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
African-American adolescents residing in high-risk urban environments do use condoms : Correlates and predictors of condom use among adolescents in public housing developments
AbstractDiClemente, R., Lodico, M., Grinstead, O. A., Harper, G., Rickman, R. L., Evans, P. E., & Coates, T. J. (n.d.).Publication year
1996Journal title
PediatricsVolume
98Issue
2Page(s)
269-278AbstractObjective. African-American adolescents living in high-risk inner-city environments have been disproportionately affected by the epidemics of human immunodeficiency virus (HIV) and other sexually transmitted diseases. Understanding the factors that influence the use of condoms by adolescents is critical for developing effective behavioral interventions. The present study examined the demographic, psychosocial, and behavioral correlates of condom use among African-American adolescents residing in public housing developments in an HIV epicenter (San Francisco) and prospectively evaluated the stability of these significant cross-sectional variables to predict consistent condom use. Design.A prospective study. Setting. Two public housing developments in San Francisco. Participants. African-American adolescents and young adults between 12 and 21 years of age were recruited though street outreach and completed a theoretically derived research interview assessing HIV-related knowledge, attitudes, and behaviors. After a 6-month period, adolescents completed a follow-up interview similar to the baseline measure. Among adolescents reporting sexual activity in the 6 months before completing the baseline interview (n = 116), logistic regression analysis evaluated the influence of demographic, psychosocial, and behavioral factors on consistent condom use. Results. Adolescents who had high assertive self-efficacy to demand condom use (adjusted odds ratio [OR], 11), perceived peer norms as supporting condom use (OR, 4.2), had greater impulse control (OR, 3.7), were male (OR, 4.7), and were younger (OR, 2.9) were more likely to report consistent condom use. Frequency of sexual intercourse was inversely related to condom use; adolescents with higher numbers of sexual episodes were less likely to use condoms consistently. Prospective analyses identified the baseline level of condom use as the best predictor of condom use at the 6-month follow-up. Adolescents who were consistent condom users at baseline were 7.4 times as likely to be consistent condom users during the follow-up period. Of those adolescents changing their frequency of condom use during the follow-up interval, significantly more engaged in risky behavior; 33.3% changed from consistent to inconsistent condom use, whereas 20.6% changed from inconsistent to consistent use (OR, 1.6). Conclusions. The findings suggest that HIV prevention programs need to be implemented early, before high-risk behaviors are established and may be more difficult to modify.Aids knowledge, teaching comfort, and support for aids education among school teachers : A statewide survey
AbstractBoscarino, J. A., & DiClemente, R. (n.d.).Publication year
1996Journal title
AIDS Education and PreventionVolume
8Issue
3Page(s)
267-277AbstractWith development of an effective HIV vaccine still elusive the control of HIV infection may depend on our ability to successfully educate diverse groups of adolescents in different communities about homosexuality and other sensitive subject matter. A statewide survey of California teachers (n = 835) indicated that teachers generally were knowledgeable about AIDS, felt comfortable presenting AIDS prevention information to students, and supported AIDS education in schools. Nevertheless, teachers' level of AIDS knowledge, comfort, and support varied by grade and other background characteristics. Elementary teachers were less knowledgeable (P < .001), felt less comfortable teaching (P < .001), and were less supportive of school-based AIDS education (P < .01). Teachers in urban schools (P < .05) and nonwhite teachers (P < .01) also had lower AIDS knowledge relative to other teachers. However, in comparison to surveys conducted in other states, California teachers appeared more knowledgeable of and progressive about AIDS education in the schools. As new school-based HIV and AIDS policies and prevention programs are formulated in the 1990s, teacher input will be critical to effective program development and implementation. To achieve success, it is important that differences in teachers' knowledge, comfort, and support be taken into consideration during both the development and implementation phases of these programs.Childhood sexual abuse and coercive sex among school-based adolescents in a midwestern state
AbstractLodico, M. A., Gruber, E., & DiClemente, R. (n.d.).Publication year
