Ralph DiClemente
Ralph DiClemente
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Professor of Social and Behavioral Sciences
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Professional overview
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Dr. Ralph DiClemente was trained as a Health Psychologist at the University of California, San Francisco where he received his PhD in 1984 after completing a ScM at the Harvard School of Public Health. He earned his undergraduate degree at the City University of New York.
Dr. DiClemente’s research has four key foci:
- Developing interventions to reduce the risk of HIV/STD among vulnerable populations
- Developing interventions to enhance vaccine uptake among high-risk adolescents and women, such as HPV and influenza vaccine
- Developing implementation science interventions to enhance the uptake, adoption and sustainability of HIV/STD prevention programs in the community
- Developing diabetes screening and behavior change interventions to identify people with diabetes who are unaware of their disease status as well as reduce the risk of diabetes among vulnerable populations.
He has focused on developing intervention packages that blend community and technology-based approaches that are designed to optimize program effectiveness and enhance programmatic sustainability.
Dr. DiClemente is the author of ten CDC-defined, evidence-based interventions for adolescents and young African-American women and men. He is the author of more than 540 peer-review publications, 150 book chapters, and 21 books. He serves as a member of the Office of AIDS Research Advisory Council.
Previously, Dr. DiClemente served as the Charles Howard Candler Professor of Public Health at the Rollins School of Public Health at Emory University. He was also Associate Director of the Center for AIDS Research, and was previously Chair of the Department of Behavioral Sciences and Health Education at the Rollins School of Public Health.
Dr. DiClemente is Past President of the Georgia chapter of the Society for Adolescent Health & Medicine. He previously served as a member of the CDC Board of Scientific Counselors, and the NIMH Advisory Council.
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Education
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BA, The City College of the City University of New York (CCNY), New York, NYScM, Behavioral Sciences, Harvard University, Cambridge, MAPhD, Health Psychology, University of California San Francisco Center for Behavioral Sciences, San Francisco, CAPostdoctoral Fellow, University of California, San Francisco, CA
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Areas of research and study
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Community InterventionsDiabetesHIV/AIDSImplementation scienceInfluenzaPsychology
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Publications
Publications
The association between cigarette smoking, virologic suppression, and CD4+ lymphocyte count in HIV-Infected Russian women
AbstractBrown, J. L., Winhusen, T., DiClemente, R., Sales, J. M., Rose, E. S., Safonova, P., Levina, O., Belyakov, N., & Rassokhin, V. V. (n.d.).Publication year
2017Journal title
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIVVolume
29Issue
9Page(s)
1102-1106AbstractCigarette smoking among people living with HIV/AIDS is associated with significant morbidity and mortality, but findings regarding the association between cigarette smoking and HIV viral load and CD4+ lymphocyte counts have been inconsistent. This study characterized the prevalence of cigarette smoking among HIV-infected Russian women and examined the association between smoking frequency and quantity and HIV viral load and CD4+ lymphocyte counts. HIV-infected Russian women (N = 250; M age = 30.0) in St. Petersburg, Russia, completed an audio computer-assisted self-interview survey assessing cigarette use, antiretroviral medication adherence, and provided blood samples assayed for HIV viral load and CD4+ lymphocyte counts. The majority (60.4%) reported cigarette smoking in the past month; 49.0% of recent smokers were classified as moderate or heavy smokers, defined as smoking ≥10 cigarettes daily. Viral load status did not differ between infrequent smokers and regular smokers. However, moderate/heavy smokers (relative to light smokers) were more likely to have a detectable viral load (AOR = 2.3, 95% CI: 1.1, 5.1). There were no significant differences in CD4+ lymphocyte counts by smoking frequency or quantity of cigarettes smoked. Results highlight the need for additional research to examine the association between cigarette smoking and virologic suppression and markers of HIV disease progression. Adverse health consequences of cigarette smoking coupled with a potential link between heavy smoking and poor virologic suppression highlight the need for assessment of cigarette use and provision of evidence-based smoking-cessation interventions within HIV medical care.The association between gang involvement and sexual behaviours among detained adolescent males
AbstractDiClemente, R., Voisin, D. R., Salazar, L. F., Crosby, R., DiClemente, R. J., Yarber, W. L., & Staples-Horne, M. (n.d.).Publication year
2004Journal title
Sexually transmitted infectionsVolume
