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
'But I'm not like that' : Young men's navigation of normative masculinities in a marginalised urban community in Paraguay
AbstractFleming, P. J., Andes, K. L., & DiClemente, R. (n.d.).Publication year
2013Journal title
Culture, Health and SexualityVolume
15Issue
6Page(s)
652-666AbstractYoung men often define themselves and their masculine identity through romantic and sexual relationships, and their resulting sexual decisions can affect their successful transition into adulthood, as well as STI, HIV and pregnancy rates. This paper looks at how young Paraguayan men's peer groups, family and masculine identity formation influence their behaviours in sexual and romantic relationships. In Asunción, Paraguay, we conducted five focus-group discussions (FGDs) examining neighbourhood norms in 2010, with male peer groups ranging in age from 14 to 19 years. We then interviewed half the members from each peer group to examine their relationships with friends, family and young women and their beliefs about existing gender norms. Young men described two types of masculine norms, 'partner/provider' and macho, and two types of romantic relationships, 'casual' and 'formal'. The language used to describe each spectrum of behaviours was often concordant and highlights the connection between masculine norms and romantic relationships. The perceived norms for the neighbourhood were more macho than the young men's reported behaviours. Norms cannot change unless young men speak out about their non-normative behaviours. This provides evidence for more research on the formation, meaning and transformation of male gender norms.Can a Multilevel STI/HIV Prevention Strategy for High Risk African American Adolescents Improve Life Satisfaction?
AbstractZullig, K. J., Valois, R. F., Hobbs, G. R., Kerr, J. C., Romer, D., Carey, M. P., Brown, L. K., DiClemente, R., & Vanable, P. A. (n.d.).Publication year
2020Journal title
Journal of Happiness StudiesVolume
21Issue
2Page(s)
417-436AbstractAddressing adolescent sexual risk behaviors in the STI/HIV prevention literature is well documented; however, impacts from interventions on life satisfaction are relatively unexplored. This study examined data (n = 1658) from a randomized, multi-site, multi-level STI/HIV prevention intervention trial (Project iMPAACS) to determine whether increased protective and reduced sexual risk-taking behaviors associated with STI/HIV would also improve self-reported life satisfaction. Taking into account the nested study design and controlling for confounders, a mixed model ANOVA was performed where Total mean life satisfaction scores were analyzed at baseline and 3, 6, 12, and 18 months post-recruitment. Significance levels of 0.05 were used to determine significance and η2 was used to assess effect size. We hypothesized that as intervention participants engaged in the intentional activity associated with increasing protective behaviors and reducing sexual risk-taking behaviors associated with STI/HIV, life satisfaction reports would also improve over the course of the intervention. A significant main effect for sex was detected (F = 5.19, p =.02, η2 =.03), along with three interactions: between experimental condition and media intervention (F = 7.96, p =.005, η2=.04); experimental condition, sex, and media intervention (F = 6.51, p =.01, η2 =.04); and experimental condition, sex, assessment point, and media intervention (F = 3.23, p =.01, η2 =.02). With the exception of the control condition, female life satisfaction reports improved from baseline assessments to 18-months post-recruitment, whereas male reports decreased. Project iMPPACS was not designed with the intent on improving participants’ life satisfaction. However, study results suggest incorporating strategies to address subjective well-being into future adolescent STI/HIV risk-reduction interventions is beneficial for females and additional research is necessary for males.Capasso A, Wingood GM, DiClemente RJ. Major Preventive Intervention Frameworks: Role and Application of Theory in Promoting Health Behavior Adoption and Sustainment. In Revenson TA, Abraido Lanza, A. APA Handbook of Health Psychology. (In Press).
