Reducing HIV Risk in AOD Abusing Multi-Cultural Youth

描述(由申请人提供)：建议的研究涉及 艾滋病毒预防科学与社区实践之间的持续脱节 由医学研究所(1998、2000)和美国国立卫生研究院紧急鉴定 (2000、2001)。值得注意的优先事项是需要将有效的艾滋病毒 以青少年为对象的社区预防干预措施 直接服务于最高风险群体。这项研究的主要目的是 评估认知行为(CB)HIV青少年的有效性 适应设计的预防干预(CB-A)，用于在 以社区为基础的组织(CBO)由CBO工作人员提供。将对CB-A进行比较 时间和注意力匹配的标准护理条件(SC)的随机化 临床试验，在该试验中，两者都由久负盛名的CBO和 工作人员。类似于我们最初开发的CB，它在 一项基于研究的疗效临床试验，CB-A纳入了同样的内容 行为技能培训、激励增强和 以前证明的预防复发的干预措施的组成部分 有效，并在疾病预防控制中心(1999)艾滋病毒预防纲要中确定 有有效证据的干预措施。在设计随机化的 临床试验和CB-A干预以实现最佳翻译和 技术转移，我们的学术大学医学中心研究团队已经 与社区组织网络建立了密切的伙伴关系和合作关系， 作为艾滋病毒预防和治疗提供者，为 周围社会经济上处于不利地位的种族/少数民族 佛罗里达州迈阿密-戴德县的社区。这个县拥有世界上最大的 艾滋病毒/艾滋病负担，是全国人口最稠密的多元文化和城市地区 州政府。使用为青年服务的社区组织作为招聘网站，建议的样本 在160名男性和160名女性青少年中，将以少数民族为主， 收入、文化多样性、性活跃的年轻人，最近有 酒精和其他药物(AOD)滥用。这项拟议研究的次要目标 是评估关键变量是否调节和缓和了 干预措施与HIV危险行为结局。这项研究具有重要意义 因为它解决了开发一种有效的、高度针对性的 CBO从业者可使用的干预措施，以减少艾滋病毒传播 在这一极其脆弱和危险的人口亚群中， 受艾滋病毒和艾滋病影响不成比例的地区 普遍存在的种族/民族健康差距的全国性问题。

DESCRIPTION (provided by applicant): The proposed study addresses the persistent disconnect between HIV prevention science and community practice as urgently identified by the Institute of Medicine (1998,2000) and the NIH (2000,2001). Of noted priority is the need to transfer effective HIV prevention interventions targeting adolescents to community-based settings that directly serve the highest risk groups. This study's primary aim is to assess the effectiveness of a Cognitive Behavioral (CB) HIV adolescent prevention intervention in an adapted design (CB-A) for implementation in Community-Based Organizations (CBOs) by CBO staff. The CB-A will be compared to a time and attention matched Standard Care condition (SC) in a randomized clinical trial, in which delivery of both is by well-established CBOs and staff. Similar to our originally developed CB that has shown great promise in a research-based efficacy clinical trial, CB-A incorporates the same innovative mix of behavioral skills training, motivational enhancement, and relapse prevention components of interventions previously demonstrated to be effective and identified in the CDC's (1999) Compendium of HIV Prevention Interventions with Evidence of Effectiveness. In designing the randomized clinical trial and the CB-A intervention for optimal translation and technology transfer, our academic university medical center research team has formed a close partnership and collaboration with a network of CBOs, well-integrated as HIV prevention and treatment providers serving the surrounding, socioeconomically disadvantaged racial/ethnic minority communities of Miami-Dade County, Florida. This county carries the greatest HIV/AIDS burden and is the most densely multicultural and urban area within the state. Using youth-serving CBOs as recruitment sites, the proposed sample of 160 male and 160 female adolescents will be predominantly minority, low income, culturally diverse, sexually active youths with recent histories of Alcohol and Other Drug (AOD) abuse. The scondary aims of this proposed study are to evaluate if key variables mediate and moderate relationships between the intervention and HIV risk behavior outcomes. This study is significant because it addresses the urgent need to develop an effective, highly targeted intervention that is usable by CBO practitioners to reduce HIV transmission behaviors in this extremely vulnerable and risky population subgroup, in an area of the country that is disproportionately affected by HIV and the pervasive national problem of racial/ethnic health disparities.