Sexual behavior change among human immunodeficiency virus-infected adolescents with hemophilia

Purpose. To determine the factors associated with the adoption or maintenan ce 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 partici pated in an intervention program designed to increase safer sexual behavior s (abstinence, condom use, or nonpenetrative behavior). The theory-based in tervention 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 co mpared with those who relapsed or did not improve. Logistic regression anal yses found that improvement and maintenance of safer sexual behavior were s ignificantly associated with perceived peer support for outercourse (odds r atio [OR]: 5.47; confidence interval [CI]: 1.4-20.8), perceived peer suppor t 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 se xual behavior were unrelated to change in safer sexual behavior. Conclusions. These longitudinal data indicate that improvement and maintena nce of safer sexual behavior among adolescents during an intervention is st rongly associated with perceptions of peer support for safer sex and lesser degrees of emotional distress. Programs for human immunodeficiency virus-i nfected adolescents may require developmentally appropriate social and psyc hological approaches to impact peer norms and emotional well-being.