HIV Prevention Maintenance for African American Teens

非裔美国青少年的艾滋病毒预防维护

• 批准号: 6915656
• 负责人: RALPH J DICLEMENTE
• 金额: $ 65.98万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6915656
• 关键词: AIDS education /prevention; African American; HIV infections; adolescence (12-20); behavior modification; behavioral /social science research tag; clinical research; condoms; cost effectiveness; disease /disorder prevention /control; disease /disorder proneness /risk; female; human subject; interview; longitudinal human study; nutrition education; safe sex /sex abstinence; sex behavior; sexually transmitted diseases; women' s health

African-American female adolescent population at high risk for HIV infection. Recent findings that culturally and gender are a suggest propriate HIV interventions can significantly enhance condom use among this vulnerable population. However, demonstrating short-term havior change, decay of intervention effects is usually observable within one-year post-intervention. Thus, the development and aluation of innovative strategies designed to enhance the long-term maintenance of HIV-preventive sexual behaviors remains a public alth priority. The proposed study is an exciting opportunity to harness the experience and multidisciplinary expertise of our research Learn to design a randomized controlled, supplementary treatment trial, to evaluate the efficacy and cost-effectiveness of an innovative Mephone-delivered HIV prevention maintenance intervention in sustaining condom protected sexual intercourse over an 18-month follow-up period. A sample of 700 African-American female adolescents, 14-18 years of age, will be recruited at Planned Parenthood, Atlanta. Subsequent to assessing their eligibility and completing consent, adolescents will be re-contacted and invited to return to Planned Parenthood to complete a baseline assessment. At baseline, adolescents will complete ACASI interview, derived from Social Cognitive theory and the Theory of Gender and Power, that assesses sociodemographic characteristics, HIV risk behaviors and key mediators associated with HIV preventive behaviors. Subsequently, adolescents will be randomized to either the experimental condition or the comparison condition. Adolescents in the experimental condition receive the "primary" treatment, the multi-session, group-delivered SiHLE HIV intervention, that has demonstrated efficacy in enhancing condom protected sexual intercourse and key mediators of HIV prevention over an 18-month follow-up period, and the supplemental intervention, an individualized telephone-delivered HIV Prevention Maintenance Intervention (SiHLE + HIVPMI). Adolescents randomized to this condition receive nine bimonthly individualized telephonc contacts designed to reinforce topics covered in the SiHLE HIV intervention, but are individualized to address each adolescent's personal attitudinal, relational, skills and environmental barriers to maintaining safer sex practices. Adolescents in the comparison condition receive the primary treatment, the SiHLE HIV intervention without the HIV prevention maintenance intervention. However, adolescents in this condition receive a structurally equivalent individualized telephone-delivered nutrition education intervention (SiHLE + NED that is designed to constitute a time- and dose-equivalent attention control comparison condition. Adolescents randomized to the comparisor condition receive nine bimonthly individualized telephone contacts on nutrition education. Adolescents in both conditions complete similm ACASI assessments at baseline, 6-, 12-, and 18-month follow-up. An intent-to-treat analysis, using generalized estimating equations, will assess the efficacy and cost-effectiveness of SiHLE + HIV PMI relative to SiHLE + NEIin maintaining adolescents' condom protected sexual intercourse over an 18-month follow-up period. Consequently, improving the sustainability of HIV prevention programs could have a substantial impact on the intersecting HIV and STD epidemics among African-American female adolescents.

非洲裔美国女性青少年群体感染艾滋病毒的风险很高。最近的研究结果表明，文化和性别因素表明，适当的艾​​滋病毒干预措施可以显着提高这一弱势群体中安全套的使用率。然而，由于短期行为变化，干预效果的衰减通常在干预后一年内即可观察到。因此，制定和评估旨在加强长期维持艾滋病毒预防性行为的创新策略仍然是公共优先事项。拟议的研究是一个令人兴奋的机会，可以利用我们研究的经验和多学科专业知识学习设计随机对照补充治疗试验，以评估创新的 Mephone 提供的 HIV 预防维持干预措施在维持安全套保护方面的功效和成本效益18 个月随访期间的性交。亚特兰大计划生育协会将招募 700 名 14 至 18 岁非裔美国女性青少年作为样本。在评估他们的资格并完成同意后，将重新联系青少年并邀请他们返回计划 为人父母完成基线评估。在基线时，青少年将完成 ACASI 访谈，该访谈源自社会认知理论和性别与权力理论，评估社会人口特征、艾滋病毒风险行为和关键中介因素 与艾滋病毒预防行为有关。随后，青少年将被随机分配到实验条件或比较条件。实验条件下的青少年接受“初级”治疗，即多疗程、分组治疗 SiHLE HIV 干预措施（在 18 个月的随访期内）显示出在增强安全套保护性交和 HIV 预防的关键介质方面的功效，以及补充干预措施，即个性化电话提供的 HIV 预防维持干预措施 (SiHLE + HIVPMI)。随机分配到这种情况的青少年每两个月接受九次个性化电话联系，旨在强化 SiHLE HIV 干预措施中涵盖的主题，但又针对每个青少年的个人情况进行个性化处理。 维持安全性行为的态度、关系、技能和环境障碍。比较条件下的青少年接受主要治疗，即 SiHLE HIV 干预，但没有 HIV 预防维持干预。然而，处于这种情况的青少年接受结构上等效的个性化电话提供的营养教育干预（SiHLE + NED，旨在构成时间和剂量等效的注意力控制比较条件。随机分配到比较条件的青少年接受九次每两个月一次的个性化电话联系两种情况下的青少年都在基线、6、12 和 18 个月的随访中完成了类似的 ACASI 评估。使用广义估计方程的意向治疗分析将评估 SiHLE + HIV PMI 相对于 SiHLE + NEI 在 18 个月的随访期内维持青少年安全套保护性交的功效和成本效益。艾滋病毒预防计划的可持续性可能会对非裔美国女性青少年中艾滋病毒和性传播疾病的交叉流行产生重大影响。