Ralph DiClemente
Ralph DiClemente
Scroll
Professor of Social and Behavioral Sciences
-
Professional overview
-
Dr. Ralph DiClemente was trained as a Health Psychologist at the University of California, San Francisco where he received his PhD in 1984 after completing a ScM at the Harvard School of Public Health. He earned his undergraduate degree at the City University of New York.
Dr. DiClemente’s research has four key foci:
- Developing interventions to reduce the risk of HIV/STD among vulnerable populations
- Developing interventions to enhance vaccine uptake among high-risk adolescents and women, such as HPV and influenza vaccine
- Developing implementation science interventions to enhance the uptake, adoption and sustainability of HIV/STD prevention programs in the community
- Developing diabetes screening and behavior change interventions to identify people with diabetes who are unaware of their disease status as well as reduce the risk of diabetes among vulnerable populations.
He has focused on developing intervention packages that blend community and technology-based approaches that are designed to optimize program effectiveness and enhance programmatic sustainability.
Dr. DiClemente is the author of ten CDC-defined, evidence-based interventions for adolescents and young African-American women and men. He is the author of more than 540 peer-review publications, 150 book chapters, and 21 books. He serves as a member of the Office of AIDS Research Advisory Council.
Previously, Dr. DiClemente served as the Charles Howard Candler Professor of Public Health at the Rollins School of Public Health at Emory University. He was also Associate Director of the Center for AIDS Research, and was previously Chair of the Department of Behavioral Sciences and Health Education at the Rollins School of Public Health.
Dr. DiClemente is Past President of the Georgia chapter of the Society for Adolescent Health & Medicine. He previously served as a member of the CDC Board of Scientific Counselors, and the NIMH Advisory Council.
-
Education
-
BA, The City College of the City University of New York (CCNY), New York, NYScM, Behavioral Sciences, Harvard University, Cambridge, MAPhD, Health Psychology, University of California San Francisco Center for Behavioral Sciences, San Francisco, CAPostdoctoral Fellow, University of California, San Francisco, CA
-
Areas of research and study
-
Community InterventionsDiabetesHIV/AIDSImplementation scienceInfluenzaPsychology
-
Publications
Publications
Correlates of casual sex among African-American female teens
AbstractCrosby, R. A., DiClemente, R., Wingood, G. M., Sionean, C., Cobb, B. K., Harrington, K., Davies, S. L., Edward Hook, I. I., & Kim Oh, M. (n.d.).Publication year
2001Journal title
Journal of HIV/AIDS Prevention and Education for Adolescents and ChildrenVolume
4Issue
4Page(s)
55-67AbstractThis study identified correlates of reporting voluntary sex with casual partner (VS-CP) among African American adolescent females. Sexually active African-American female teens (N = 522) were recruited from neighborhoods characterized by high rates of unemployment, substance abuse, violence and STDs. Of the 609 eligible adolescents, 522 (85.7%) agreed to participate in the study. VS-CP was reported by 15.9% of adolescents. Identified correlates of VS-CP were acquiescing to unwanted sex, living with a non-parent relative, never being pregnant, rejecting messages about the value of condoms for disease prevention, low parental supervision, and dissatisfaction with body image. These correlates may be important in the targeting and design of STD/HIV prevention programs for African -American adolescent females.Correlates of hepatitis B vaccination in a high-risk population : An internet sample
AbstractRhodes, S. D., DiClemente, R., Yee, L. J., & Hergenrather, K. C. (n.d.).Publication year
2001Journal title
American Journal of MedicineVolume
110Issue
8Page(s)
628-632AbstractPURPOSE: We sought to identify factors associated with hepatitis B virus vaccination, including knowledge and attitudes about hepatitis vaccination, and sexual and nonsexual risk behaviors among at-risk homosexual and bisexual men. SUBJECTS AND METHODS: Internet electronic communications were used to collect data from homosexual and bisexual men from the United States, using a 31-item online questionnaire accessible for 1 month. RESULTS: The mean (± SD) age of the 336 respondents was 38 ± 11 years. Nearly 42% (142) reported at least one dose of vaccine; the remainder were completely unvaccinated. About 21% (n = 71) reported having no information about hepatitis. Approximately 72% (242) of respondents reported never using condoms during oral intercourse, and 26% (n = 87) reported using condoms during less than half of their episodes of anal intercourse. In multivariate analysis, variables associated with vaccination were younger age (odds