80Issue
6Page(s)
440-442AbstractObjective: Data were collected from 270 detained male adolescents (aged 14-18 years) to determine the association between ever having been in a gang and a range of sexual behaviours such as sexual activity, male condom use, sex with multiple partners, and drug use during sex. Methods: Participants answered survey questions using audio computer assisted self interviewing (A-CASI) procedures, which assessed demographic, family factors, history of gang membership, and sexual behaviours. Results: Multiple logistic regression analyses, controlling for demographic, socioeconomic status, and family factors, indicated that adolescents who reported having been in a gang, relative to their peers reporting no gang involvement, were 5.7 times more likely to have had sex, 3.2 times more likely to have got a girl pregnant, and almost four times more likely to have been "high" on alcohol or other drugs during sexual intercourse, have had sex with a partner who was "high" on alcohol or other drugs, or have had sex with multiple partners concurrently. Conclusions: Findings suggest that having been in a gang can discriminate between levels of STI associated risk behaviours among an otherwise high risk population-detained adolescent males.The association between stress, coping, and sexual risk behaviors over 24 months among African-American female adolescents
AbstractHulland, E. N., Brown, J. L., Swartzendruber, A. L., Sales, J. M., Rose, E. S., & DiClemente, R. (n.d.).Publication year
2015Journal title
Psychology, Health and MedicineVolume
20Issue
4Page(s)
443-456AbstractHeightened psychosocial stress coupled with maladaptive coping may be associated with greater sexual risk engagement. This study examined the association between stress levels and coping strategy use as predictors of sexual risk behavior engagement over 24 months among African-American adolescent females (N = 701; M = 17.6 years) enrolled in an STI/HIV risk-reduction intervention program. Participants completed audio computer assisted self-interview (ACASI) measures of global stress, interpersonal stress, coping strategy use, and sexual behaviors prior to intervention participation. Follow-up ACASI assessments were conducted at 6, 12, 18, and 24 months post-intervention. Generalized estimated equation models examined associations between baseline stress levels and coping strategy use as predictors of condom use (past 90 days, last sex) and multiple partners during follow-up. Global stress and individual coping strategy usage were not associated with differences in condom use. Higher interpersonal stress was associated with lower proportion condom use (p =.018), inconsistent condom use (p =.011), and not using a condom at last sex (p =.002). There were no significant associations between stress levels, coping strategy use, and multiple partners. Future research should explore mechanisms that may underlie the association between elevated interpersonal stress and decreased condom use among this population.The concrete jungle : City stress and substance abuse among young adult African American men
AbstractSeth, P., Murray, C. C., Braxton, N. D., & DiClemente, R. (n.d.).Publication year
2013Journal title
Journal of Urban HealthVolume
90Issue
2Page(s)
307-313AbstractSubstance use is prevalent among African American men living in urban communities. The impact of substance use on the social, psychological, and physical health of African American men has important public health implications for families, communities, and society. Given the adverse consequences of alcohol and drug abuse within communities of color, this study evaluated the relationship between city stress, alcohol consumption, and drug use among African American men. Eighty heterosexual, African American men, 18 to 29 years old, completed psychosocial risk assessments that assessed substance use and city stress. Multiple logistic regression analyses, controlling for age, indicated that participants reporting high levels of urban stress, relative to low levels of urban stress, were more likely to report a history of marijuana use (AOR = 5.19, p =.05), history of ecstasy and/or GHB use (AOR = 3.34, p =.04), having family/friends expressing strong concerns about their illicit drug use (AOR = 4.06, p =.02), and being unable to remember what happened the night before due to drinking (AOR = 4.98, p =.01). African American men living within the confines of a stressful urban environment are at increased risk for exposure to and utilization of illicit substances. Culturally competent public health interventions for substance use/abuse should address psychological factors, such as stress and neighborhood violence.The contribution of male and female partners' substance use to sexual risks and stds among african american hiv serodiscordant couples
AbstractEl-Bassel, N., Wingood, G., Wyatt, G. E., Jemmott, J. B., Pequegnat, W., Landis, J. R., Bellamy, S., Gilbert, L., Remien, R. H., Witte, S., Wu, E., DiClemente, R., Myers, H., Jemmott, L. S., Metzger, D., Ballard, S., Brown, T., Greene, Q., Helker, C., … Wyatt, C. (n.d.).Publication year
2010Journal title
AIDS and BehaviorVolume
14Issue
5Page(s)