1996Journal title
Journal of Adolescent HealthVolume
18Issue
3Page(s)
211-217AbstractPurpose: Childhood sexual abuse has been identified in several studies as a predictor of adult sexual aggression or sexual victimization. Aggression and victimization are defined in this study as coercive sex. To date, no study of a sample of high school adolescents has investigated the association between a self-reported history of childhood sexual abuse and adolescent coercive sex. Method: Findings from the present study are based on a 10% random sample of the white and all the African American and Native American 9th and 12th grade students of a Midwestern state who completed a state-wide anonymous survey of risk-taking behavior in 1989. Results: The present study identified a 10% prevalence of sexual abuse. Females were four times more likely to report sexual abuse than males, while Native Americans and African Americans were approximately twice as likely as whites to report sexual abuse. Sexually abused adolescents were five times more likely to report any type of coercive sex with a friend or date than their nonabused peers. Specifically, compared to nonabused peers, sexually abused adolescents were twice as likely to report sexual aggression, and six times more likely to report sexual victimization and the co-occurrence of sexual aggression and victimization. Conclusions: Both by victimizing and being revictimized, sexually abused adolescents perpetuate their abusive experience. Adolescent health care providers should assess patients for sexually coercive behavior if they report childhood sexual abuse and assess adolescents who report current sexually coercive behavior for childhood sexual abuse.Early drinking onset and its association with alcohol use and problem behavior in late adolescence
AbstractGruber, E., DiClemente, R., Anderson, M. M., & Lodico, M. (n.d.).Publication year
1996Journal title
Preventive MedicineVolume
25Issue
3Page(s)
293-300AbstractObjective. To examine the relationship between age of drinking onset and patterns of use, abuse of other substances, and the prevalence of other alcohol-related problems in a population of midwestern high school seniors. Design. We analyzed self-report survey data on public school students' history of alcohol and other drug use and related problems from the Minnesota Student Survey conducted in 1969. The sample consisted of 2,650 male and female seniors, representing a 10% random sample of all white seniors in the study. Results. The findings suggest that early onset of alcohol use (by age 12) is associated with subsequent abuse of alcohol and related problem behaviors in later adolescence, including alcohol-related violence, injuries, drinking and driving, and absenteeism from school or work, as well as increased risks for using other drugs. Conclusion. This paper identifies the preadolescent years from age 10 to 12 as a particularly vulnerable period for the development of early alcohol dependence and abuse. Delaying alcohol use onset to age 13 may significantly reduce the risk of severe alcohol abuse in later adolescence.HIV sexual risk reduction interventions for women : A review
AbstractDiClemente, R., Wingood, G. M., & DiClemente, R. J. (n.d.).Publication year
1996Journal title
American journal of preventive medicineVolume
12Issue
3Page(s)
209-217AbstractAIDS has emerged as a serious public health threat for women. Reducing the risk for HIV infection among sexually active women requires the adoption of preventive strategies that effectively inhibit viral transmission. However, there is a paucity of published literature describing interventions targeted toward women and even fewer published reports evaluating their effectiveness. We conducted a search of HIV prevention interventions for women using the MEDLINE, ERIC and PSYCHLIT on-line computer database for the years January 1984-May 1995 to assess the effectiveness of interventions in increasing condom use during sexual intercourse. Interventions efficacious at increasing condom use applied a social psychological model of behavior to guide the development and implementation of the intervention, used randomized controlled designs to evaluate program efficacy, emphasized gender-related influences, were peer-led, and used multiple intervention sessions. While these findings are promising, methodologic limitations preclude any definitive assessment of programmatic efficacy. One challenge for future studies is to corroborate and extend these findings using rigorous methodologic research designs to evaluate programmatic efficacy, in particular, longer follow-up to assess stability of treatment effects over time. Another challenge is to understand the implications of previous research for the development of more gender-relevant interventions. The urgency of the HIV epidemic demands that the development and evaluation of HIV-prevention interventions tailored toward women remain a public health priority. Medical Subject Headings (MeSH): women, HIV/AIDS, interventions, prevention.HIV sexual risk-reduction interventions for African-American women [1]
