Purpose

Interventions focused on promoting resilience or protective factors of youth have been proposed as a strategy for reducing risky behaviours associated with HIV infection among youth; however few studies have explored their effectiveness. This study assessed the impact of a resilience-based HIV prevention intervention (You Only Live Once) on risky sexual behaviours, resilience and protective factors of youth.

Methods

A one-group pretest-posttest design was used. One hundred and ninety-seven youth aged 15–24 years were conveniently recruited from a non-profit organisation in Maluti-a-Phofung Local Municipality, South Africa and participated in a 12-session, resilience-based HIV intervention delivered over a 1-week period by trained adult facilitators. Outcomes of interest were assessed at baseline and 3-month follow-up using validated risky sexual behaviour measures, and Child and Youth Resilience Measure. Mixed effect logistic and linear regression models were formulated to assess the impact of the intervention on risky sexual behaviours; resilience and protective factors respectively.

Results

Compared to baseline, participants at 3-month follow-up were 68 % less likely to have unprotected sex, 22 % less likely to regret their decision to engage in sexual activity and 0.4 % less likely to be pregnant or made someone pregnant. Conversely, participants at the 3-month follow-up had a higher propensity to engage in multiple sexual partnerships, transactional sex and intergenerational sex than baseline. Participants at 3-month follow-up had significant improvements in their scores of resilience, individual capacities and contextual factors that facilitate a sense of belonging (p < 0.05).

Conclusion

You Only Live Once intervention appeared to have mitigated some risky sexual behaviours, and improved resilience and protective factors over a 3-month period. These findings suggest that the intervention has ability to reduce risky sexual behaviours associated with HIV, and improve resilience and protective factors among youth in South Africa. Further evaluation of the intervention with a rigorous study design, larger sample size and longer period for follow-up is warranted.

中文翻译：

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你只活一次的影响：基于恢复力的艾滋病毒预防干预措施，以减少南非青年人的危险性行为

目的

已提议将侧重于促进青年的复原力或保护因素的干预措施作为减少青年与艾滋病毒感染相关的危险行为的战略；然而，很少有研究探讨它们的有效性。本研究评估了基于复原力的 HIV 预防干预措施（You Only Live Once）对青少年危险性行为、复原力和保护因素的影响。

方法

使用了一组前测后测设计。从南非 Maluti-a-Phofung 地方自治市的一家非营利组织方便地招募了 197 名 15-24 岁的青年，并参加了为期 12 次、基于复原力的 HIV 干预，为期 1-由训练有素的成人辅导员进行一周的培训。使用经过验证的危险性行为措施以及儿童和青少年复原力措施，在基线和 3 个月的随访中评估了感兴趣的结果。混合效应逻辑和线性回归模型被制定来评估干预对危险性行为的影响；弹性和保护因素分别。

结果

与基线相比，在 3 个月的随访中，参与者发生无保护性行为的可能性降低了 68%，后悔他们进行性活动的决定的可能性降低了 22%，怀孕或使某人怀孕的可能性降低了 0.4%。相反，在 3 个月的随访中，参与者比基线更倾向于从事多重性伙伴关系、性交易和代际性行为。在 3 个月的随访中，参与者的复原力得分、个人能力和促进归属感的环境因素都有显着改善 (p < 0.05)。

结论

You Only Live Once干预似乎减轻了一些危险的性行为，并在 3 个月的时间内提高了恢复力和保护因素。这些发现表明，该干预措施能够减少与 HIV 相关的危险性行为，并提高南非青年的适应力和保护因素。有必要通过严格的研究设计、更大的样本量和更长的随访时间来进一步评估干预措施。