1045-1054AbstractGrowing evidence suggests that drug and alcohol use are fueling the heterosexual transmission of HIV among African Americans. This study aims to examine the relative contribution of drug and alcohol use of male and female partners to risks of heterosexual transmission of HIV among 535 African American HIV serodiscordant couples (N = 1,070 participants) who participated in an HIV prevention trial. Associations found between use of drugs and alcohol by one or both partners and sexual risk indicators varied by type of substance and whether male or female partner or both partners reported use. The findings suggest multiple ways in which substance use of male and female partners may be contributing to the heterosexual transmission of HIV and other STDs among African Americans and underscore the need for HIV prevention strategies to address dyadic patterns of substance use that lead to sexual risks.The developmental implications of prenatal and/or postnatal crack cocaine exposure in preschool children : A preliminary report
AbstractBender, S. L., Word, C. O., DiClemente, R., Crittenden, M. R., Persaud, N. A., & Ponton, L. E. (n.d.).Publication year
1995Journal title
Journal of Developmental and Behavioral PediatricsVolume
16Issue
6Page(s)
418-424AbstractPrevious studies examining the development of prenatally cocaine-exposed children through 3 years of age have found no significant differences between exposed and control groups. This study explored the developmental correlates of prenatal and/or postnatal crack cocaine exposure in children between 4 and 6 years of age. Three groups were studied: Group 1, 18 prenatally—exposed children whose mothers continue to use crack; Group II, 28 children without prenatal exposure whose mothers presently use crack; and Group III, 28 children whose mothers never used crack. Mothers were street-recruited and were comparable in race and socioeconomic status. The three groups of children did not differ on neurological gross motor and expressive language measures. However, prenatally exposed children performed significantly worse than others on receptive language and visual motor drawing tests. Prenatal crack exposure predicted poor visual motor performance even after control for intrauterine alcohol and marijuana exposure, age, birth weight, and duration of maternal crack use.The effect of high rates of bacterial sexually transmitted infections on hiv incidence in a cohort of black and white men who have sex with men in Atlanta, Georgia
AbstractKelley, C. F., Vaughan, A. S., Luisi, N., Sanchez, T. H., Salazar, L. F., Frew, P. M., Cooper, H. L., DiClemente, R., Del Rio, C., Sullivan, P. S., & Rosenberg, E. S. (n.d.).Publication year
2015Journal title
AIDS Research and Human RetrovirusesVolume
31Issue
6Page(s)
587-592AbstractData reporting sexually transmitted infection (STI) incidence rates among HIV-negative U.S. men who have sex with men (MSM) are lacking. In addition, it is difficult to analyze the effect of STI on HIV acquisition given that sexual risk behaviors confound the relationship between bacterial STIs and incident HIV. The InvolveMENt study was a longitudinal cohort of black and white HIV-negative, sexually active MSM in Atlanta who underwent routine screening for STI and HIV and completed behavioral questionnaires. Age-adjusted incidence rates were calculated for urethral and rectal Chlamydia (CT), gonorrhea (GC), and syphilis, stratified by race. Propensity-score-weighted Cox proportional hazards models were used to estimate the effect of STI on HIV incidence and calculate the population attributable fraction (PAF) for STI. We included 562 HIV-negative MSM with 843 person-years of follow-up in this analysis. High incidence rates were documented for all STIs, particularly among black MSM. Having a rectal STI was significantly associated with subsequent HIV incidence in adjusted analyses (aHR 2.7; 95% CI 1.2, 6.4) that controlled for behavioral risk factors associated with STI and HIV using propensity score weights. The PAF for rectal STI was 14.6 (95% CI 6.8, 31.4). The high incidence of STIs among Atlanta MSM and the association of rectal STI with HIV acquisition after controlling for behavioral risk underscore the importance of routine screening and treatment for STIs among sexually active MSM. Our data support targeting intensive HIV prevention interventions, such as preexposure chemoprophylaxis (PrEP), for Atlanta MSM diagnosed with rectal STIs.The effects of a mass media HIV-risk reduction strategy on HIV-related stigma and knowledge among African American adolescents
AbstractKerr, J. C., Valois, R. F., DiClemente, R., Carey, M. P., Stanton, B., Romer, D., Fletcher, F., Farber, N., Brown, L. K., Vanable, P. A., Salazar, L. F., Juzang, I., & Fortune, T. (n.d.).Publication year
2015Journal title
AIDS patient care and STDsVolume
29Issue
3Page(s)