ratio [OR] 0.7 per 10-year increase in age; 95% confidence interval [CI] 0.59 to 0.84, P = 0.002), high level of knowledge about the vaccine (OR 1.4; 95% CI: 1.03 to 1.83, P = 0.007), communication with a health-care provider about hepatitis (OR 1.98; 95% CI 1.31 to 2.98, P = 0.006), and professional training that included hepatitis education (OR 2.77; 95% CI 1.7 to 4.5, P = 0.001). CONCLUSIONS: Our findings underscore the need for health care providers to emphasize vaccine efficacy and safety, and to encourage high-risk patients to receive vaccination, particularly among men at high risk based on sexual and drug use behaviors.Correlates of using dual methods for sexually transmitted diseases and pregnancy prevention among high-risk african-american female teens
AbstractCrosby, R. A., DiClemente, R., Wingood, G. M., Sionean, C., Cobb, B. K., Harrington, K., Davies, S. L., Hook, E. W., & Oh, M. K. (n.d.).Publication year
2001Journal title
Journal of Adolescent HealthVolume
28Issue
5Page(s)
410-414AbstractPurpose: To identify correlates of consistent dual-method use among African-American female adolescents at risk of sexually transmitted diseases (STDs) and pregnancy. Methods: A convenience sample of 522 sexually active female teens attending adolescent medicine clinics, health department clinics, and school health classes volunteered. Recruitment sites were in low-income neighborhoods of Birmingham, Alabama. Adolescents completed a questionnaire and a face-to-face interview and provided vaginal swab specimens for laboratory diagnosis of STDs. Those reporting use of condoms and at least one other method of contraception, for each of the last five occasions they had sex were classified as consistent dual-method users. The questionnaire assessed frequency of adolescents' communication with their parents and partners about sex. The questionnaire also assessed two measures of parental supervision and adolescents' desire to avoid pregnancy. Multiple logistic regression assessed the independent contribution of each correlate of consistent dual-method use. Results: Seventy-one adolescents (13.6%) were classified as consistent dual-method users. A strong desire to avoid pregnancy was the most influential correlate of consistent dual-method use [odds ratio (OR) =2.3]. Adolescents reporting that their parents generally knew whom they were with (OR = 2.0) and those reporting more frequent communication with parents (OR = 1.9) were also more likely to be consistent dual users. Conclusions: The findings suggest the need for research to examine the efficacy of interventions building on adolescent females' desire to avoid pregnancy. Study findings also suggest that interventions promoting improved parent-adolescent communication and improved parental supervision may contribute to adolescents' use of dual methods for STD and pregnancy prevention.Dating violence and the sexual health of black adolescent females.
AbstractDiClemente, R., Wingood, G. M., DiClemente, R. J., McCree, D. H., Harrington, K., & Davies, S. L. (n.d.).Publication year
2001Journal title
PediatricsVolume
107Issue
5Page(s)
E72AbstractOBJECTIVE: This study examines the association between having a history of dating violence and the sexual health of adolescent females. METHODS: Black adolescent females (n = 522) completed a survey that assessed dating violence, defined as ever having a physically abusive boyfriend, and an interview that assessed sexual behaviors. RESULTS: Dating violence was reported by 18.4% of adolescents (n = 96). Adolescents with a history of dating violence were, in the past 6 months, 2.8 times more likely to have a sexually transmitted disease, 2.8 times more likely to have nonmonogamous male partners, and half as likely to use condoms consistently. Furthermore, adolescents with a history of dating violence were significantly more likely to fear the perceived consequences of negotiating condom use (odds ratio [OR] = 2.8); fear talking with their partner about pregnancy prevention (OR = 2.6); have a higher perceived risk of acquiring a sexually transmitted disease (OR = 2.1); perceive less control over their sexuality (OR = 2.4); have peer norms nonsupportive of using condoms (OR = 3.1); and have norms nonsupportive of having a healthy relationship (OR = 2.1). CONCLUSIONS: Adolescents who have experienced dating violence are more likely to exhibit a spectrum of unhealthy sexual behaviors, attitudes, beliefs, and norms.Development of programmes for enhancing sexual health : Commentary
AbstractDiClemente, R. (n.d.).Publication year
2001Journal title
LancetVolume
358Issue
9296Page(s)
1828-1829Abstract~Exposure to X-rated movies and adolescents' sexual and contraceptive-related attitudes and behaviors
AbstractWingood, G. M., DiClemente, R., Harrington, K., Davies, S., Hook, E. W., & Oh, M. K. (n.d.).Publication year
2001Journal title
PediatricsVolume