AbstractDiClemente, R., Winett, R. A., Kalichman, S. C., Branson, B. M., Moore, J. S., Byers, R., DiClemente, R. J., & Wingood, G. M. (n.d.).Publication year
1996Journal title
JAMAVolume
275Issue
8Page(s)
593-595Abstract~HIV sexual risk-reduction interventions for African-American women [1]
AbstractDiClemente, R., Winett, R. A., Kalichman, S. C., Branson, B. M., Moore, J. S., Byers, R., DiClemente, R. J., & Wingood, G. M. (n.d.).Publication year
1996Journal title
JAMAVolume
275Issue
8Page(s)
593-595Abstract~Predictors of sun exposure in adolescents in a southeastern U.S. population
AbstractReynolds, K. D., Blaum, J. M., Jester, P. M., Weiss, H., Soong, S. J., & DiClemente, R. (n.d.).Publication year
1996Journal title
Journal of Adolescent HealthVolume
19Issue
6Page(s)
409-415AbstractPurpose: With the increase in melanoma incidence, the sun exposure and protective behaviors of adolescents are of great concern. Limited data are available on the prevalence and predictors of risk behavior in adolescents in the southeastern United States. This study examined the levels of sun exposure and variables predictive of sun exposure among adolescents in two Alabama middle schools. Methods: A total of 509 sixth-graders completed a self-administered survey assessing: (a) their knowledge, attitudes, and beliefs about malignant melanoma; and (b) their sun exposure and sunburns for a specific weekend and for the summer. Results: Levels of sun exposure and frequency of sunburn were high. Regression models determined the predictors of weekend and summer sun exposure, and weekend sunburn. Significant predictors varied by outcome and included gender, perceived importance of a suntan, parent and peer modeling, and sunscreen use. Conclusions: Reducing the risk of melanoma will require a three-pronged intervention strategy with efforts directed at adolescents, their parents, and the broader community.Risk-taking behavior among native American adolescents in Minnesota public schools : Comparisons with black and white adolescents
AbstractGruber, E., DiClemente, R., & Anderson, M. M. (n.d.).Publication year
1996Journal title
Ethnicity and HealthVolume
1Issue
3Page(s)
261-267AbstractObjectives. To examine rates of risk-taking behavior among native American adolescents in comparison with blacks and whites, and then to compare our off-reservation native American sample to available national statistics on reservation youth. Methods. A secondary data analysis of a Minnesota public school health survey. Contingency table analyses were performed on a 10% random sample of over 6000 young people focussing on three categories of behavioral risk: antisocial behavior, sexual behavior and substance use. Comparisons were then made to a national convenience sample from reservations and adjacent rural areas. Results. In general, native American adolescents have a significantly higher prevalence of risk behaviors across all indices of antisocial behavior and substance use relative to white and black peers. Native American females presented the most troubling picture. Comparisons to a national convenience sample from reservation lands indicated that native American adolescents in the sample often exceeded national rates of risk behavior. Conclusions. Residence and attendance at public schools outside reservation lands may make native American adolescents more likely to engage in risky behaviors which endanger their health.A Randomized Controlled Trial of an HIV Sexual Risk—Reduction Intervention for Young African-American Women
AbstractDiClemente, R., & Wingood, G. M. (n.d.).Publication year
1995Journal title
JAMA: The Journal of the American Medical AssociationVolume
274Issue
16Page(s)
1271-1276AbstractTo evaluate the efficacy of a community-based social skills human immunodeficiency virus (HIV) prevention intervention to enhance consistent condom use. —A randomized, single-blind controlled trial. —Bayview-Hunter's Point neighborhood of San Francisco, Calif, a predominantly African-American community that is economically disadvantaged. —A sample of 128 sexually active, heterosexual, African-American women 18 through 29 years of age was recruited using street outreach techniques. Participants completed a structured baseline interview; 100 women (78.1%) completed 3-month follow-up interviews. —Women randomized to the social skills intervention completed five sessions that emphasized ethnic and gender pride, HIV risk—reduction