DiClemente RJ, Patel N. Sex Education – A Global Perspective. In McQueen D, MacDonald N, Ashton J, Buss P, Campostrini S, Lawrence R, Lin V, McBridge C, Perry H (Eds.). Oxford Research Encyclopedia of Global Public Health. New York, NY: Oxford University Press. (In press)
Dembo R, Faber J, Cristiano J, DiClemente RJ, Terminello A. Multi-Group Study of Depression among Youth Entering the Juvenile Justice System. In Hanson A. (Ed.), Mental Health Services: A Public Health Perspective. New York, NY: Oxford University Press. (In Press)
Robbins R, Allegrante J, Duncan D, Zeepfat J, DiClemente R. Influence of Mobile and Wearable Technology on Population Health. In Mares ML, Van den Bulck J (Eds.). The International Encyclopedia of Media Psychology. Hoboken, NJ: Wiley. (In Press)AbstractDiClemente, R. (n.d.).Abstract~Cash, cars, and condoms : Economic factors in disadvantaged adolescent women's condom use
AbstractRosenbaum, J., Zenilman, J., Rose, E., Wingood, G., & DiClemente, R. (n.d.).Publication year
2012Journal title
Journal of Adolescent HealthVolume
51Issue
3Page(s)
233-241AbstractEvaluate whether adolescent women who received economic benefits from their boyfriends were more likely never to use condoms. Data are obtained from a longitudinal HIV prevention intervention study with 715 African American adolescent women in urban Atlanta surveyed at baseline, 6 months, and 12 months. The primary outcome was never using condoms in the past 14 and 60 days at 6 and 12 months. The primary predictor was having a boyfriend as primary spending money source at baseline. Analysis minimized confounding using propensity weighting to balance respondents on 81 variables. A boyfriend was the primary spending money source for 24% of respondents, who did not differ in neighborhood or family context but had lower education, more abuse history, riskier sex, and more sexually transmitted infections. After propensity score weighting, no statistically significant differences for 81 evaluated covariates remained, including age distributions. Women whose boyfriend was their primary spending money source were 50% more likely never to use condoms at 6 and 12 months and less likely to respond to the intervention at 12 months. Women whose boyfriend had been their primary spending money source but found another spending money source were more likely to start using condoms than women who continued. Women whose boyfriends owned cars were more likely never to use condoms. Receiving spending money from a boyfriend is common among adolescent women in populations targeted by pregnancy and sexually transmitted infection prevention interventions, and may undermine interventions' effectiveness. Clinicians and reproductive health interventions need to address females' economic circumstances.Causally Interpretable Meta-analysis : Application in Adolescent HIV Prevention
AbstractBarker, D. H., Dahabreh, I. J., Steingrimsson, J. A., Houck, C., Donenberg, G., DiClemente, R., & Brown, L. K. (n.d.).Publication year
2022Journal title
Prevention ScienceVolume
23Issue
3Page(s)
403-414AbstractEndowing meta-analytic results with a causal interpretation is challenging when there are differences in the distribution of effect modifiers among the populations underlying the included trials and the target population where the results of the meta-analysis will be applied. Recent work on transportability methods has described identifiability conditions under which the collection of randomized trials in a meta-analysis can be used to draw causal inferences about the target population. When the conditions hold, the methods enable estimation of causal quantities such as the average treatment effect and conditional average treatment effect in target populations that differ from the populations underlying the trial samples. The methods also facilitate comparison of treatments not directly compared in a head-to-head trial and assessment of comparative effectiveness within subgroups of the target population. We briefly describe these methods and present a worked example using individual participant data from three HIV prevention trials among adolescents in mental health care. We describe practical challenges in defining the target population, obtaining individual participant data from included trials and a sample of the target population, and addressing systematic missing data across datasets. When fully realized, methods for causally interpretable meta-analysis can provide decision-makers valid estimates of how treatments will work in target populations of substantive interest as well as in subgroups of these populations.Centers for Disease Control and Prevention Partnerships with External Behavioral and Social Scientists. Roles, Extramural Funding, and Employment
