HIV/STD RISK REDUCTION FOR AFRICAN AMERICAN ADOLESCENTS

降低非洲裔美国青少年的艾滋病毒/性病风险

• 批准号: 6526394
• 负责人: KAYE F SLY
• 金额: $ 50.3万
• 依托单位: JACKSON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-01 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6526394
• 关键词: AIDS education /prevention; African American; HIV infections; adolescence (12-20); behavioral /social science research tag; biomarker; clinical research; community health services; culture; disease /disorder proneness /risk; education evaluation /planning; functional ability; health behavior; high risk behavior /lifestyle; human immunodeficiency virus; human subject; interpersonal relations; longitudinal human study; motivation; safe sex /sex abstinence; sex education; sexually transmitted diseases; social behavior; urban area; urinalysis

Sexually experienced adolescents less than 19 years of age are at greater risk for the acquisition of sexually transmitted diseases (STDs) and typically have higher STD rates than other age- specific groups. Nationally, this population accounted for about a quarter of all reportable STDs. In Mississippi (MS), this age group also accounted for greater than 40 percent of the common reportable STDs in 1998. Despite such alarming STD rates, African American adolescents are at even greater risk for contracting STDs, including the human immunodeficiency virus (HIV) infection, and unplanned pregnancies. Few studies have documented the relative benefits of safer-sex and theory-based abstinence risk reduction programs as the framework for achieving effective change in risky behaviors among vulnerable adolescents. However, these models have been marred by either (1) the lack of sustainability, generalizability and replicability of the intervention effects, and/or (2) the integration of contraceptive knowledge and sexual negotiation skills into theory-based abstinence programs, strategies not in conformity with the conceptual framework of "pure" abstinence. Additionally, the National Institutes of Health (NIH) Consensus Panel recently highlighted the lack of sufficient scientific knowledge concerning the relative effectiveness of broader-based safer sex intervention versus the narrowly focused abstinence intervention funded by the United States (US) Congress under the current Welfare Reform Act. While the debate lingers among behavioral scientists and policy makers, studies designed to provide critical information and scientific knowledge for reaching a consensus concerning the relative efficacy of safer sex and "pure" abstinence-based interventions are scanty. Nevertheless, the fundamental research questions remain unanswered: Which behavioral interventions are the most appropriate, realistic and effective? Which mechanisms do exist to sustain and augment intervention effects on adolescent HIV- risk behaviors? What is the role of biological markers in behavioral research? Hence, the primary focus of this proposed study. Therefore, over a five-year period, we propose (A) to recruit 450 African American at-risk youths ages 12-16 years from inner-city youth serving organizations (YSOs) and a comprehensive community- based health center in Jackson, MS; (B) to stratify, and randomize into 1 of 2 culturally-sensitive and age-appropriate theory-based STD/HIV risk reduction interventions and an experimental control condition-- (1) safer sex group: Becoming A Responsible Team (BART) Program; (2) Abstinence group: Advisor/Advisee Character Education Program; and (3) the experimental control group: African History (AKOMA)-- consisting of 8 modules of 1-hourly interactive instructional lessons per week, coordinated by trained community health facilitators; and (C) to finally evaluate the role and value of biological markers in behavioral research by longitudinally assessing the enrolled participants at baseline, and 6-, 12- and 18-months post- intervention for behavioral outcome measures, as well as, life skills that are critical in eliciting answers to our research questions.

19 岁以下有性经验的青少年感染性传播疾病 (STD) 的风险更大，并且通常比其他特定年龄群体的 STD 发病率更高。 在全国范围内，这一人群约占所有可报告性病的四分之一。 1998 年，在密西西比州 (MS)，这一年龄组也占常见可报告性病的 40% 以上。尽管性病发病率如此惊人，非裔美国青少年感染性病的风险更大，包括人类免疫缺陷病毒 (HIV)感染和意外怀孕。很少有研究记录了安全性行为和基于理论的禁欲风险降低计划的相对益处，作为有效改变弱势青少年危险行为的框架。 然而，这些模型因以下原因而受到损害：（1）干预效果缺乏可持续性、普遍性和可复制性，和/或（2）将避孕知识和性谈判技巧整合到基于理论的禁欲计划中，而策略并未纳入其中。符合“纯粹”禁欲的概念框架。此外，美国国立卫生研究院 (NIH) 共识小组最近强调，关于基础更广泛的安全性行为干预与美国国会根据当前福利法案资助的狭隘禁欲干预的相对有效性，缺乏足够的科学知识。改革法案。 虽然行为科学家和政策制定者之间的争论仍然存在，但旨在提供关键信息和科学知识以就安全性行为和“纯粹”禁欲干预措施的相对功效达成共识的研究却很少。然而，基本的研究问题仍然没有得到解答：哪些行为干预措施是最合适、现实和有效的？ 存在哪些机制可以维持和增强对青少年艾滋病毒危险行为的干预效果？ 生物标记在行为研究中的作用是什么？ 因此，这是本项研究的主要重点。因此，我们建议 (A) 在五年内从市中心青年服务组织 (YSO) 和密西西比州杰克逊市的一个综合性社区健康中心招募 450 名 12-16 岁的非裔美国高危青少年; (B) 分层并随机分为 2 种文化敏感且适合年龄的基于理论的 STD/HIV 风险降低干预措施和实验控制条件中的 1 种 - (1) 安全性行为组：成为负责任的团队 (BART) 计划; (2) 禁欲组：顾问/受顾问品格教育计划； (3) 实验对照组：非洲历史 (AKOMA)——由 8 个模块组成，每周 1 小时互动教学课程，由经过培训的社区健康促进者协调； (C) 通过在基线和干预后 6、12 和 18 个月纵向评估入组参与者的行为结果测量以及生活技能，最终评估生物标记在行为研究中的作用和价值这对于寻找我们研究问题的答案至关重要。