Jornal de Ensaios Clínicos
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Make It Last: Using a Supplemental Treatment Trial Design to Maintain Effects of a Sexual Risk Reduction Intervention for African-American Adolescent Females

Erin LP Bradley, Ralph J DiClemente, Jessica M Sales, Eve S Rose, Teaniese L Davis, Gina M Wingood, Jennifer L Brown and Delia L Lang

Effective interventions have been developed to promote STI/HIV protective behaviors among populations most vulnerable to infection, including African-American adolescent females. However, intervention effects show marked and rapid decay following cessation of the intervention. Consequently, the maintenance of protective behaviors for extended periods of time has become a priority for researchers and health professionals. The objective of this report is to describe the use of a supplemental treatment trial design of a behavioral STI/HIV prevention maintenance intervention, which includes a primary treatment (i.e., intervention workshop) followed by an additional treatment (i.e., calls) designed to maintain the effects of the primary treatment. The treatment was tested in a randomized controlled trial among 701 African-American adolescent females, ages 14-20, over a 36-month follow-up period. Upon completion of an evidence-based intervention (primary treatment), participants randomly assigned to the
experimental condition received brief, telephone-delivered counseling sessions (supplemental treatment) reinforcing intervention content every 8 weeks over the 36-month follow-up period. Participants randomly assigned to the comparison condition after the primary treatment received time-match health and wellness calls. Experimental condition participants had significantly fewer incident chlamydial infections, and reported higher proportion condom use and fewer instances of sex while intoxicated by alcohol or drugs. Supplemental treatment trials are not frequently used in STI/HIV prevention but may be a promising approach for evaluating behavior change maintenance.