Faith-based intervention for HIV risk reduction shows significant mediation by self-efficacy in adolescentsFaith-based programs may help African American teens with HIV

African American youth face disproportionate risks for human immunodeficiency virus (HIV) and other sexually transmitted infections, highlighting the need for culturally tailored, evidence-based interventions. This research reports a secondary, exploratory analysis examining the mediation effects of theoretical constructs on the efficacy of sexual risk-reduction interventions promoting abstinence for African American adolescents in church-based settings. The participants are African American adolescents aged 11-14 from 14 churches in Philadelphia, PA (N = 613) who participated in a randomized controlled trial of parent-child faith-based and non-faith-based sexual risk-reduction interventions. Data were collected at baseline, immediate post-intervention, and 3-, 6-, 12-, and 18-month post-intervention. We examined whether the interventions' effects on the frequency of sexual intercourse in the past 3 months were mediated through theoretical constructs, including outcome expectancies, subjective norms, self-efficacy, and intention, using a product-of-coefficients approach. We also explored potential moderation effects of sexual experience, church membership, child gender, and parent gender. We found that self-efficacy mediated the effect of the faith-based intervention (α × β × γ product =  - 0.028, 95% ACI [- 0.064, - 0.002]). However, no significant mediators were identified for the non-faith-based intervention. Neither intervention had significant moderators, indicating no differences in efficacy among adolescents differing in sexual experience, church membership, gender, and parent's gender. These findings suggest that parent-child faith-based sexual risk-reduction interventions among African American adolescents in church-based settings could benefit from focusing on boosting self-efficacy.