information, sexual self-control, sexual assertiveness and communication skills, proper condom use skills, and developing partner norms supportive of consistent condom use. Women randomized to the HIV education condition participated in a single session that provided HIV risk—reduction information. Women randomized to the delayed HIV education control condition received no HIV risk—reduction information until all follow-up interviews were completed. —Consistent condom use, HIV risk—reduction knowledge, sexual self-control, sexual assertiveness, sexual communication, and partner norms supportive of consistent condom use. —Compared with the delayed HIV education control condition, women in the social skills intervention demonstrated increased consistent condom use (adjusted odds ratio [OR], 2.1; 95% confidence interval [CI], 1.03 to 4.15; P=.04), greater sexual self-control (adjusted OR, 1.9; 95% CI, 1.00 to 3.60; P=.05), greater sexual communication (adjusted OR, 4.1; 95% CI, 1.67 to 10.01; P=.002), greater sexual assertiveness (adjusted OR, 1.8; 95% CI, 1.01 to 3.27; P=.05), and increased partners' adoption of norms supporting consistent condom use (adjusted OR, 2.1; 95% CI, 1.08 to 3.87; P=.03). No statistically significant differences in outcome variables were observed between the HIV education condition relative to the delayed HIV education control condition. —Community-based HIV risk—reduction programs that are gender relevant and culturally sensitive and provide social skills training can effectively enhance consistent condom use.Adverse factors associated with forced sex among southern adolescent girls
AbstractDiClemente, R., Nagy, S., DiClemente, R., & Adcock, A. G. (n.d.).Publication year
1995Journal title
PediatricsVolume
96Issue
5 IPage(s)
944-946AbstractObjective. To identify adverse behavioral and psychological factors associated with forced sex experiences of adolescent girls compared with their sexually active counterparts. Method. An anonymous self-report survey examining an array of psychosocial items, to which 3124 grade 8 and grade 10 female students responded. Results. Sexually abused girls were more likely to have been pregnant, to have initiated sexual intercourse at a younger age, to indicate illegal drug use, to have feelings of depression, to express more frequent suicidal ideation, and to have been physically abused. Conclusions. Behaviors such as gateway drug use, truancy, binge drinking of alcohol, and participation in violent episodes that were previously identified as indicators of sexual abuse did not distinguish between sexually active adolescents and those who had been sexually abused. Physicians should consider carefully a structured series of questions relating to behaviors as one approach in determining the risk of sexual abuse. Positive responses to young sexual initiation, pregnancy, illegal drug use, negative mental health states, and evidence of physical abuse are potential markers of sexual abuse in adolescent female clients.Change in junior high school students' AIDS-related knowledge, misconceptions, attitudes, and HIV-preventive behaviors : Effects of a school-based intervention
AbstractDiClemente, R., Siegel, D., DiClemente, R., Durbin, M., Krasnovsky, F., & Saliba, P. (n.d.).Publication year
1995Journal title
AIDS Education and PreventionVolume
7Issue
6Page(s)
534-543AbstractA school-based AIDS-prevention program for junior high school students was developed and implemented in an inner-city area in northern California that serves predominately African-American and Asian students. The curriculum, taught by science teachers, consisted of twelve classroom sessions using both didactic and interactive exercises covering sex education, HIV biology, drug use, decision-making and refusal skills, and public response to AIDS and community resources. Changes from baseline of self-reported responses to questions on pre- and posttests concerning AIDS knowledge and misconceptions, tolerance toward persons with AIDS, and high-risk behaviors were compared between intervention and control schools. Students in the intervention schools had a significant increase in AIDS knowledge (P < .0001) and became more tolerant of people with AIDS (P < .001) compared with students in the control school. Changes in high risk behavior could not be detected, perhaps due to the small number of sexually active students (24% of the sample). Students who increased their AIDS knowledge (p < .0001) as a result of the intervention became more tolerant of people with AIDS. A school-based HIV-prevention curriculum, taught by trained classroom teachers, can modify middle adolescents' HIV-related knowledge about the casual transmission of HIV, and their attitudes toward persons with AIDS.Correlates of condom use among incarcerated adolescents in a rural state
