Protogerou, C., & Johnson, B. T. AIDS and Behavior (October 2014), Vol 18, pp. 1847–1863.
The authors analyzed quantitative and qualitative reviews published to date to identify characteristics of successful HIV prevention interventions for adolescents aged 10–19, focusing on reduction of sexual risk-taking. After examining five eligible meta-analyses and six qualitative reviews, they identified four categories (factors) of interventions that were associated with reduced sexual risk-taking: (1) use of behavior change techniques (e.g., training to enhance motivation and build skills in cognitive behavior); (2) participant characteristics (e.g., age and vulnerability to contracting sexually transmitted infections including HIV); (3) application of design features (e.g., application of theory, formative research); (4) and socio-ecological features (e.g., supportive school environment). The findings showed that behavioral interventions had positive outcomes in at least one of the following: improving knowledge about HIV or safer sex, self-efficacy, delaying next sexual intercourse, encouraging abstinence, decreasing frequency of sex or number of partners, and increasing condom use. Of the four categories examined, the first, use of behavior change techniques (such as practicing communication and negotiation skills) was most closely linked to reduced sexual risk-taking; the fourth category, socio-ecological features, was the least effective. The authors concluded by endorsing the efficacy of behavioral HIV prevention interventions for adolescents, and called for formative research for full implementation of each of the four elements discussed.