AbstractRugg, D. L., Levinson, R., DiClemente, R., & Fishbein, M. (n.d.).Publication year
1997Journal title
American PsychologistVolume
52Issue
2Page(s)
147-153AbstractThe Centers for Disease Control and Prevention (CDC) must have strong external partnerships with behavioral and social scientists to refine and carry out its research and programmatic mission. This article examines funding, employment, and other mechanisms used to develop and foster such partnerships. The authors describe in detail funding mechanisms (especially the often-used cooperative agreement and contracting mechanisms) and identify specific sources of information about funding opportunities. Furthermore, they describe several different long- and short-term employment mechanisms that can be used to link CDC staff and external behavioral scientists. Finally, external behavioral and social scientists can serve in important roles as members of CDC advisory committees, peer reviewers of funding applications, and consultants; examples of these opportunities are also provided.Challenges in addressing depression in HIV research : Assessment, cultural context, and methods
AbstractSimoni, J. M., Safren, S. A., Manhart, L. E., Lyda, K., Grossman, C. I., Rao, D., Mimiaga, M. J., Wong, F. Y., Catz, S. L., Blank, M. B., DiClemente, R., & Wilson, I. B. (n.d.).Publication year
2011Journal title
AIDS and BehaviorVolume
15Issue
2Page(s)
376-388AbstractDepression is one of the most common co-morbidities of HIV infection. It negatively impacts self-care, quality of life, and biomedical outcomes among people living with HIV (PLWH) and may interfere with their ability to benefit from health promotion interventions. State-of-the-science research among PLWH, therefore, must address depression. To guide researchers, we describe the main diagnostic, screening, and symptom-rating measures of depression, offering suggestions for selecting the most appropriate instrument. We also address cultural considerations in the assessment of depression among PLWH, emphasizing the need to consider measurement equivalence and offering strategies for developing measures that are valid cross-culturally. Finally, acknowledging the high prevalence of depression among PLWH, we provide guidance to researchers on incorporating depression into the theoretical framework of their studies and employing procedures that account for participants with depression.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.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.Changes in incarcerated adolescents' human immunodeficiency virus knowledge and selected behaviors from 1988 to 1996
AbstractLanier, M. M., Pack, R. P., & DiClemente, R. (n.d.).Publication year
1999Journal title
Journal of Adolescent HealthVolume
25Issue
3Page(s)
182-186AbstractData were collected from juveniles in Alabama and Florida correctional facilities. The samples were closely demographically matched. Analysis indicated significant increases in knowledge about human immunodeficiency virus between 1988 and 1996 and increased sexual risk behaviors. Knowledge levels were lower for ethnic minority groups and boys, suggesting ethnic- and gender-specific pedagogical aids are needed.Changing risk trajectories and health outcomes for vulnerable adolescents : Reclaiming the future
AbstractDiClemente, R., & Wingood, G. M. (n.d.).Publication year
2017Journal title
PediatricsVolume
139Issue
2Abstract~Changing the landscape of South Asian migrant health research by advancing second-generation immigrant health needs
AbstractAli, S. H., DiClemente, R., & Parekh, N. (n.d.).Publication year
2021Journal title
Translational Behavioral MedicineVolume
11Issue
6Page(s)
1295-1297AbstractSouth Asian immigrants confront a growing non-communicable disease burden, a significant issue in countries such as the USA. While efforts have slowly begun to address South Asian migrant health, second-generation communities remain underserved and understudied despite facing many of the same non-communicable disease concerns. The aim of this commentary is to highlight unique health disparities contributing to the current South Asian migrant health status and identify pathways for further formative research needed to inform subsequent development, implementation, and evaluation of health interventions targeting this community. Extant peer-reviewed literature addressing second-generation South Asian health issues was used to identify key research pathways needed to address existing gaps. Specifically, we call for (a) enhancing targeted surveillance and recruitment in research and (b) collecting data to help characterize behavioral and cultural patterns that may contribute to disease onset and progression. Expanding research on second-generation South Asian migrant health may help to develop tailored and targeted interventions.Characteristics of African American adolescent females who perceive their current boyfriends have concurrent sexual partners
