Testing the Efficacy of an Alternative Platform for Delivering HIV Risk Prevention Programs to Rural African American Parents and Youths

Introduction: HIV/AIDS has reached epidemic proportions among African Americans residing in US southern region, especially among those who also are poor (Williams, 2001).Compared to youth in other regions of the United States, rural southern African American adults and adolescents are 8 times more likely to have AIDS, and are disproportionately represented in other STI cases, 60% of gonorrhea infections, 67% primary and secondary syphilis, and 82% of latent syphilis (CDC 2010). HIV is preventable and can be reduced effectively through well-designed, targeted, theory-based behavior change interventions (Fishbein, 2000). 

Theory of Planned Behavior (TPB) contends that that behavior is influenced by proximal determinants of behavioral performance, and includes --intentions to engage in the behavior; positive perceptions or images of peers who are engaging in the behaviors; and one’s perception of their willingness to exert control when confronting risk opportunity situations. This current study utilized the TPB to test the efficacy of The Pathways for African American Success (PAAS) program as an alternative delivery platform to speed up the process of widespread dissemination of effective HIV risk prevention programs from science to practice. PAAS, a six-session manualized and technology-driven program, is designed to enhance parent-youth knowledge and skills to deter early sexual onset, risky sexual practices, and the initiation and escalation of drugs/alcohol among rural African American youths.

Method: 412 African American parents and their 6^thgrader from five rural counties in Tennessee were randomly assigned to the following: traditional didactic in-person delivery, CD-ROM, or minimal control conditions.  To achieve the overall goal of the current study, analyses were conducted on families assigned PAAS intervention conditions (CD-ROM, n=138, in-person, and minimal control, n =137, respectively).

Results: Intent-to-treat analyses indicated that PAAS evinced induced changed in intervention targeted behaviors.  Compared to families in the minimal control condition, PAAS youths were less inclined to engage in risky behavior. Having less favorable images or prototypes of risk gaging agemates was associated with youths’ unwillingness to engage in risky behavior should the opportunity occur.

Conclusions: The lack of uptake of evidence-based program in clinical settings has been hindered by the costs, burdensome materials, and labor intensive training required to implement such programs. Further, the field is in need of culturally tailored programs for use with racial/ethnic families.  PAAS holds promise for speeding up the dissemination of evidence-based programs designed to enhance family protective factors that can promote healthy youth development and adjustment.