150-156AbstractHIV-related stigma undermines HIV prevention, testing, and treatment. Multipronged risk-reduction strategies may reduce stigma among African American adolescents. To test the effectiveness of a risk-reduction strategy in addressing stigma, 1613 African American adolescents from four mid-sized cities participated in a randomized control trial. Participants received a sexual-risk reduction [Focus on Youth (FOY)] or general health curriculum [Promoting Health Among Teens (PHAT)]. Two cities received a culturally-tailored media intervention. Participants completed baseline, 3-, 6-, and 12-month surveys to measure HIV-related stigma and knowledge. Analysis of covariance tested for stigma and knowledge differences by media city status and curriculum/media city status (PHAT media vs. PHAT non-media, FOY media vs. FOY non-media; FOY media vs. PHAT media; FOY non-media vs. PHAT non-media) at each measurement. Hierarchical linear modeling (HLM) determined stigma and knowledge differences over time. Media participants demonstrated greater HIV-related knowledge (pThe effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women
AbstractWingood, G. M., & DiClemente, R. (n.d.).Publication year
1997Journal title
American journal of public healthVolume
87Issue
6Page(s)
1016-1018AbstractObjectives. This study examined the consequences of having a physically abusive primary partner on the condom use and sexual negotiation practices of young African-American women. Methods. Interviews were conducted with 165 sexually active African-American women aged 18 through 29 in San Francisco, Calif. Results. Women in abusive relationships were less likely than others to use condoms and were more likely to experience verbal abuse, emotional abuse, or threats of physical abuse when they discussed condoms. They were more fearful of asking their partners to use condoms, worried more about acquiring the human immunodeficiency virus (HIV), and felt more isolated than did women not in abusive relationships. Conclusions. HIV prevention programs for women should address domestic violence prevention strategies.The effects of child abuse and race on risk-taking in male adolescents.
AbstractDiClemente, R., Hernandez, J. T., Lodico, M., & DiClemente, R. J. (n.d.).Publication year
1993Journal title
Journal of the National Medical AssociationVolume
85Issue
8Page(s)
593-597AbstractThis study explores the effects of abuse on the risk-taking behaviors of 2973 black and white adolescent males, 412 of whom were sexually or physically abused. Surveys on mental and physical health, risk-taking behaviors and attitudes, and family living were administered to 9th and 12th graders in an urban midwestern state. The surveys included questions on past history of sexual and physical abuse. More black than white males reported experiencing incest, extrafamilial sexual abuse, and physical abuse. As for outcome risk-taking behaviors, blacks were more likely to use illegal substances, run away, skip school, attempt suicide, force partners into sex, and commit violent acts; however, the racial effects decreased when abuse histories were taken into consideration. Whites were more likely to drink and drive, and to drink before having sex; abuse history did not decrease this racial effect. Abuse but not race was predictive of drinking and of having serious drinking problems. The results point to the importance of pediatricians, psychologists, and other healthcare workers, as well as those in the legal and criminal justice system screening for a history of abuse among adolescents who demonstrate these or other risk-taking behaviors.The Emergence of Adolescents as a Risk Group for Human Immunodeficiency Virus Infection
AbstractDiClemente, R. (n.d.).Publication year
1990Journal title
Journal of Adolescent ResearchVolume
5Issue
1Page(s)
7-17AbstractAdolesceents have only recently been identified as a risk group for human immunodeficiencv, virus inifectioni. Limited data suggest that the prevalence of HIV infection among selected adolescent populatiotns is considerable. These data, however, are not generalizable because of the unrepresentative nature of the adolescent populations studied. Surrogate epidemiologic markers for projecting the potential spread of HIV in the adolescent populationi are idenitified. These markers include the prevalence of contraceptive behavior, rate of untinttetided pregnancy, and the prevalence of sexually transmitted diseases. Adolescetits kniowledge, attitudes, atid clanges in AIDS-preventive behavior are described. Psychosocial factors that may influence the adoption and maintenance of AIDS-prev entitie behav iors are identified and discussed. To increase the potentialfor developing the most effective HIV prevention programs, there is a need for greater understanding of the psxychosocial determinants motivating behavior change among adolescents.The first national scientific meeting of the Social and Behavioral Science Research Network
AbstractBlank, M. B., Metzger, D. S., Wingood, G. M., & DiClemente, R. (n.d.).Publication year
2008Journal title
Journal of Acquired Immune Deficiency SyndromesVolume
47Issue
SUPPL. 1Page(s)
S1-S4Abstract~The Health and Recovery Peer (HARP) Program : A peer-led intervention to improve medical self-management for persons with serious mental illness
AbstractDruss, B. G., Zhao, L., von Esenwein, S. A., Bona, J. R., Fricks, L., Jenkins-Tucker, S., Sterling, E., DiClemente, R., & Lorig, K. (n.d.).Publication year
2010Journal title
Schizophrenia ResearchVolume
118Issue
1-3Page(s)