AbstractBrown, J. L., Sales, J. M., DiClemente, R., Latham Davis, T. P., & Rose, E. S. (n.d.).Publication year
2012Journal title
Journal of Adolescent HealthVolume
50Issue
4Page(s)
377-382AbstractPurpose: Perceived partner concurrency, reporting that a current sexual partner has other sexual partners, may pose sexual health risks to adolescents. We examined the contextual characteristics of African American female adolescents who reported their current boyfriend was having concurrent sexual relationships. Methods: Participants were African American adolescent females (N = 511; mean age = 17.6) recruited from sexual health clinics. Before participating in an STD/HIV prevention trial, the participants completed audio computer-assisted self-interviews with measures of perceived partner concurrency and individual- (e.g., depression, substance use), interpersonal- (e.g., social support, interpersonal stress), and community-level factors (i.e., neighborhood quality). Results: Twenty-seven percent of participants reported their belief that their current boyfriend had concurrent sexual partners during their relationship. In a logistic regression analysis, participants endorsing perceived partner concurrency reported less relational power (adjusted odds ratio [AOR] =.94, 95% confidence interval [CI] =.89.98, pChild Sexual Abuse of Asians Compared with Other Populations
AbstractRAO, K., DiClemente, R., & PONTON, L. E. (n.d.).Publication year
1992Journal title
Journal of the American Academy of Child and Adolescent PsychiatryVolume
31Issue
5Page(s)
880-886AbstractThis retrospective chart review study of a child sexual abuse clinic compared a consecutive sample of substantiated sexual abuse cases of Asian victims with random samples of black, white, and Hispanic victims. The findings suggest that there are clinically relevant differences between Asians and the other three populations. Asian victims showed a distinct demographic profile, suffered less physically invasive forms of abuse, were more likely to express suicidality, less likely to display anger and sexual acting out, and had less supportive primary caretakers than non-Asians. Awareness of such ethnic differences will help clinicians better evaluate and treat minority victims.Child sexual abuse, HIV sexual risk, and gender relations of African- American women
AbstractDiClemente, R., Wingood, G. M., & DiClemente, R. J. (n.d.).Publication year
1997Journal title
American journal of preventive medicineVolume
13Issue
5Page(s)
380-384AbstractIntroduction: A cross-sectional study was conducted to examine the association between childhood abuse, HIV-related sexual risks, and gender relations among African-American women. Methods: The sample 165 African- American women, 18-29 years of age, were recruited by street outreach from a lower socioeconomic community in San Francisco, CA. A face-to-face interview was administered to assess HIV/STD-sexual risk practices, alcohol use, physical abuse, affective health, and relationship commitment. Childhood sexual abuse was defined as experiencing forced sex prior to age 16. Results: The prevalence of childhood sexual abuse in this sample was 13.3%. Compared to women who were not abused during childhood, women who reported a history of childhood sexual abuse were 1.5 times more likely to have had an abortion, 1.4 times more likely to report having an STD, 2.4 times as likely to report having greater than two lifetime STDs, 3.8 times as likely to have a history of anal sex, 2.6 times as likely to worry about acquiring HIV, 3.9 times more likely to believe their partner did not care for them, twice as likely to doubt the longevity of their relationship, 5.1 times as likely to have a partner who had been physically abusive within the previous 3 months, 2.6 times as likely to have a partner who was physically abusive when asked to use condoms, and 1.5 times as likely to consume three or more glasses of alcohol at one time. Conclusions: Awareness of a woman's history of child sexual abuse can assist in making appropriate medical and social referrals and can lead to the development of more tailored HIV prevention programs for African-American women.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.Childhood Violence, High School Academic Environment, and Adult Alcohol Use Among Latinas and Black Women : A Structural Equation Modeling Study
AbstractCapasso, A., Tozan, Y., DiClemente, R., & Pahl, K. (n.d.).Publication year
2024Journal title
