Blocking the Benefit of Group-Based HIV-Prevention Efforts in At-Risk African-American Adolescents: The Problem of HIV-Related Stigma

• Authors: David H. Barker, Rhode Island Hospital; Rebecca R. Swenson, Rhode Island Hospital; Larry K. Brown, Rhode Island Hospital; Bonita F. Stanton, Wayne State University; Peter A. Vanable, Syracuse University; Michael P. Carey, Brown University; Robert F. Valois, University of South Carolina; Ralph Joseph Diclemente, Emory University; Laura F. Salazar, Emory University; Daniel Romer, University of Pennsylvania
• Journal Title: AIDS and Behavior
• Volume: Volume 16, Number 3
• Publisher: Springer Verlag (Germany) | 2012-04-01, Pages 571-577
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1007/s10461-011-0101-1
• Subjects: Health Sciences, Public Health; Psychology, Behavioral; Education, Social Sciences
• Keywords: Science & Technology; Social Sciences; Life Sciences & Biomedicine; Public, Environmental & Occupational Health; Social Sciences, Biomedical; Biomedical Social Sciences; HIV; Stigma; Adolescence; Knowledge; Prevention; AFRICAN-AMERICAN ADOLESCENTS; HIV/AIDS STIGMA; SEXUAL-BEHAVIOR; AIDS EDUCATION; SOUTH-AFRICA; KNOWLEDGE; PROGRAM; HEALTH; RISK; INTERVENTIONS

Abstract

HIV-related stigma has been shown to impede HIV-antibody testing and safer sexual practices in adults. Less is known about its effects on prevention programs among at-risk youth. This study examined the longitudinal relationships between HIV-stigma and HIV-knowledge following completion of a validated group-based intervention. Data were provided by 1,654 African-American adolescents who participated in a large multi-city prevention trial (Project iMPACCS). Participants were randomly assigned to an empirically-validated skill-based intervention or a general health promotion control group. Both stigma and knowledge were assessed at baseline and post-intervention. Results suggested that adolescents participating in the intervention showed improvements in knowledge and decreases in stigma when compared to controls. Improvements in stigma appeared to be partly driven by improvements in knowledge. Higher baseline stigma was shown to reduce gains in knowledge in both the treatment and control groups. Results suggest that HIV-stigma can interfere with how youth identify with and internalize messages from group-based prevention trials.