107Issue
5Page(s)
1116-1119AbstractObjectives. To examine the association between exposure to X-rated movies and teens' contraceptive attitudes and behaviors. Methods. Black females, 14 to 18 years old (n = 522) were recruited from adolescent medicine clinics, health departments, and school health clinics. Results. Exposure to X-rated movies was reported by 29.7% of adolescents. Exposure to X-rated movies was associated with being more likely to have negative attitudes toward using condoms (odds ratio [OR]: 1.4), to have multiple sex partners (OR: 2.0), to have sex more frequently (OR: 1.8), to not have not used contraception during the last intercourse (OR: 1.5), to have not used contraception in the past 6 months (OR: 2.2), to have a strong desire to conceive (OR: 2.3), and to test positive for chlamydia (OR: 1.7). Conclusions. Additional research is needed to understand the impact of X-rated movies on adolescents' sexual and contraceptive health.Factors associated with testing for hepatitis C in an internet-recruited sample of men who have sex with men
AbstractRhodes, S. D., DiClemente, R., Yee, L. J., & Hergenrather, K. C. (n.d.).Publication year
2001Journal title
Sexually Transmitted DiseasesVolume
28Issue
9Page(s)
515-520AbstractBackground: Nearly 4 million individuals in the United States (1.8%) have been infected with hepatitis C virus, yet few are aware of their infection. Goal: To identify correlates associated with hepatitis C virus testing among a sample of men who have sex with men. Study Design: Internet communications were used for solicitation and collection of data, using a 31-question survey. Results: When the study was restricted to men who have sex with men in the United States (n = 381), 95% of the respondents (n - 361) reported at least one risk factor for hepatitis C virus transmission, 39% of these respondents (n = 140) reported having been tested for hepatitis C virus. Testing was associated with a history of nonsexual risk behavior, increased knowledge of the hepatitis C virus, and health care provider communication. Conclusion: A significant proportion of at-risk respondents had not been tested. Interventions are needed to increase hepatitis C virus knowledge in the community of men who have sex with men, and to encourage providers to communicate about hepatitis to the men in this group who screen as high risk on the basis of their risk behaviors.HIV/STD-protective benefits of living with mothers in perceived supportive families : A study of high-risk African American female teens
AbstractCrosby, R. A., DiClemente, R., DiClemente, R., DiClemente, R., Wingood, G. M., Cobb, B. K., Harrington, K., Davies, S. L., Hook, E. W., & Oh, M. K. (n.d.).Publication year
2001Journal title
Preventive MedicineVolume
33Issue
3Page(s)
175-178AbstractBackground. The joint influence of living with the mother in a perceived supportive family may be an important HIV/STD-protective factor among sexually active female adolescents. Methods. Sexually active African American female adolescents (N = 522) completed a self-administered survey and structured interview. Adolescents scoring high on family support and reporting that their mother lived with them were compared with the remaining adolescents in respect to unprotected vaginal sex (past 30 days), sex with a non-steady partner (past 6 months), communication with sex partners, attitudes toward condoms, and perceived ability to negotiate condom use. Logistic regression analyses controlled for the influence of parent-adolescent communication about sex and parental monitoring. Results. Adolescents residing with their mothers in a perceived supportive family were more likely to communicate with their sex partners about sexual risk (OR = 1.53). They were less likely to report sex with a non-steady partner (OR = 0.51) or having unprotected sex with a steady partner (OR = 0.52) or any partner (OR = O.55). Conclusions. Controlled analyses suggest that living with the mother in a perceived supportive family is an important HIV/STD-protective factor among female adolescents. HIV/STD prevention programs for female adolescents that include the mothers may promote positive and lasting effects.Measurement of the role of families in prevention and adaptation to HIV/AIDS
AbstractPequegnat, W., Bauman, L. J., Bray, J. H., DiClemente, R., DiIorio, C., Hoppe, S. K., Jemmott, L. S., Krauss, B., Miles, M., Paikoff, R., Rapkin, B., Rotheram-Borus, M. J., & Szapocznik, J. (n.d.).Publication year
2001Journal title
AIDS and BehaviorVolume
5Issue
1Page(s)