Journal of Interpersonal ViolenceAbstractObjective: Young Latinas and Black women drink less than women of other racial/ethnic groups but experience more alcohol-related problems in midlife. This study aims to identify modifiable factors to prevent adult onset of alcohol use disorder (AUD) in this population. Methods: Data were collected at six time points as part of the Harlem Longitudinal Development Study from 365 Latinas (47%) and Black (53%) women (mean age at time 1 = 14, standard deviation 1.3). Structural equation modeling was used to test hypothesized pathways from childhood physical and sexual abuse to AUD via depressive mood, anxiety disorders, and somatic complaints in the 20s. We also tested the moderation effect of the high school academic environment by including in the structural equation model two latent variable interaction terms between the school environment and each of the abuse variables. Results: Childhood physical and sexual abuse was positively associated with depressive mood, anxiety disorders, and somatic complaints when participants were in the 20s. Depressive mood mediated childhood abuse and AUD when women were in the 30s. The high school academic environment attenuated the effect of physical, but not sexual abuse, on depressive mood (β = −0.59, B = −9.38, 95% CI [−14.00, −4.76]), anxiety symptoms (β = −0.61, B = −14.19, 95% CI [−21.76, −6.61]), appetite loss (β = −0.41, B = −10.52, 95% CI [−15.61, −5.42]), and sleeplessness (β = −0.50, B = −9.56, 95% CI [−13.95, −5.17]) in the early 20s. Conclusions: Our findings underscore the need to invest in early violence prevention interventions and in education to ensure equitable access to quality, academically oriented, and safe schools.Childhood violence, high school academic environment, and adult alcohol use among Latinas and Black women: A structural equation modeling
AbstractDiClemente, R., Capasso, A., Tozan, Y., & Pahl, K. (n.d.).Publication year
2024Volume
Journal of Interpersonal Violence, 39Page(s)
4924-4953Abstract~Co-occurrence of intoxication during sex and sexually transmissible infections among young African American women : Does partner intoxication matter?
AbstractCrosby, R. A., DiClemente, R., Wingood, G. M., Salazar, L. F., Lang, D., Rose, E., & McDermott-Sales, J. (n.d.).Publication year
2008Journal title
Sexual HealthVolume
5Issue
3Page(s)
285-289AbstractBackground: The co-occurrence of a behaviour (being intoxicated on alcohol/drugs during sex) with a disease outcome [laboratory-confirmed sexually transmissible infection (STI) prevalence] among young African American women and their male sex partners was studied. Methods: A cross-sectional study was conducted. Recruitment and data collection occurred in three clinics located in a metropolitan city of the Southern USA. A total of 715 African American adolescent females (15-21 years old) were enrolled (82% participation rate). The primary outcome measure was the analysis of self-collected vaginal swabs using nucleic acid amplification assays for Trichomonas vaginalis, Chlamydia trachomatis, and Neisseria gonorrhoeae. Results: After controlling for age and self-efficacy to negotiate condom use, young women's alcohol/drug use while having sex was not significantly associated with STI prevalence [adjusted odds ratios (AOR):≤:1.29, 95% confidence interval (CI):≤:0.90-1.83]. However, using the same covariates, the association between male partners' alcohol/drug use and sexually transmitted disease prevalence was significant (AOR:≤:1.44, 95% CI:≤:1.03-2.02). Young women reporting that their sex partners had been drunk or high while having sex (at least once in the past 60 days) were ∼1.4 times more likely to test positive for at least one of the three assessed STIs. Conclusion: Young African American women reporting a male sex partner had been intoxicated during sex were significantly more likely to have an STI. The nature of this phenomenon could be a consequence of women's selection of risky partners and lack of condom use possibly stemming from their intoxication or their partners' intoxication.College Graduation Reduces Vulnerability to STIs/HIV among African-American Young Adult Women
AbstractPainter, J. E., Wingood, G. M., DiClemente, R., DePadilla, L. M., & Simpson-Robinson, L. S. (n.d.).Publication year
2012Journal title
Women's Health IssuesVolume
22Issue
3Page(s)
