HIV PREVENTION AMONG ALTERNATIVE SCHOOL YOUTH

四分之一的新艾滋病毒感染是在13岁至21岁的年轻人中诊断出来的。虽然一些研究已经在主流学校环境中解决了这个问题，但这些项目往往无法接触到感染艾滋病毒风险最大的学生。接触到高危学生群体的一种可能方法是通过在替代学校实施计划。在另类教育环境中的学生从事的行为使他们感染艾滋病毒的风险非常高。我们的数据显示，在德克萨斯州的另类高中就读的9年级学生比在普通学校就读的9年级学生有更多的性体验，但在性交过程中使用保护措施的可能性要小得多。虽然为主流学校的学生制定的有效方案相对较少，但尚未在就读替代学校的高危青年中进行调整和评估。为了满足这一需求，我们建议调整、实施和评估一种以理论为基础的、多组分的艾滋病毒干预措施，名为安全选择。安全选择是少数几个已被证明在减少青少年性行为风险方面有效的计划之一。干预的目的是通过减少开始性交的青年人数和在性行为活跃的学生中增加避孕套的使用，减少从事无保护措施性行为的高危青年的人数。社会认知理论和社会影响过程构成了该计划的主要框架。青年发展部分还利用了社会资源理论和社会纽带模型。本研究建议的干预措施包括：1)课程，2)家长教育，3)同伴资源，4)青少年发展，5)社区联系和资源。我们将对德克萨斯州休斯敦另类学校的九年级学生进行小组随机干预试验，以评估该计划。主要的因变量是无保护的性行为、性伴侣的数量和过去三个月发生性行为的比例。9年级学生(n=1000)将从德克萨斯州休斯敦的10所替代学校招募。

One-fourth of new HIV infections are diagnosed in young people between the ages of 13 and 21 years. While a number of research studies have addressed this problem in mainstream school settings, these programs often fail to reach students who run the greatest risk of HIV infections. One possible way of reaching a higher risk population of students is through implementing programs in alternative schools. Students in alternative educational settings engage in behaviors that put them at very high risk of contracting HIV. Our data indicate that 9th-grade students attending Texas alternative high schools are greater than two times more likely to be sexually experienced than 9th graders attending regular schools but much less likely to use protection during sexual intercourse. While relatively few effective programs have been developed for mainstream school students, none have been adapted and evaluated among high-risk youth attending alternative schools. To address this need, we propose to adapt, implement, and evaluate a theoretically-based, multi-component HIV intervention entitled Safer Choices. Safer Choices is one of the few programs that has been demonstrated to be effective in reducing sexual risk-taking behaviors among adolescents. The aims of the intervention are to reduce the number of high-risk youth who engage in unprotected sexual intercourse by reducing the number of youth who initiate sexual intercourse and by increasing condom use among those students who are sexually active. Social cognitive theory and social influence processes form the primary framework for the program. The youth development component additionally makes use of social resources theory and social bonding model. The intervention components proposed for this study include: 1) curriculum, 2) parent education 3) peer resources, 4) youth development, and 5) Community linkages and resources. We will evaluate the program using a group-randomized intervention trial among ninth-grade students attending alternative schools in Houston, Texas. The major dependent variables are unprotected sexual intercourse, number of sexual partners, and proportion having sexual intercourse in the past three months. 9th-grade students (n=1000) will be recruited from 10 alternative schools in Houston, Texas.