AbstractBarthlow, D. J., Horan, P. F., DiClemente, R., & Lanier, M. M. (n.d.).Publication year
1995Journal title
Criminal Justice and BehaviorVolume
22Issue
3Page(s)
295-306AbstractAn anonymous self-report survey was completed by 335 sexually active, incarcerated adolescents in a southern rural state. Multivariate logistic regression analysis was used to identify correlates of condom use during sexual intercourse. Four variables were identified as associated with frequent condom use: Nonuse of marijuana, nonuse of beer, asking sexual partners about their sexual history, and feeling worried about friends contracting AIDS. This four-variable model was highly significant, correctly classifying 70% of the adolescents in their condom-use categories. The intersecting nature of substance use and the HIV epidemic is discussed, as well as the importance of teaching substance refusal skills and sexual communication and negotiation skills to incarcerated adolescents.Overweight and obesity in Native-American adolescents : Comparing nonreservation youths with African-American and Caucasian peers
AbstractDiClemente, R., Gruber, E., Anderson, M. M., Ponton, L., & DiClemente, R. (n.d.).Publication year
1995Journal title
American journal of preventive medicineVolume
11Issue
5Page(s)
306-310AbstractPrevious studies have consistently shown that, compared to national standards, Native Americans across all age groups are disproportionately overweight or obese. Although most available data on rates of obesity in this group come from studies conducted on reservations, the proportion of Native Americans residing on reservation lands is rapidly declining. This study examines the prevalence of overweight and obesity in a population of Midwestern adolescents in public school settings and contrasts Caucasian and African-American adolescents with Native-American youths of the same age. Data were derived from a secondary analysis of an anonymous health-risk survey. Height, weight, and ethnicity were ascertained through self-report. The results call into question whether rates of overweight or obesity in Native-American adolescents are disproportionate relative to those for Caucasian and African-American adolescents. Cumulative comparisons of all overweight and obese adolescents in the sample (n = 5,655) show significant differences among ethnic groups, but age-specific comparisons do not yield a consistent pattern, especially for Native-American girls. To compare the entire sample to national weight standards, we plotted mean body mass index (BMI) for each ethnic group by age against NHANES II reference data. Age- specific BMI means for Native-American and Caucasian girls fell largely below the NHANES II reference data. We present several explanations for these results. Given the study limitations, further objective study of the weight status of Native-American children and adolescents in direct comparison with other ethnic groups is recommended.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 role of gender relations in HIV prevention research for women.
AbstractDiClemente, R., Wingood, G. M., & DiClemente, R. J. (n.d.).Publication year
1995Journal title
American journal of public healthVolume
85Issue
4Page(s)
592Abstract~Expanding the Pediatrician's Role in HIV Prevention for Adolescents
AbstractDiClemente, R., & Brown, L. K. (n.d.).Publication year
1994Journal title
Clinical PediatricsVolume
33Issue
4Page(s)
235-240Abstract~Sexual communication is associated with condom use by sexually active incarcerated adolescents
AbstractRickman, R. L., Lodico, M., DiClemente, R., Morris, R., Baker, C., & Huscroft, S. (n.d.).Publication year
1994Journal title
Journal of Adolescent HealthVolume
15Issue
5Page(s)
383-388AbstractPurpose: Incarcerated adolescents are at increased risk for infection by sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV). Moreover, condom use by this population is extremely low. Although interpersonal variables such as sexual communication have been found to be associated with condom use in other populations, few researchers have investigated this relationship among adolescents requiring detention in juvenile facilities. The present study investigated the relationship between communication about sexual history and incarcerated adolescents' condom use. Methods: We used multivariate logistic regression techniques to analyze interview data from a predominantly Latino sample of 2,132 sexually active adolescents detained in Los Angeles County Juvenile Hall. Results: Despite high numbers of lifetime sexual partners, a substantial majority of respondents (67%) reported that they never used condoms during sexual intercourse. Respondents who communicated with their sex partner(s) about each others' sexual history were significantly more likely to use condoms during sexual intercourse. Adolescents who reported that they knew someone with AIDS were also more likely to use condoms. Conclusions: Interventions designed to increase condom use among sexually active incarcerated adolescents should include a component addressing sexual communication practices. More research is needed on the ways in which adolescents learn to communicate about sex.The Association Between Childhood Sexual Abuse and Prevalence of HIV-Related Risk Behaviors
