HIV prevention interventions in adolescent girls: what is the state of the science?

Adolescent girls now represent one of the fastest growing groups of persons infected with HIV. A systematic review was undertaken to identify and critique the most scientifically rigorous HIV prevention interventions identified in the literature that focused on adolescent girls. Due to the limited number of randomized controlled trials (RCTs) in adolescent girls, the search was extended to identify any NIH-funded studies underway to provide an additional dimension to our understanding of the state of the science in this area.

An extensive search of the Cochrane database of systematic reviews, PubMed, Medline, PsycInfo, CINAHL, and CRISP was undertaken. Ultimately, six completed RCTs targeted at adolescent girls and measuring behavioral outcomes were critiqued and summarized. Key strengths and limitations were identified. Four additional studies were also summarized but were not critically reviewed because of their ongoing nature.

Most intervention studies targeted at adolescent girls have been shown to affect change in HIV risk-related behaviors to varying degrees. Most intervention studies have been conducted using predominantly racial minority samples in the United States. Clinically relevant components of successful interventions include the combination of providing information and behavioral skills training, as well as enhancing motivation to reduce risk within these interventions. Considerable diversity in study methods (e.g., intervention, measures, outcomes assessed) was noted, thus limited research evidence has been amassed to guide practice implications.

The state of the science for evidence-based practice is severely restricted in the area of gender-specific HIV prevention interventions for adolescent girls despite worldwide epidemiological trends that identify them as a high-risk group. The critical need for full-scale longitudinal interventions provided to both groups and individuals is evident. Studies that target various subpopulations of adolescent girls as well as those that address diverse cultures throughout the world are needed. Research in progress will provide further evidence of the efficacy of individual versus group-based interventions.