264-270AbstractObjectives: Persons with serious mental illnesses (SMI) have elevated rates of comorbid medical conditions, but may also face challenges in effectively managing those conditions. Methods: The study team developed and pilot-tested the Health and Recovery Program (HARP), an adaptation of the Chronic Disease Self-Management Program (CDSMP) for mental health consumers. A manualized, six-session intervention, delivered by mental health peer leaders, helps participants become more effective managers of their chronic illnesses. A pilot trial randomized 80 consumers with one or more chronic medical illness to either the HARP program or usual care. Results: At six month follow-up, participants in the HARP program had a significantly greater improvement in patient activation than those in usual care (7.7% relative improvement vs. 5.7% decline, p=0.03 for group time interaction), and in rates of having one or more primary care visit (68.4% vs. 51.9% with one or more visit, p=0.046 for group time interaction). Intervention advantages were observed for physical health related quality of life (HRQOL), physical activity, medication adherence, and, and though not statistically significant, had similar effect sizes as those seen for the CDSMP in general medical populations. Improvements in HRQOL were largest among medically and socially vulnerable subpopulations. Conclusions: This peer-led, medical self-management program was feasible and showed promise for improving a range of health outcomes among mental health consumers with chronic medical comorbidities. The HARP intervention may provide a vehicle for the mental health peer workforce to actively engage in efforts to reduce morbidity and mortality among mental health consumers.The hidden burden of extragenital chlamydial and gonorrheal infections in a population of U.S. Army service members and their medical beneficiaries
AbstractDiClemente, R., Bartolanzo, D., Romo, M., Reynolds, A., Wingood, G., Ake, J., Calvano, T., Sevilla, M., & Colby, D. (n.d.). (Military Medicine).Publication year
2025AbstractBartolanzo D, Romo ML, Moreland SC, Dear N, Reynolds A, Sevilla MM, MacArthur JL, Cebula B, Faestel PM, Wingood GM, DiClemente RJ, Crowell TA, Ake JA, Calvano TP, Kunz A, Colby DJ. The hidden burden of extragenital chlamydial and gonorrheal infections in a population of U.S. Army service members and their medical beneficiaries. Military Medicine.The impact of alcohol use on HIV/STI intervention efficacy in predicting sexually transmitted infections among young African-American women
AbstractSeth, P., Wingood, G. M., Robinson, L. S., & DiClemente, R. (n.d.).Publication year
2014Journal title
AIDS and BehaviorVolume
18Issue
4Page(s)
747-751AbstractThe impact of alcohol use on the efficacy of an HIV/STI intervention designed for young African-American women in predicting STIs was examined. Eight hundred forty-eight African-American women, 18-29 years, were randomly assigned to either the HIV/STI intervention or a control condition. Participants were assessed on alcohol use and provided two vaginal swab specimens for STI testing. Women in the intervention who consumed alcohol were less likely to test STI-positive than women in the control and abstainers (AOR = 2.47, 95 % CI = 1.01-6.22). STI risk factors may vary across different populations. Further research on heavy drinking and HIV intervention efficacy is needed.The Impact of Community-Based Sexually Transmitted Infection Screening Results on Sexual Risk Behaviors of African American Adolescents
AbstractSznitman, S. R., Carey, M. P., Vanable, P. A., DiClemente, R., Brown, L. K., Valois, R. F., Hennessy, M., Farber, N., Rizzo, C., Caliendo, A., Salazar, L. F., Stanton, B. F., & Romer, D. (n.d.).Publication year
2010Journal title
Journal of Adolescent HealthVolume
47Issue
1Page(s)
12-19AbstractPurpose: To examine the effect of a community-based sexually transmitted infection (STI) screening program on sexual risk behavior among African American adolescents. We hypothesized that adolescents testing positive for an STI and receiving post-test counseling would reduce risky sexual practices, whereas STI-negative adolescents would show little or no change in protective sexual behavior after screening. Methods: From August 2006 to January 2008, we recruited 636 sexually active African American adolescents (age, 14-17) from community-based organizations in two mid-sized U.S. cities with high STI prevalence. Participants were screened for three STIs (gonorrhea, chlamydia, and trichomoniasis) and completed an audio computer-assisted self-interview. Youth who tested positive for an STI (6.6%) received treatment and counseling. Youth testing negative received no further intervention. Approximately 85% of participants completed 3- and 6-month follow-up assessments. Generalized estimating equations determined the effects of STI screening on adolescents' number of sexual partners and occurrence of unprotected sex. Results: Adolescents who tested positive for an STI reduced their number of vaginal and oral sex partners and the probability of unprotected sex. STI-negative adolescents demonstrated no change for numbers of partners or unprotected sex. Conclusions: Community-based STI screening can help to reduce sexual risk behavior in youth who test positive for STIs. Alternative approaches will be needed to reduce risk behavior in youth who test negative but who are nevertheless at risk for acquiring an STI.The impact of depressive symptomatology on risky sexual behavior and sexual communication among African American female adolescents