e303-e310AbstractAfrican-American women are disproportionately affected by sexually transmitted infections (STIs), including HIV. The Theory of Gender and Power (TGP) posits that socioeconomic exposures, including educational attainment, place women at increased risk for STIs/HIV. This study examined the association between educational attainment and vulnerability to STIs/HIV, as well as potential TGP-driven mediators of this association, among African-American women. Baseline data were assessed from an STI/HIV prevention intervention for African-American women (n = 848) aged 18 to 29 recruited from three Kaiser Permanente Centers in Atlanta, Georgia. Data collection included a survey of demographic, psychosocial, and behavioral measures and self-collected, laboratory-confirmed vaginal swabs for STIs (trichomoniasis, chlamydia, gonorrhea, and human papillomavirus). Multiple regression analyses and multivariate mediation analyses were used to examine the association between educational attainment with a laboratory-confirmed STI and potential TGP mediators. Controlling for age and receipt of public assistance, the odds of an STI diagnosis were 73% lower among participants with a college degree or greater compared with participants who had not completed high school. There were also significant associations between educational attainment and multiple TGP mediators from the sexual division of power and the structure of cathexis. TGP constructs did not mediate the association between educational attainment and laboratory-confirmed STI. The current study suggests that graduating from college may lead to a beneficial reduction in vulnerability to STIs/HIV among African-American women. Findings from this study support expanding structural-level interventions, emphasizing both high school and college graduation, as a means of reducing vulnerability to STIs/HIV among African-American women.College students' knowledge and attitudes about AIDS and changes in HIV-preventive behaviors
AbstractDiClemente, R., DiClemente, R. J., Forrest, K. A., & Mickler, S. (n.d.).Publication year
1990Journal title
AIDS Education and PreventionVolume
2Issue
3Page(s)
201-212AbstractData were collected from 1,127 students at geographically diverse universities and colleges in the United States to assess students' knowledge and attitudes about AIDS and self-reported changes in HIV-preventive behaviors. The findings indicate that while students demonstrate a high level of knowledge with respect to AIDS transmission they are also likely to possess many misconceptions about casual contact as a route of HIV transmission. HIV-related sexual risk-taking behavior was also substantial. A large proportion of students report never using condoms during sexual intercourse and having had multiple sexual partners during the year preceding the survey. A significant proportion of students report increasing health-protective behavior, although identification of the magnitude of these changes was not attained. Knowledge of AIDS transmission was not related to behavior change, although perceived risk of HIV infection was strongly associated with a self-reported increase in health-protective behaviors. The findings suggest that college students, while knowledgeable about AIDS and reporting marked behavioral changes, possess many misconceptions about casual contact and have a high prevalence of sexual risk-taking behaviors. The development of HIV prevention education programs for the college population is discussed.Combination HIV Prevention Interventions : The Potential of Integrated Behavioral and Biomedical Approaches
AbstractBrown, J. L., Sales, J. M., & DiClemente, R. (n.d.).Publication year
2014Journal title
Current HIV/AIDS ReportsVolume
11Issue
4Page(s)
363-375AbstractCombination HIV prevention interventions that integrate efficacious behavioral and biomedical strategies offer the potential to reduce new HIV infections. We overview the efficacy data for three biomedical HIV prevention approaches, namely microbicides, pre-exposure prophylaxis (PrEP), and HIV vaccination; review factors associated with differential acceptability and uptake of these methods; and suggest strategies to optimize the effectiveness and dissemination of combination HIV prevention approaches. A narrative review was conducted highlighting key efficacy data for microbicides, PrEP, and an HIV vaccination and summarizing acceptability data for each of the three biomedical HIV prevention approaches. Recommendations for the integration and dissemination of combined behavioral and biomedical HIV prevention approaches are provided. To date, microbicides and an HIV vaccination have demonstrated limited efficacy for the prevention of HIV. However, PrEP has demonstrated efficacy in reducing HIV incident infections. A diverse array of factors influences both hypothetical willingness and actual usage of each biomedical prevention method. Strategies to effectively integrate and evaluate combination HIV prevention interventions are urgently needed.Community trauma as a predictor of sexual risk, marijuana use, and psychosocial outcomes among detained African-American female adolescents
AbstractSeth, P., Jackson, J. M., DiClemente, R., & Fasula, A. M. (n.d.).Publication year
2017Journal title
Vulnerable Children and Youth StudiesVolume
12Issue
4Page(s)