AbstractLodico, M. A., & DiClemente, R. (n.d.).Publication year
1994Journal title
Clinical PediatricsVolume
33Issue
8Page(s)
498-502Abstract~A Pilot Study of Sexual Communication and Negotiation Among Young African American Women : Implications for HIV Prevention
AbstractWingood, G. M., Hunter-Gamble, D., & DiClemente, R. (n.d.).Publication year
1993Journal title
Journal of Black PsychologyVolume
19Issue
2Page(s)
190-203AbstractRecent epidemiological studies indicate that African American female adolescents are at a markedly higher riskfor diagnoses with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) than their White female counterparts. Although epidemiologic data are informatve with respect to monitoring the course of the epidemic and quantifying the differential riskfor AIDSIHIV infection among young Afican American women in relation to other populations, they provide less insight into the influence of the diverse cultural, gender, andpsychosocial determinants ofHIV-associated risk behaviors. Afactor ofparticular importance is communication between sexual partners about condom use. Focus groups were conducted with African American women aged 18 to 25, to explore the process ofsexual communication and barriers toward sexual negotiation of condom use. HlVprevention programs tailored to African American women should emphasize training in sexual negotiation, conflict resolution, and refusal skills.Changes in adolescents' knowledge and attitudes about AIDS over the course of the AIDS epidemic
AbstractZimet, G. D., DiClemente, R., Lazebnik, R., Anglin, T. M., Ellick, E. M., & Williams, P. (n.d.).Publication year
1993Journal title
Journal of Adolescent HealthVolume
14Issue
2Page(s)
85-90AbstractWe compared AIDS-related attitudes of junior and senior high school students from 1988 to 1991 and across grade level to examine how effectively schools are addressing AIDS. Attitudes measured included knowledge and social anxiety about AIDS, as well as perceptions of vulnerability to HIV infection. Junior high school students (grades 7-9) were sampled three times, from 1989 to 1991. High school students (grades 10-12) were sampled four times, from 1988 to 1991. The 1991 junior high school sample had lower AIDS knowledge scores than the 1989 sample. Conversely, the 1991 high school sample had more accurate knowledge than earlier groups. With respect to grade level, 9th graders had more accurate knowledge than 7th and 8th graders, but knowledge did not increase from 10th through 12th grade. Anxiety about interacting with a person with AIDS and perceptions of vulnerability to HIV infection were unrelated to either sampling time or grade level. It is concluded that it will be important to redouble efforts to educate adolescents about AIDS and that particular attention needs to be paid to young adolescents.Comparison of AIDS knowledge and HIV-related sexual risk behaviors among adolescents in low and high AIDS prevalence communities
AbstractDiClemente, R., Brown, L. K., Beausoleil, N. I., & Lodico, M. (n.d.).Publication year
1993Journal title
Journal of Adolescent HealthVolume
14Issue
3Page(s)
231-236AbstractData were collected from students attending high school in a rural, low acquired immunodeficiency syndrome (AIDS) prevalence community in Northern California, and compared with students in an inner-city AIDS epicenter (San Francisco). The findings demonstrate that rural adolescents have higher levels of human immunodeficiency virus (HIV) knowledge, especially about risk-reduction strategies. However, rural adolescents also report higher rates of HIV-related sexual risk behaviors. Rural adolescents may not perceive the personal salience of practicing HIV risk-reduction behaviors thus increasing their risk for exposure to sexually-transmitted diseases, including HIV infection. School-based HIV prevention programs developed for rural communities will need to enhance the personal salience of HIV for adolescents' and discourage their discounting of personal risk attributable to a lower prevalence of AIDS in the community. Physicians must become more actively involved in HIV prevention efforts by routinely assessing adolescent patient's sexual behavior and utilizing their clinical interaction to provide HIV education and promote the adoption of HIV risk-reduction behaviors.Confronting the Challenge of AIDS among Adolescents : Directions for Future Research
