As shown in , at baseline both intention to use a condom if having sex (a protective behavior) and intention to engage in sex in the next six months (a risk behavior) were significantly higher among FOYC+CImPACT youth compared to controls among the total sample and among the subsample of males. No significant differences in other sexual risk or protective perceptions, skills, or knowledge at baseline. Not shown in this table, GLAT scores were lower among FOYC+CImPACT schools (average 18.2 with three of the five schools having significantly lower mean scores of 11.2, 9.7 and 11.3 compared to the overall mean) compared to WW+GFI schools (average 24.2, with only one school having a significantly lower mean of 15.2 and one school a significantly higher mean of 31.7) (data available upon request).
Sexual risk and protection intervention effect of youth participating in WW+GFI and FOYC+CImPACT overall and by gender controlling for age and baseline differences.
depicts the frequency distributions of risk behaviors by intervention group. Overall, at baseline there were no significant differences between FOYC+CImPACT and WW+GFI youth. Alcohol use was significantly higher among FOYC+CImPACT males compared to control males. There were no other significance differences by gender at baseline.
Intervention effect of youth participating in WW+GFI and FOYC+CImPACT overall and by gender on nonsexual risk behaviors controlling for age and baseline differences.
As shown in , postintervention, sexual initiation increased among both groups of youth, although the rate of initiation among all FOYC+CImPACT youth appeared to be faster than among WW+GFI youth; differences in sexual initiation between the two groups achieved statistical significance at 18 and 36 months. Sexual intentions were higher among FOYC+CImPACT in some waves. However, as noted above, given the significantly higher percentage of males in FOYC+CImPACT and the significantly higher rates of sexual initiation among males compared to females in both groups, the analyses were then conducted within gender subgroups. Among males only and among females only, there were no significant differences in either intentions or sexual initiation between FOYC+CImPACT and WW+GFI.
Condom-use intentions, after controlling for baseline differences, were significantly higher at all followups except the six month follow-up among FOYC+CImPACT youth overall and among males; these differences were significantly higher among FOYC+CImPACT females at 18, 24, and 36 months. Condom-use intentions and behavior increased over time among both intervention and control youth and among males and females. Also apparent in , HIV knowledge, condom-use skills, and condom-use perceptions were significantly higher after intervention among FOYC+CImPACT youth. These differences were also apparent among the subset of males and the subset of females. The fact that differences were not present at baseline and that these postintervention effects did not differ by gender indicates an intervention rather than a sampling (randomization) effect.
demonstrates substantial increases in six of the nine behaviors with age among both the FOYC+CImPACT and the WW+GFI youth; being suspended, smoking cigarettes and use of cocaine did not increase. Carrying a gun as a weapon and being involved in a physical fight was significantly higher among FOYC+CImPACT males, raising the possibility that the intervention may have in some way increased this risk behavior.
Because it appeared that the significant increases in risk behaviors seen among the FOYC+CImPACT group were largely attributable to differences in gender composition of the two intervention groups, although sexual initiation remained somewhat higher overall even when controlling for gender, we explored the perception of our Bahamian local team members that the FOYC+CImPACT group was a higher risk group at baseline from an environmental effect (increased risk propensity). As noted above, the GLAT scores were somewhat lower among the FOYC+CImPACT schools compared to the WW+GFI schools. To explore the possibility that the GLAT scores might be a marker for future risk behaviors, in we show the relationship between each of the 11 targeted risk behaviors and the GLAT score. With the exceptions of “suspended from school” and “consistent condom use” these relationships were all negative (e.g., the higher the GLAT score, the lower the frequency of risk behavior). Other than “suspended from school,” “alcohol use,” and “consistent condom use,” across 36 months of followup, these correlations achieved statistical significance for at least one of the follow-up periods. For “ever had sex,” these negative correlations were significant at all assessments. That is, regardless of intervention condition, youth in schools with lower GLAT scores were more likely to initiate sex. The negative correlations between the GLAT score and “sold or delivered drugs” and for carrying both guns and knives to “use as a weapon” were statistically significant. also demonstrated the negative correlations between GLAT scores and perceptions of relatives and neighbor's involvement in four risk behaviors (using alcohol, marijuana and cocaine and selling drugs) at baseline, and each follow-up interval, with the exception of perceived frequency of relatives drinking alcohol. After baseline through 36 months followup, the majority of these correlations were significant.
Standardized regression coefficients for GLAT scores1 predicting youth reported behavior over the past 6 months.
Therefore, in we adjusted the rates for each of the eight behaviors which were significantly associated (in all cases negatively) at one or more assessment periods with the English GLAT scores and (gender for the overall group). The three behaviors without significant associations were adjusted without using GLAT scores. Following this adjustment “involved in a physical fight” (overall) and “carrying a gun as a weapon” remained higher (overall and among males) among FOYC+CImPACT youth. Sexual initiation, carrying a knife, and selling drugs overall were no longer significantly higher among FOYC+CImPACT youth.
Rate of sexual and other risk behaviors by intervention condition after adjusting for GLAT score1.