353-359AbstractSocial determinants contribute to health disparities. Previous research has indicated that community trauma is associated with negative health outcomes. This study examined the impact of community trauma on sexual risk, marijuana use and mental health among African-American female adolescents in a juvenile detention center. One hundred and eighty-eight African-American female adolescents, aged 13–17 years, were recruited from a short-term detention facility and completed assessments on community trauma, sexual risk behavior, marijuana use, symptoms of posttraumatic stress disorder and psychosocial HIV/STD risk factors. Findings indicate that community trauma was associated with unprotected sex, having a sex partner with a correctional/juvenile justice history, sexual sensation seeking, marijuana use, affiliation with deviant peers and posttraumatic stress disorder symptoms at baseline and longitudinally. Findings reinforce the impact of community-level factors and co-occurring health issues, particularly in high-risk environments and among vulnerable populations. Structural and community-level interventions and policy-level changes may help improve access to resources and improve adolescents’ overall health and standard of living in at-risk communities.Comparative effectiveness of a faith-based HIV intervention for African American women : Importance of enhancing religious social capital
AbstractWingood, G. M., Robinson, L. S., Braxton, N. D., Er, D. L., Conner, A. C., Renfro, T. L., Rubtsova, A. A., Hardin, J. W., & DiClemente, R. (n.d.).Publication year
2013Journal title
American journal of public healthVolume
103Issue
12Page(s)
2226-2233AbstractObjectives. We assessed the effectiveness of P4 for Women, a faith-based HIV intervention. Methods. We used a 2-arm comparative effectiveness trial involving 134 African American women aged 18 to 34 years to compare the effectiveness of the Centers for Disease Control and Prevention-defined evidence-based Sisters Informing Sisters about Topics on AIDS (SISTA) HIV intervention with P4 for Women, an adapted faith-based version of SISTA. Participants were recruited from a large black church in Atlanta, Georgia, and completed assessments at baseline and follow-up. Results. Both SISTA and P4 forWomen had statistically significant effects on this study's primary outcome-consistent condom use in the past 90 days-as well as other sexual behaviors. However, P4 for Women also had statistically significant effects on the number of weeks women were abstinent, on all psychosocial mediators, and most noteworthy, on all measures of religious social capital. Results were achieved by enhancing structural social capital through ministry participation, religious values and norms, linking trust and by reducing negative religious coping. High intervention attendance may indicate the feasibility of conducting faith-based HIV prevention research for African American women. Conclusions. P4 for Women enhanced abstinence and safer sex practices as well as religious social capital, and was more acceptable than SISTA. Such efforts may assist faith leaders in responding to the HIV epidemic in African American women.Comparing the Influences of Spouses or Partners With Other Family Members in the Ability of Young Asian Americans to Maintain a Healthy Lifestyle
AbstractKwon, S., Ali, S. H., & DiClemente, R. (n.d.).Publication year
2024Journal title
American Journal of Lifestyle MedicineAbstractThe relationship between family dynamics and health has been extensively studied, but the specific pathways involved are not yet fully understood. The role of intimate partner relationships in promoting and maintaining healthy lifestyle behaviors remains understudied, particularly in minority populations. This study addressed this gap by examining how frequent spousal and familial interactions affect healthy lifestyle behaviors in young Asian Americans. Survey data from Asian American adults aged 18 to 35, collected in March 2021, is used to compare two groups: one interacting most with an intimate partner and the other interacting most with other non-intimate family members. The results showed that young Asian Americans interact most with their spouses/partners and mothers. Participants who interacted most frequently with their spouses/partners reported a greater influence in maintaining a healthy lifestyle, particularly in the domains of exercise and sleep. Moreover, those who interacted more with their spouses/partners exhibited a greater sense of connectedness, which impacted spousal and personal influence on healthy lifestyle behaviors. The findings suggest that promoting interaction and fostering stronger spousal/partner relationships can positively influence the healthy lifestyle behaviors of young Asian Americans.