AbstractSeth, P., Patel, S. N., Sales, J. M., DiClemente, R., Wingood, G. M., & Rose, E. S. (n.d.).Publication year
2011Journal title
Psychology, Health and MedicineVolume
16Issue
3Page(s)
346-356AbstractAdolescents, particularly African American adolescents, are at high risk for sexually transmitted infections (STIs). The association between psychosocial factors and risky sexual behavior has been well established. However, only a small number of studies have examined the relationship between depressive symptomatology among African American female adolescents, specifically over time. The present study examined depressive symptoms as a predictor of risky sexual behavior, sexual communication, and STIs longitudinally among African American female adolescents between the ages 15 and 21. Binary generalized estimating equation models were conducted assessing the impact of depressive symptoms at baseline on risky sexual behavior and STIs over six- and 12-months follow-up. Age, intervention group, and baseline outcome measures were entered as covariates. The results indicated that high levels of depressive symptoms predicted no condom use during last sexual encounter and multiple sexual partners over six-months follow-up. Depressive symptoms also predicted having a main partner with concurrent partners, high fear of communication about condoms, and sex while high on alcohol or drugs over six- and 12-months follow-up. These findings could be used to inform HIV/STI prevention intervention programs and clinicians providing regular health care maintenance to African American female adolescents engaging in risky sexual behavior.The Influence of Familial and Peer Social Support on Post-Traumatic Stress Disorder Among Black Girls in Juvenile Correctional Facilities
AbstractQuinn, C. R., Boyd, D. T., Kim, B. K., Menon, S. E., Logan-Greene, P., Asemota, E., DiClemente, R., & Voisin, D. (n.d.).Publication year
2021Journal title
Criminal Justice and BehaviorVolume
48Issue
7Page(s)
867-883AbstractBlack girls bear a higher burden of juvenile justice involvement in the United States, relative to other racial/ethnic female groups. Emerging evidence suggests that system involvement is related to trauma histories and post-traumatic stress disorder (PTSD). This study investigated the associations between individual, family, and peer factors, and their relationship to PTSD among Black girls with juvenile justice involvement. Cross-sectional data were collected from 188 Black girls in detention. Measures assessed were history of abuse, negative peer norms, future orientation, caregiver support, self-esteem, age, and PTSD symptoms. Major regression findings indicated that higher rates of caregiver support, higher negative peer norms, lower self-esteem rates, and lower future orientation rates were correlated with greater PTSD symptoms. Treatment programs for this population warrant a multisystemic approach, which includes caregivers and peers, and bolstering important constructs such as self-esteem and hopefulness.The influence of psychosocial factors, alcohol, drug use on African- American women's high-risk sexual behavior
AbstractWingood, G. M., & DiClemente, R. (n.d.).Publication year
1998Journal title
American journal of preventive medicineVolume
15Issue
1Page(s)
54-59AbstractObjectives: The present study examines psychosocial and behavioral influences, particularly drug and alcohol use, as correlates of inconsistent condom use and having multiple sexual partners during the past month among African-American women. Methods: This cross-sectional study, conducted between May and June 1996, recruited a convenience sample of 180 African- American women in Birmingham, Alabama. Women completed a face-to-face interview that assessed alcohol and drug use, sexual behaviors, depression, condom use, and negotiation skills. Results: The majority of women, 51.6% (n = 93), had used either alcohol or drugs during the previous month. Many women, 31.1%, consumed alcohol, 18.3% used marijuana, and 8.3% had smoked crack within the past month. Nearly 42.7% of women used condoms inconsistently in the past month and 13.3% of women had multiple sexual partners within the past month. A logistic regression model predicting inconsistent condom use indicated that women were less likely to use condoms if they consumed alcohol between 20 and 30 days of the month (OR = 2.8, 90% CI = 1.3-5.9) and if they had not negotiated condom use (OR = 32.4, 90% CI = 7.9-131.6). The logistic regression model predicting multiple sexual partners indicated that women were more likely to have multiple sexual partners if they had smoked crack in the past month (OR = 5.3, 90% CI = 1.6-18.2). Conclusion: HIV sexual risk-reduction interventions for African-American women need to address the overlapping epidemics of drugs, alcohol, and STDs. Additionally, HIV sexual risk reduction efforts should be incorporated into existing drug and alcohol treatment programs and STD clinics.The influence of role status on risky sexual behavior among African Americans during the transition to adulthood
