A Family-Based HIV Prevention Program for Black Men to Protect Black Girls

针对黑人男性的基于家庭的艾滋病毒预防计划，以保护黑人女孩

• 批准号: 10716525
• 负责人: Natasha Kaella Crooks
• 金额: $ 73.05万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-25 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10716525
• 关键词: 18 year old; 19 year old; 2 arm randomized control trial; AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adolescence; Adoption; Attention; Attitude; Awareness; Belief; Black AIDS; Black race; Caregivers; Chicago; Communication; Consent; Control Groups; Data; Development; Discrimination; Disparity; Educational Curriculum; Effectiveness; Evidence based intervention; Evidence based program; Exploration, Preparation, Implementation, and Sustainment; Exposure to; Family; Family Relationship; Female; Focus Groups; Gender; HIV; HIV diagnosis; HIV/AIDS; Health Disparities Research; Health Promotion; Human Resources; Incidence; Individual; Infection; Infertility; Intervention; Interview; Knowledge; Link; Mediation; Monitor; Outcome; Pelvic Inflammatory Disease; Phase; Prevention program; Process; Public Health; Race; Randomized; Randomized, Controlled Trials; Reporting; Reproductive Health; Research; Resources; Risk; Role; STI prevention; Sex Behavior; Sexual Health; Sexual Partners; Sexually Transmitted Diseases; Socialization; Stereotyping; Surveys; Testing; Time; United States; Violence; Woman; Youth; acceptability and feasibility; arm; black men; black women; community organizations; comparison control; condoms; consistent condom use; design; effectiveness testing; efficacy trial; emotion regulation; empowerment; follow-up; future implementation; girls; health outcome disparity; implementation determinants; implementation efforts; implementation process; improved; infection rate; infection risk; innovation; intervention delivery; intervention effect; male; men; neglect; pilot test; prevent; primary outcome; programs; protective effect; racial disparity; racial population; resilience; risk mitigation; secondary outcome; sex; sexual debut; sexual risk behavior; sexual violence; social culture; success; theories

Abstract Sexually transmitted infections (STI) continue to be a major public health problem for Black girls in the United States. Each year 1 in 4 Black girls, 14-19 years-old acquires an STI, placing them at risk for poor sexual and reproductive health outcomes (SRH) (i.e., pelvic inflammatory disease, infertility, HIV/AIDS). In Chicago, STI rates are highest among 13- to 29-year-old Black girls and they represent 56% of new HIV diagnoses, compared to other racial groups, making adolescence an exceptionally vulnerable period. These racial disparities require new and innovative strategies to reduce Black girls' negative SRH outcomes. Familial protection is seen as critical to mitigating risk, particularly exposure to sexual violence which is linked to girls' HIV/STI risk. Interventions that strengthen family relationships and communication as strategies to protect Black girls have demonstrated success improving Black girls SRH outcomes. Yet, with few exceptions, these programs engage only female caregivers, whereas male caregivers may amplify the protective effects of families on Black girls' SRH. We systematically adapted IMARA (an evidence-based program designed for Black girls and their female caregivers) to create IMARA for Black Male caregivers and Girls Empowerment (IMAGE), adding drivers of structural violence (i.e., stereotype messaging and lack of protection) aligning with the Becoming a Sexual Black Woman framework and the Health Disparities Research Framework. Preliminary data (interviews, focus groups, theatre, and pilot testing) with Black girls, male and female caregivers justify the proposed randomized control trial (RCT). We will simultaneously conduct an effectiveness RCT with individual- level randomization and examine implementation processes at five community-based organizations. Aim 1 is to conduct a 2-arm RCT (IMAGE vs. a health promotion control) with 372 14-18-year-old Black girls and their male caregivers and compare girls' sexual risk behavior (condom use, sexual debut, and sexual partners) and STI incidence at baseline, 6- and 12-months. We hypothesize Girls in IMAGE will report more condom use, later sexual debut, fewer sexual partners, and have lower STI incidence at 6- and 12- months (primary outcome) compared to the control group. Aim 2 is to examine change in the theoretical mechanisms posited by the Becoming a Sexual Black Woman. Aim 3 is to identify processes, barriers, and facilitators associated with primary outcomes to inform future implementation into community-based organizations. The long-term significance and impact of this application is high. By including Black male caregivers in the protection of girls, this study leverages a long-neglected yet important resource in Black girls SRH, thereby amplifying the protective effects of family-based programs and pushing the science of health disparities forward.

抽象的 性传播感染（STI）仍然是美国黑人女孩的主要公共卫生问题 国家。每年，14-19 岁的黑人女孩中就有四分之一感染性传播感染，这使她们面临性行为不良和性传播疾病的风险。 生殖健康结果（SRH）（即盆腔炎、不孕症、艾滋病毒/艾滋病）。在芝加哥，STI 13 至 29 岁的黑人女孩的感染率最高，她们占新艾滋病毒诊断的 56%， 与其他种族群体相比，青春期是一个异常脆弱的时期。这些种族 差异需要新的创新战略来减少黑人女孩的性健康和生殖健康负面结果。家族式 保护被认为对于减轻风险至关重要，特别是避免遭受性暴力，这与女童的健康状况有关。 艾滋病毒/性传播感染风险。加强家庭关系和沟通的干预措施作为保护战略 黑人女孩在改善黑人女孩性健康和生殖健康结果方面取得了成功。然而，除了少数例外，这些 计划只涉及女性护理人员，而男性护理人员可能会放大保护作用 接受黑人女孩性健康和生殖健康的家庭。我们系统地采用了 IMARA（一项基于证据的计划，旨在 黑人女孩及其女性照顾者）为黑人男性照顾者和女孩赋权创建 IMARA （图片），添加结构性暴力的驱动因素（即刻板印象信息和缺乏保护），与 成为性黑人女性框架和健康差异研究框架。初步的 与黑人女孩、男性和女性护理人员的数据（访谈、焦点小组、剧场和试点测试）证明了 提议的随机对照试验（RCT）。我们将同时与个人进行有效性随机对照试验 进行随机化并检查五个社区组织的实施过程。目标 1 是 对 372 名 14-18 岁黑人女孩及其她们进行了 2 组 RCT（IMAGE 与健康促进对照） 男性照顾者并比较女孩的性危险行为（安全套使用、首次性行为和性伴侣）和 基线、6 个月和 12 个月时的 STI 发病率。我们假设 IMAGE 中的女孩会报告更多使用安全套， 首次性行为较晚，性伴侣较少，并且 6 个月和 12 个月时性传播感染的发病率较低（主要 结果）与对照组相比。目标 2 是检验所提出的理论机制的变化 成为一个性感的黑人女性。目标 3 是确定与相关的流程、障碍和促进因素 主要成果为未来在社区组织中的实施提供信息。长期来看 该应用的意义和影响很高。通过让黑人男性看护者参与保护女孩的工作， 这项研究利用了黑人女孩 SRH 中长期被忽视但重要的资源，从而扩大了 以家庭为基础的计划的保护作用并推动健康差异科学的发展。