD/HIV-associated sexual behaviors and high-risk attitudes. Brief screening to detect distress or depressive symptoms among adolescent females can alert the clinician to the need to conduct a sexual health history, initiate STD/HIV-preventive counseling, and refer for comprehensive psychological assessment and appropriate treatment. Among adolescents receiving STD treatment, those with even moderate emotional distress may be at heightened risk for further unhealthy outcomes. STD/HIV interventions should also consider psychological distress as one potential risk factor that may impact program efficacy.

Condom carrying is not associated with condom use and lower prevalence of sexually transmitted diseases among minority adolescent females

Correct condom application among African-American adolescent females: The relationship to perceived self-efficacy and the association to confirmed STDs

Correlates of Adolescent Females' Worry About Undesired Pregnancy: The Importance of Partner Desire for Pregnancy

Correlates of casual sex among African-American female teens

Correlates of hepatitis B vaccination in a high-risk population: An internet sample

Correlates of using dual methods for sexually transmitted diseases and pregnancy prevention among high-risk african-american female teens

Dating violence and the sexual health of black adolescent females.

Exposure to X-rated movies and adolescents' sexual and contraceptive-related attitudes and behaviors

Factors associated with testing for hepatitis C in an internet-recruited sample of men who have sex with men

HIV/STD-protective benefits of living with mothers in perceived supportive families: A study of high-risk African American female teens

Measurement of the role of families in prevention and adaptation to HIV/AIDS

Parent-adolescent communication and sexual risk behaviors among African American adolescent females

Parental monitoring: Association with adolescents' risk behaviors

DiClemente, R. J., Wingood, G. M., Crosby, R., Sionean, C., Cobb, B. K., Harrington, K., Davies, S., Hook, E. W., & Oh, M. K. (n.d.).

Publication year

2001

Journal title

Pediatrics

Volume

107

Issue

Page(s)

1363-1368

10.1542/peds.107.6.1363

Abstract

Abstract

Context. Contemporary threats to adolescents' health are primarily the consequence of risk behaviors and their related adverse outcomes. Identifying factors associated with adolescents' risk behaviors is critical for developing effective prevention strategies. A number of risk factors have been identified, including familial environment; however, few studies have examined the impact of parental monitoring. Objective. To examine the influence of less perceived parental monitoring on a spectrum of adolescent health-compromising behaviors and outcomes. Design. Survey. Setting. A family medicine clinic. Participants. To assess eligibility, recruiters screened a sample of 1130 teens residing in low-income neighborhoods. Adolescents were eligible if they were black females, between the ages of 14 and 18 years, sexually active in the previous 6 months, and provided written informed consent. Most teens (n = 609) were eligible, with 522 (85.7%) agreeing to participate. Main Outcome Measures. Variables in 6 domains were assessed, including: sexually transmitted diseases, sexual behaviors, marijuana use, alcohol use, antisocial behavior, and violence. Results. In logistic regression analyses, controlling for observed covariates, adolescents perceiving less parental monitoring were more likely to test positive for a sexually transmitted disease (odds ratio [OR]: 1.7), report not using a condom at last sexual intercourse (OR: 1.7), have multiple sexual partners in the past 6 months (OR: 2.0), have risky sex partners (OR: 1.5), have a new sex partner in the past 30 days (OR: 3.0), and not use any contraception during the last sexual intercourse episode (OR: 1.9). Furthermore, adolescents perceiving less parental monitoring were more likely to have a history of marijuana use and use marijuana more often in the past 30 days (OR: 2.3 and OR: 2.5, respectively); a history of alcohol use and greater alcohol consumption in the past 30 days (OR: 1.4 and OR: 1.9, respectively); have a history of arrest (OR: 2.1); and there was a trend toward having engaged in fights in the past 6 months (OR: 1.4). Conclusions. The findings demonstrate a consistent pattern of health risk behaviors and adverse biological outcomes associated with less perceived parental monitoring. Additional research needs to focus on developing theoretical models that help explain the influence of familial environment on adolescent health and develop and evaluate interventions to promote the health of adolescents.

Ralph DiClemente