1-19AbstractHIV is a family disease. Family research in HIV is challenging because of complexities of family measurement, the range of family constellations across cultures, and the issues specific to HIV-affected families. A Consortium of NIMH-funded investigators is conducting HIV research on families - defined as networks of mutual commitments. A procedure for identifying the "family" is proposed. This article reviews assessment strategies from two research traditions, both of which have been greatly concerned with social context: family assessment tradition - family membership, parenting, and interactional dynamics; HIV/AIDS research tradition - HIV-relevant constructs generalized to minority families. Initially, a systematic procedure for defining family membership is provided. Constructs and measures derived from the family assessment tradition are described, including self-report and observational procedures. Constructs and measures of relevance to family research that originated in the HIV/AIDS research tradition are described: HIV knowledge, stigma, disclosure, and social support. Constructs presented derive from the Consortium's research on the role of families in prevention and adaptation to HIV/AIDS. Most of the research conducted by the Consortium has taken place with inner-city, minority, heterosexual families. By informing the selection of constructs and measures relevant to investigating the role of families in HIV prevention, and adaptation to living with HIV/AIDS, it is the Consortium's intention to enhance the quality and quantity of research at the intersection of families and HIV/AIDS.Parent-adolescent communication and sexual risk behaviors among African American adolescent females
AbstractDiClemente, R., Wingood, G. M., Crosby, R., Cobb, B. K., Harrington, K., & Davies, S. L. (n.d.).Publication year
2001Journal title
Journal of PediatricsVolume
139Issue
3Page(s)
407-412AbstractObjective: To examine associations between parent-adolescent communication about sex-related topics and the sex-related communication and practices of African American adolescent females with partners, as well as their perceived ability to negotiate safer sex. Design: A theory-guided survey and structured interview were administered to 522 sexually active African American females 14 to 18 years old. Recruitment sites were neighborhoods with high rates of unemployment, substance abuse, violence, and sexually transmitted diseases. Multivariate analyses, controlling for observed covariates, were used to identify the association of less frequent parent-adolescent communication with multiple assessed outcomes. Results: Less frequent parent-adolescent communication (scores below the median) was associated with adolescents' non-use of contraceptives in the past 6 months (adjusted odds ratio [AOR] = 1.7) and non-use of contraceptives during the last 5 sexual encounters (AOR = 1.6). Less communication increased the odds of never using condoms in the past month (AOR = 1.6), during the last 5 sexual encounters (AOR = 1.7), and at last intercourse (AOR = 1.7). Less communication was also associated with less communication between adolescents and their sex partners (AOR = 3.3) and lower self-efficacy to negotiate safer sex (AOR = 1.8). Conclusions: The findings demonstrate the importance of involving parents in human immunodeficiency virus/sexually transmitted disease and pregnancy prevention efforts directed at female adolescents. Pediatricians and other clinicians can play an important role in facilitating parent-adolescent communication about sexual activity.Parental monitoring : Association with adolescents' risk behaviors
AbstractDiClemente, R., Wingood, G. M., Crosby, R., Sionean, C., Cobb, B. K., Harrington, K., Davies, S., Hook, E. W., & Oh, M. K. (n.d.).Publication year
2001Journal title
PediatricsVolume
107Issue
6Page(s)
1363-1368AbstractContext. 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.Psychosocial correlates of adolescents' worry about STD versus HIV infection : Similarities and differences
AbstractCrosby, R., DiClemente, R., Wingood, G. M., Sionéan, C., Harrington, K., Davies, S. L., Hook, E. W., & Oh, M. K. (n.d.).Publication year
2001Journal title
Sexually Transmitted DiseasesVolume
28Issue
4Page(s)
208-213AbstractBackground: Adolescents' worry (perceived threat) of sexually transmitted diseases (STDs) and HIV infection may have different correlates. This study examined associations between selected psychosocial and behavioral constructs and adolescents' worry about STD and HIV infection. Goal: To assess levels and correlates of worry about STD and HIV among a high-risk sample of black adolescent females. Study Design: High-risk black females (n = 522), enrolled in a randomized, controlled HIV and STD prevention trial, completed a questionnaire and structured interview at baseline. Worry about STD and HIV infection, recent risk behaviors, and several measures potentially related to worry were assessed. Results: Levels of worry for both STD and HIV were low. Recent history of STD infection was associated with STD worry (OR, 4.6) and HIV worry (OR, 2.0). Infrequent communication about sex (OR, 2.0) and low perceived ability to negotiate condom use (OR, 2.0) were related to STD worry; whereas, only partner-specific barriers were related to HIV worry (OR, 1.9). Conclusions: Despite high risk, adolescents were generally complacent about the threat of infection with STD and HIV. Adolescents' worry about STD and HIV infection had different sets of correlates.Self-obtained vaginal swabs for diagnosis of treatable sexually transmitted diseases in adolescent girls
