Assessment of the Effectiveness of the Comprehensive Integrated HIV Prevention Program in Reducing Risky Sexual Behavior and Increasing Safe Sex Practice among Minority Young Adults: A Latent Growth Curve Model Approach

Aim: Since the early 1980s, sexual risk behaviors have become a severe public health concern in preventing the prevalence of HIV infection, especially among minority young adults. In the United States, minority young adults have higher than expected HIV infection than other racial groups. The spread of HIV infection among this vulnerable population has created a need to identify risk and protective factors, disease, and evidence-based prevention strategies to reduce disease transmission. The Comprehensive, Integrated HIV Prevention Program (CIHPP), is based on a derivative of the ecological epistemology framework that views risk factors as a multilevel concentric, including the individual, family, community, and societal levels. The framework asserts that any meaningful prevention strategy should examine these different levels and the effects on the population of interest. This study aims to assess the effectiveness of CIHPP in increasing sexual risk practice and reducing risky sexual behavior among minority young adults. Methods: Data on risky sexual behavior and safe sex practice were derived from the National Minority Adult HIV Questionnaire. Components of the survey were administered to a random sample of young adults who participated in 24 months of CIHPP. Changes in risky sexual behaviors and safe sex practices, during 24 months of minority young adults' participation in CIHPP, were measured. The data was analyzed using the latent growth curve (LGC) model within structural equation modeling. Result: The mean and covariance estimate showed that CIHPP was not effective in increasing safe sex practices hypothesized (t=1.73=0.058; p=0.073 and t=2.69; p=0.039 respectively). Safe sex variance estimate for the intercept and slope were significant (t=0.733; p=01 and =2.745; p 006; respectively), suggesting evidence of intra-individual and inter-individual change among the participants. Using gender as a static predictor, showed no difference in safe sex practice between female and male participants at the beginning of CIHPP intervention. However, female participants practiced safe sex more than male participants during the 24 months. For risky sexual behavior, the means, covariance estimates, and slope estimates indicated that CIHPP was effective in reducing risky sexual behavior (t=-84.810; p=0.00 and t=27.967; t=0.001, respectively). The variance intercept and slope for risky sexual behavior showed inter-individual and intra-individual differences changes both at the beginning of CIHPP intervention and its rate of change in the 24 months t=30.015, p=0.001 and t=-2.67696; p=0.001). Using gender as a timeinvariant predictor of change, shows no meaningful difference in risky sexual behavior at the beginning between male and female participants. However, the rate of change in risky sexual behavior for males was less than for female participants (t=0.24-67; P=0.001 and t=-0.015, p=001, respectively). Conclusion: CIHPP effectively increased safe sex awareness and decreased risky sexual behavior among minority young adults during the 24 months of intervention. There were intra-individual and inter-individual differences in safe sex practice among the participants at the beginning (intercept) of CIHPP intervention and the rate of change (slope) during the 24 months. Female participants had a higher rate of change in safe sex practice than their male counterparts. There were intra-individual and inter-individual differences in risky sexual behavior among the participants at the beginning (intercept) of CIHPP intervention and the rate of change (slope) during the 24 months. Female participants had a higher rate of change in risky sexual behavior than their male counterparts. We conclude from these findings that hypotheses 1 and 2, as stated in the Introduction of this article, are confirmed.