PEDIATRICS Vol. 106 No. 2 August 2000, p. e22
Received Jul 12, 1999; accepted Feb 28, 2000.
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From the * Department of Psychiatry and Human Behavior, Brown
University School of Medicine, Providence, Rhode Island;
Department
of Psychology, Xavier University, Cincinnati, Ohio; § Department of
Psychology, New Jersey City University, Jersey City, New Jersey;
Division of Hematology, Children's Hospital of Philadelphia,
Philadelphia, Pennsylvania; ¶ New England Hemophilia Center, University
of Massachusetts Memorial Hospital, Worcester, Massachusetts;
# Hemophilia Care Program, Puget Sound Blood Center, Seattle,
Washington; ** Department of Biobehavioral Health, Pennsylvania State
University, University Park, Pennsylvania; 
Division of
Hematology, University of Colorado Health Sciences Center, Aurora,
Colorado; and the §§ Division of Hematology, Mount Sinai Medical
Center, New York, New York.
Purpose. To determine the factors associated with the adoption or maintenance of consistent safer sexual behaviors among human immunodeficiency virus-positive adolescents and young adults with hemophilia.
Methods. One hundred eleven adolescents at 10 hemophilia care sites participated in an intervention program designed to increase safer sexual behaviors (abstinence, condom use, or nonpenetrative behavior). The theory-based intervention spanned 1 year. Adolescents attended individual sessions, small group activities, and an intensive group retreat.
Results. Patients who maintained or improved safer sexual behaviors were compared with those who relapsed or did not improve. Logistic regression analyses found that improvement and maintenance of safer sexual behavior were significantly associated with perceived peer support for outercourse (odds ratio [OR]: 5.47; confidence interval [CI]: 1.4-20.8), perceived peer support for abstinence (OR: 5.08; CI: 1.2-20.1), and decreased general emotional distress (OR: 4.65; CI: 1.04-20.6). Perceived health status and previous sexual behavior were unrelated to change in safer sexual behavior.
Conclusions. These longitudinal data indicate that improvement and maintenance of safer sexual behavior among adolescents during an intervention is strongly associated with perceptions of peer support for safer sex and lesser degrees of emotional distress. Programs for human immunodeficiency virus-infected adolescents may require developmentally appropriate social and psychological approaches to impact peer norms and emotional well-being. Key words: human immunodeficiency virus, sexual behavior, stages of change, peer norms, emotional distress, transtheoretical model.