AbstractSmith, K., Harrington, K., Wingood, G., Kim Oh, M., Hook, E. W., & DiClemente, R. (n.d.).Publication year
2001Journal title
Archives of Pediatrics and Adolescent MedicineVolume
155Issue
6Page(s)
676-679AbstractObjective: To ascertain the acceptability of testing and prevalence of 3 readily treatable sexually transmitted diseases (STDs) (infections with Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis) with the use of patient-obtained vaginal swabs. Study Design: Study participants at each initial session were asked to provide self-obtained vaginal swabs for ligase chain reaction testing to detect N gonorrhoeae and C trachomatis, and for culture of T vaginalis. Setting: Behavioral intervention sessions with African American adolescent girls in a nonclinical program to reduce risk of STDs, human immunodeficiency virus infection, and pregnancy. Results: All study participants were offered their choice of STD screening in the context of a traditional pelvic examination or using self-obtained vaginal swabs. All eligible participants chose self-administered vaginal swabs. Of the 512 participants examined at their initial study visit, 28.7% were found to be infected with 1 or more treatable STDs (5.3% with N gonorrhoeae, 17.8% with C trachomatis, and 12.9% with T vaginalis). Conclusions: With the use of newer detection systems, STDs can be readily detected in nonclinical settings with the use of self-obtained vaginal swabs, providing new opportunities for efforts to control STDs.Socioeconomic status and self-reported gonorrhea among African American female adolescents
AbstractSionéan, C., DiClemente, R., Wingood, G. M., Crosby, R., Cobb, B. K., Harrington, K., Davies, S. L., Hook, E. W., & Oh, M. K. (n.d.).Publication year
2001Journal title
Sexually Transmitted DiseasesVolume
28Issue
4Page(s)
236-239AbstractBackground: Socioeconomic status is often used to explain race differences in sexually transmitted diseases (STDs), yet the independent association of socioeconomic status and STDs among adolescents has been understudied. Objective: To examine the associations between socioeconomic status and self-reported gonorrhea among black female adolescents, after controlling for sexual risk behaviors. Methods: Interviews and surveys were completed by 522 sexually active black adolescent females residing in low-income urban neighborhoods. Results: Adolescents whose parents were unemployed were more than twice as likely to report a history of gonorrhea, compared with those with employed parents. Adolescents living with two parents were less likely to report a history of gonorrhea. Conclusions: The results of this study indicate that gonorrhea is associated with low socioeconomic status among black adolescent females regardless of the level of sexual risk behaviors. Lower socioeconomic status may be an marker for risky sociosexual environments.Validity of self-reported sexually transmitted diseases among african american female adolescents participating in an HIV/STD prevention intervention trial
AbstractHarrington, K. F., DiClemente, R., Wingood, G. M., Crosby, R. A., Person, S., Oh, M. K., & Hook, E. W. (n.d.).Publication year
2001Journal title
Sexually Transmitted DiseasesVolume
28Issue
8Page(s)
468-471AbstractBackground: Studies assessing the validity attributed to self-reported measures of sexually transmitted diseases (STDs) clearly are needed, particularly those used for high-risk populations such as female adolescents, in whom STD prevention is a priority. Goal: To determine the accuracy of self-reported STD test results in female adolescents over a relatively brief period (≈28 days). Study Design: A prospective, randomized, controlled clinical trial of STD/HIV prevention for African American females, ages 14 to 18, was conducted. Study participants were recruited from medical clinics and school health classes in low-income neighborhoods of Birmingham, Alabama, that had high rates of unemployment, substance abuse, violence, STDs, and teenage pregnancy. Results: Of the 522 adolescents enrolled in the trial, 92% (n = 479) completed baseline STD testing and follow-up surveys. At baseline, 28% had positive test results for at least one disease: 4.8 % for Neisseria gonorrhoeae, 17.1% for Chlamydia trachomatis, and 12.3% for Trichomonas vaginalis. Of the adolescents with negative STD test results, 98.8% were accurate in their self. report of STD status, as compared with 68.7% of the adolescents with positive results. Underreporting varied by type of STD. Adolescents who accurately reported their positive STD status were significantly more likely to report their receipt of treatment accurately (P < 0.001). Conclusions: The substantial underreporting of STD incidence in this study suggests that reliance on self-reports of STD history may introduce misclassification bias, potentially leading to false conclusions regarding the efficacy of prevention interventions. This observation highlights the importance of using biologic indicators as outcome measures.Adverse consequences of intimate partner abuse among women in non-urban domestic violence shelters