AbstractKogan, S. M., Brody, G. H., Gibbons, F. X., Murry, V. M., Cutrona, C. E., Simons, R. L., Wingood, G., & DiClemente, R. (n.d.).Publication year
2008Journal title
Journal of Black PsychologyVolume
34Issue
3Page(s)
399-420AbstractLittle research has examined the links between role status changes during the transition to adulthood and sexual behaviors that place African Americans at risk for sexually transmitted infections. Moreover, the mediating processes that explain these links, or protective factors that may buffer young adults from risky sexual behavior, are unknown. African American young adults who had either completed or dropped out of high school (ages 18 to 21, N = 186) provided information regarding their sexual behavior, role status, substance use, peer affiliations, religiosity, and receipt of protective family processes. Anticipated school attendance, part-time rather than full-time employment, and residence in a dorm or barracks rather than with peers or alone were negatively associated with risk behavior. Parenthood was positively associated with risk behavior; affiliation with peers who encourage risky sex partially accounted for this effect. Substance use fully accounted for the effect of part-time versus full-time employment on sexual risk behavior. Protective family processes and religiosity moderated the association of parenthood with sexual risk behavior. Prospective studies on these processes are warranted.The Longitudinal Impact of a Family-Based Communication Intervention on Observational and Self-Reports of Sexual Communication
AbstractHadley, W., Lansing, A., Barker, D. H., Brown, L. K., Hunter, H., Donenberg, G., & DiClemente, R. (n.d.).Publication year
2018Journal title
Journal of Child and Family StudiesVolume
27Issue
4Page(s)
1098-1109AbstractParents can play a vital role in shaping teenagers’ sexual attitudes, behavior, and contraceptive use through communication, however, less is known about how to modify parent–adolescent communication among youth with mental health problems. The impact of a family-based sexual risk prevention intervention on both observational and self-report of parent–adolescent sexual communication was examined at 12 months among adolescents with mental health problems. Of the 721 parent–adolescent dyads recruited for the study, 167 videotapes of sexual discussions between parents and adolescent were coded for the family-based intervention and 191 videotapes for the active comparison. Longitudinal analyses examined differences between conditions (family-based vs. comparison) in self-reported and observed parent–adolescent sexual discussions and also examined the impact of gender on intervention response. More parent I-statements, healthier parent body language, and fewer adolescent Negative Vocalizations were detected for family-based intervention participants 12 months after participating in the brief intervention (11 h of total intervention time) relative to those in the comparison condition. Parents in the family-based intervention also self-reported better sexual communication at 12 months. The current study provides supporting evidence that a relatively brief family-based intervention was successful at addressing parent–adolescent sexual communication among a mental health sample.The MEDIA model : An innovative method for digitizing and training community members to facilitate an HIV prevention intervention
AbstractRenfro, T., Johnson, E., Lambert, D. N., Wingood, G., & DiClemente, R. (n.d.).Publication year
2018Journal title
Translational Behavioral MedicineVolume
8Issue
6Page(s)
815-823AbstractAs human immunodeficiency virus (HIV) continues to disproportionately affect African American women, practitioners remain committed to developing innovative strategies to reduce HIV prevalence. These strategies include training community organizations, such as churches, and utilizing digital media to make intervention dissemination more sustainable. This article describes one such effort to train lay community members within predominantly Black churches in Atlanta, GA, to implement an HIV prevention intervention. Lay educators were trained by translating a face-to-face Training of Facilitators (TOF) to a digital platform using the MEDIA (Motivate-Engage-Digitize-Implement-Assess) model. Formative evaluations, consultation with experts in the digital platform of choice, and the experience of two P 4 for Women Master Trainers informed our translation. The model guided the translation process as our research team worked alongside topical experts and a production company to develop storyboards for core curriculum activities, which were later scripted and filmed with mock participants. A user guide, toolkit, and program website were also developed as supplemental materials to accompany the video training. Lessons learned from this study indicate future attempts at digitizing TOFs should keep in mind that digitization can be a time-consuming process, pilot testing in the new format is necessary even for a previously tested intervention, and the structure provided by facilitators in face-to-face training must be embedded into the format of digitized trainings.The mediating role of partner communication frequency on condom use among African American adolescent females participating in an HIV prevention intervention
