Moderation and mediation of an effective HIV risk-reduction intervention for South African adolescents
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Updated: May 22, 2026

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Published on: March 30, 2014
Ann O'Leary1, John B Jemmott, Loretta Sweet Jemmott
1Prevention Research Branch, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. aao0@cdc.gov
Background:
"Let Us Protect Our Future" is a sexual risk-reduction intervention for sixth-grade adolescents in South Africa. Tested in a cluster-randomized controlled trial, the intervention significantly reduced self-reported intercourse and unprotected intercourse during a 12-month follow-up period.
Purpose:
The present analyses were conducted to identify moderators of the intervention's efficacy as well as, which theory-based variables mediated the intervention's effects.
Methods:
Intervention efficacy over the 3-, 6-, and 12-month follow-up was tested using generalized estimating equation models.
Results:
Living with their father in the home, parental strictness, and religiosity moderated the efficacy of the intervention in reducing unprotected intercourse. Self-efficacy to avoid risky situations and expected parental disapproval of their having intercourse, derived from Social Cognitive Theory, significantly mediated the intervention's effect on abstinence.
Conclusions:
This is the first study to demonstrate that Social Cognitive variables mediate the efficacy of a sexual risk-reduction intervention among South African adolescents.
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