AbstractWingood, G. M., DiClemente, R., & Raj, A. (n.d.).Publication year
2000Journal title
American journal of preventive medicineVolume
19Issue
4Page(s)
270-275AbstractObjective: This study examined the health consequences of having experienced both sexual and physical abuse relative to women experiencing physical abuse but not sexual abuse. Methods: A cross-sectional study was conducted among 203 women seeking refuge in battered women's shelters. Controlling for sociodemographics, logistic regression analyses were conducted to assess the consequences of experiencing both sexual and physical abuse. Results: Compared to women experiencing physical abuse, women experiencing both sexual and physical abuse were more likely to have a history of multiple sexually transmitted diseases (STDs) in their abusive relationships, have had an STD in the past 2 months, be worried about being infected with HIV, use marijuana and alcohol to cope, attempt suicide, feel as though they had no control in their relationships, experience more episodes of physical abuse in the past 2 months, rate their abuse as more severe, and be physically threatened by their partner when they asked that condoms be used. Conclusions: Given the prevalence of adverse health outcomes, domestic violence shelters could counsel women to avoid using alcohol/drugs as a coping strategy, educate women about alternative healthy coping strategies, counsel women about methods of STD prevention that they can control, and provide STD screening and treatment. (C) American Journal of Preventive Medicine.Application of the Theory of Gender and Power to Examine HIV-Related Exposures, Risk Factors, and Effective Interventions for Women
AbstractWingood, G. M., & DiClemente, R. (n.d.).Publication year
2000Journal title
Health Education & BehaviorVolume
27Issue
5Page(s)
539-565AbstractDeveloped by Robert Connell, the theory of gender and power is a social structural theory based on existing philosophical writings of sexual inequality and gender and power imbalance. According to the theory of gender and power, there are three major social structures that characterize the gendered relationships between men and women: the sexual division of labor, the sexual division of power, and the structure of cathexis. The aim of this article is to apply an extended version of the theory of gender and power to examine the exposures, social/behavioral risk factors, and biological properties that increase women's vulnerability for acquiring HIV. Subsequently, the authors review several public health level HIV interventions aimed at reducing women's HIV risk. Employing the theory of gender and power among women marshals new kinds of data, asks new and broader questions with regard to women and their risk of HIV, and, most important, creates new options for prevention.Correlates of unprotected vaginal sex among African American female adolescents : Importance of relationship dynamics
AbstractCrosby, R. A., DiClemente, R., Wingood, G. M., Sionéan, C., Cobb, B. K., & Harrington, K. (n.d.).Publication year
2000Journal title
Archives of Pediatrics and Adolescent MedicineVolume
154Issue
9Page(s)
893-899AbstractObjective: To determine the associations between the frequency of unprotected vaginal sex (UVS) and female adolescents' perceptions, particularly their perceptions of relationship dynamics. Design: Cross-sectional study of 522 African American female adolescents enrolled in a sexually transmitted disease (STD) and human immunodeficiency virus prevention intervention trial. Setting and Participants: A volunteer sample of adolescents recruited from neighborhoods characterized by high rates of unemployment, substance abuse, violence, and STDs; 28% tested positive for STDs as assessed by DNA amplification or culture. Main Outcome Measure: Frequency of UVS assessed by interview using a 6-month recall period. Results: Among adolescents having steady relationships, those spending more time with their boyfriends and having longer relationships reported a significantly greater frequency of UVS. Other significant correlates included perception of more girlfriends using condoms, no history of STDs, stronger normative beliefs favoring male decision