AbstractDiClemente, R. (n.d.).Publication year
1993Journal title
Journal of Adolescent ResearchVolume
8Issue
2Page(s)
156-166AbstractTo effectively combat the AIDS health crisis among adolescents, future research must address three key issues: (a) the risk of disease for culturally differing adolescent populations, particularly African-American adolescents; (b) the need for empirical investigations to identify and understand the variables influencing adolescents ‘adoption of HIV-preventive sexual practices; and (c) the development of more effective prevention programs to reduce adolescents’ existing HIV-associated risk behaviors. This article reviews the relevance of these issues for prevention research and suggests policy recommendations. These recommendations argue for: (a) expanded funding for basic behavioral surveys to identify the prevalence of risk-taking behavior among adolescents in general, and among high-risk adolescent subgroups, for example, incarcerated and homeless adolescents; (b) encouraging more epidemiologic and ethnographic research to understand the psychosocial and cultural variables associated with high and low-risk behavior among understudied and underserved racial/ethnic populations such as African-American adolescents; and (c) urging that evaluation of HIV prevention programs include multisite trials and larger samples in ethnically and geographically diverse populations.Factors associated with multiple sex partners among junior high school students
AbstractDurbin, M., DiClemente, R., Siegel, D., Krasnovsky, F., Lazarus, N., & Camacho, T. (n.d.).Publication year
1993Journal title
Journal of Adolescent HealthVolume
14Issue
3Page(s)
202-207AbstractTwenty-one percent of a sample of inner-city junior high school students were found to be sexually active (n = 403). Only 31% of them reported a single lifetime sexual partner, 25% reported two partners, and 43% reported three or more partners. Logistic regression analysis evaluated the influence of demographic, psychosocial, and behavioral factors on the adolescents' lifetime number of sex partners. Respondents whose sexual debut occurred before age 13 years were nine times more likely to report three or more sex partners compared with those whose first sexual intercourse was at age 15 or 16 years, blacks were four times more likely than non-Hispanic whites to report three or more sex partners; and males were four times as likely as females to report this number of sexual partners. Factors not independently associated with the number of sex partners included: age, Asian or Hispanic ethnicity, human immunodeficiency virus (HIV) knowledge, self-efficacy (belief that one can protect oneself from the virus), condom use, and alcohol and drug use. We conclude that a significant proportion of school-based middle adolescents are sexually active and that most of these are at risk for contracting HIV because of behaviors such as having multiple sexual partners. Topics often stressed in school-based HIV education, such as factual knowledge about HIV, avoiding drugs and alcohol, and condom use are not associated with adolescents' choice about their number of sex partners. Intervention programs will have to identify and then target each specific HIV risk behavior and its motivations in order to reduce adolescents' risks of contracting and transmitting the disease.HIV knowledge, communication, and risk behaviors among white, Chinese-, and Filipino-American adolescents in a high-prevalence AIDS epicenter : a comparative analysis.
AbstractDiClemente, R., Horan, P. F., & DiClemente, R. J. (n.d.).Publication year
1993Journal title
Ethnicity & diseaseVolume
3Issue
2Page(s)
97-105AbstractWe conducted a comparative analysis of human immunodeficiency virus (HIV) knowledge, communication, and risk behaviors among 1272 white, Chinese-, and Filipino-American 10th and 11th graders in San Francisco, California, a high-prevalence AIDS epicenter. We performed principal components analysis on an epidemiologic survey instrument, and we identified five factors: HIV prevention knowledge, sexual behavior risk index, drug use risk index, HIV misconceptions, and communication about HIV. White students had higher HIV prevention scores than did Chinese and Filipino students, and whites had significantly greater ability to communicate with others about HIV disease and prevention. Chinese- and Filipino-American students had fewer misconceptions about HIV than did white students. Ethnicity did not have a significant influence on sexual behavior or drug use risk indices. Findings are discussed with reference to culturally sensitive HIV education.