AbstractSales, J. M., Lang, D. L., DiClemente, R., Latham, T. P., Wingood, G. M., Hardin, J. W., & Rose, E. S. (n.d.).Publication year
2012Journal title
Health PsychologyVolume
31Issue
1Page(s)
63-69AbstractObjective: Although effective HIV prevention interventions have been developed for adolescents, few interventions have explored whether components of the intervention are responsible for the observed changes in behaviors postintervention. This study examined the mediating role of partner communication frequency on African American adolescent females' condom use postparticipation in a demonstrated efficacious HIV risk-reduction intervention. Methods: As part of a randomized controlled trial, African American adolescent females (N = 715), 15-21 years, seeking sexual health services, completed a computerized interview at baseline (prior to intervention) and again 6 and 12 months follow-up post-intervention participation. The interview assessed adolescents' sexual behavior and partner communication skills, among other variables, at each time point. Using generalized estimating equation (GEE) techniques, both logistic and linear regression models were employed to test mediation over the 12-month follow-up period. Additional tests were conducted to assess the significance of the mediated models. Results: Mediation analyses observed that partner communication frequency was a significant partial mediator of both proportion of condom-protected sex acts (p = .001) and consistent condom use (p = .001). Conclusion: Partner communication frequency, an integral component of this HIV intervention, significantly increased as a function of participating in the intervention, partially explaining the change in condom use observed 12 months postintervention. Understanding what intervention components are associated with behavior change is important for future intervention development.The mediating role of partner communication skills on HIV/STD-associated risk behaviors in young African American females with a history of sexual violence
AbstractSales, J. M., Salazar, L. F., Wingood, G. M., DiClemente, R., Rose, E., & Crosby, R. A. (n.d.).Publication year
2008Journal title
Archives of Pediatrics and Adolescent MedicineVolume
162Issue
5Page(s)
432-438AbstractObjectives: To examine the prevalence of sexual violence among young African American females and to explore the mediating role that partner communication plays on human immunodeficiency virus (HIV)/sexually transmitted disease-associated risk behaviors among youth with a history of sexual violence relative to those without. Design: Only data from baseline, before randomization, were used for this analysis. Setting: A clinic-based sample of young females enrolled in a randomized trial of an HIV-prevention program in Atlanta, Georgia, from March 2002 to August 2004. Participants: African American females aged 15 to 21 years who reported sexual activity in the previous 60 days. Of 1558 screened, 874 females were eligible and 82% (n=715) participated at baseline. Outcome Measures: History of sexual violence as well as (1) sexual partner communication skills, (2) current sexual behaviors, and (3) psychological well-being. Results: Lifetime prevalence of sexual violence was 26%. Communication skills partially mediated the relationship between sexual violence and psychological well-being and sexual behavior outcomes. Conclusions: Given the lifetime prevalence of sexual violence and its adverse sexual, psychological, and relational sequelae, it is paramount that effective interventions are developed. Based on our findings, improving partner communications skills is one particularly important area for HIV/sexually transmitted disease risk-reduction interventions for youths with a history of sexual violence.The moderating role of parental psychopathology on response to a family-based HIV prevention intervention among youth in psychiatric treatment
AbstractDiClemente, R. (n.d.).Publication year
2015Journal title
Journal of Family StudiesVolume
21Issue
2Page(s)
178-194AbstractPrevious research suggests parents with mental health concerns are more likely to engage in maladaptive parenting practices and are less likely to benefit from parenting interventions. The current study examined the moderating influence of parent mental health problems on response to a family HIV prevention program delivered to youth in mental health treatment and their caregivers. The family intervention targeted parentadolescent communication and parental monitoring. Study hypotheses were tested using general linear models at three- and six-month follow-ups. Tests of moderation were conducted by modeling the interaction between treatment condition (family versus control) and parental psychopathology controlling for other relevant psychosocial factors (i.e., single parenthood, income, and education). Parents with elevated psychiatric symptoms demonstrated greater improvements in sexual communication (three and six months) and parental monitoring (three months) following the familybased intervention. These results suggest that parents with mental health problems can benefit from a brief family HIV prevention program.