making in relationships, greater pregnancy worry, and greater perceived invulnerability to STDs. For adolescents reporting casual relationships, personal barriers to condom use, no history of STDs, and reporting that their boyfriends typically decide when to have sex were associated with more frequent UVS. Conclusions: Adolescents' perceptions, particularly their perceptions of relationship dynamics, played an integral role in explaining female adolescents' frequency of UVS with both steady and casual partners. Female adolescents in steady relationships differ from those in casual relationships relative to their prevention needs. These findings have implications for clinic- or community-based STD and human immunodeficiency virus prevention programs.Drug use and HIV risk-related sex behaviors : A street outreach study of black adults
AbstractWang, M. Q., Collins, C. B., Kohler, C. L., DiClemente, R., & Wingood, G. (n.d.).Publication year
2000Journal title
Southern Medical JournalVolume
93Issue
2Page(s)
186-190AbstractBackground. Our street outreach project investigated the relationship between use of noninjecting drugs (alcohol, marijuana, cocaine) and human immunodeficiency virus (HIV) risk-related sex behaviors of black adults. The study focused on three HIV-related risks: multiple sex partners, unprotected sex, and drugs during sex. Methods. Data for this study were collected in a street outreach community survey for a drug abuse and HIV intervention study in Birmingham, Ala. A total of 780 black men and women completed the survey. Results. High-risk sex behaviors were far more prevalent among cocaine users than marijuana or alcohol users. A greater number of cocaine users reported having multiple sex partners, not using condoms, and using drugs during sex. Female cocaine users showed the same risk level for HIV infection as male cocaine users. Conclusions. Increased risk of HIV infection through sexual transmission is associated with use of noninjecting cocaine for both men and women. Condom use should be considered as a major component of HIV prevention programs.Expanding the scope of HIV prevention for adolescents : Beyond individual-level interventions
AbstractDiClemente, R., DiClemente, R. J., & Wingood, G. M. (n.d.).Publication year
2000Journal title
Journal of Adolescent HealthVolume
26Issue
6Page(s)
377-378Abstract~Health care service use and sexual communication : Past experience and future intention of high-risk male adolescents
AbstractRoberts, J., Boker, J. R., Oh, M. K., & DiClemente, R. (n.d.).Publication year
2000Journal title
Journal of Adolescent HealthVolume
27Issue
5Page(s)
298-301AbstractHigh-risk male adolescents were surveyed to collect data to be used to develop strategies to enhance communication with their partners about sexually transmitted diseases (STDs). Participants were concerned about acquiring an STD from their partner, and reported an increased likelihood of communicating about STD-related issues when confidential health care was available. Copyright (C) 2000 Society for Adolescent Medicine.Hepatitis B vaccination in a high risk MSM population : The need for vaccine education [4]
AbstractDiClemente, R., Rhodes, S. D., DiClemente, R. J., Yee, L. J., & Hergenrather, K. C. (n.d.).Publication year
2000Journal title
Sexually transmitted infectionsVolume
76Issue
5Page(s)
408-409Abstract~High prevalence of asymptomatic STDs in incarcerated minority male youth : A case for screening
AbstractPack, R. P., DiClemente, R., Hook, E. W., & Oh, M. K. (n.d.).Publication year
2000Journal title
Sexually Transmitted DiseasesVolume
27Issue
3Page(s)
175-177AbstractBackground and Objectives: To assess STD prevalence among a sample of incarcerated minority male youth in a southern US city. Methods: A consecutive entrant, cross-sectional study of 284 minority males 14 to 18 years was performed. All adolescents were screened for gonorrhea and chlamydia using ligase chain reaction tests. Results: Eighteen percent of youth were identified as having either gonorrhea, chlamydia, or both. Approximately 84% of those with sexually transmitted diseases (STDs) self- reported having no symptoms. Failure to use condoms in the past month was significantly associated with a positive test result for STDs (odds ratio = 1.9, 95% CI = 1.1-3.3). Conclusions: The findings indicate an urgent need for routine STD screening and STD-prevention programs for adolescent males in detention facilities. A study of 284 detained black male adolescents revealed 18% prevalence of gonorrhea, chlamydia, or both. Approximately 84% of those with sexually transmitted diseases self-reported not having symptoms.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.Reconceptualizing Women's HIV Risk
AbstractWingood, G. M., & DiClemente, R. (n.d.).Publication year
2000Journal title
Health Education & BehaviorVolume
27Issue
5Page(s)
570-571Abstract~