PREVENTING HIV/AIDS IN TEEN MOTHERS AND THEIR PARTNERS

青少年母亲有通过异性性行为感染艾滋病毒/艾滋病的风险。他们的亲密伴侣往往是从事多种艾滋病毒风险行为的青少年父亲，包括性行为、非法药物使用和共用针头穿孔和纹身。许多人都有帮派纠葛和入狱史。处于一夫一妻制的关系中以及害怕消极的伴侣态度已被确定为青少年母亲使用避孕套的重要障碍。然而，初步研究表明：1)年轻父亲不认为他们主要关系之外的性行为与他们的一夫一妻制地位相冲突；2)据报道，有子女的青少年夫妇在12个月内的分手率为50%。尽管青少年对关系的稳定性存在误解，但目前的恋爱关系可能为他们提供了关键技能，使他们能够与现在和未来的伴侣保持更安全的性行为。将男性伴侣排除在经过科学评估的艾滋病预防项目之外，这是一个严重的研究缺口。本实验研究将评估青少年父母参加的一个项目对他们安全性行为的影响。286对夫妇的样本将由高危人群组成，主要是拉丁裔青年。从洛杉矶县的其他学校招募，夫妇将被随机分配到实验或控制条件。实验条件包括一个12小时的艾滋病预防项目，分6个阶段进行。该课程基于CDC模式“骄傲！”“负责！”针对目标人群进行了调整和扩展，利用母亲的保护感和父亲的责任感来促进更安全的性行为。活动包括分组讨论、互动游戏、技能培养练习（冲突和性谈判、避孕套的使用）以及一位艾滋病毒阳性母亲的介绍。与性别和权力有关的文化问题贯穿始终。对照条件是1小时的艾滋病教育课程（录像后进行简短的讨论）。这些项目将在社区环境中提供（如娱乐设施和图书馆）。参与者将通过在基线、干预后立即、3个月、6个月和12个月的随访进行个人访谈，评估主要结果（性风险行为）和中间结果（与艾滋病毒预防相关的社会认知因素）。据推测，在恋爱关系的背景下，通过解决性别和权力问题，同时提供社会认知技能建设学习经验，青少年父母的性冒险行为将会减少。

Adolescent mothers are at risk for acquiring HIV/AIDS through heterosexual sex. Their intimate partners are often teen fathers who engage in multiple HIV risk behaviors, including sexual behaviors, illicit drug use, and needle-sharing for body- piercing and tattoos. Many have a history of gang involvement and incarceration. Being in a monogamous relationship and fear of negative partner attitudes have been identified as important barriers to condom use for adolescent mothers. Yet, preliminary studies indicate that 1) young fathers do not perceive sexual activity outside their main relationship to conflict with their monogamous status; and 2) a 50 percent break-up rate within 12 months is reported for parenting adolescent couples. Despite teens' misperceptions about relationship stability, current romantic connections may provide the key to building skills needed to maintain safer sex with current and future partners. The exclusion of male partners from scientifically evaluated HIV prevention programs represents a serious research gap. This experimental study will evaluate the impact of a program attended by parenting adolescent couples on their safer sex practices. The sample of 286 couples will be composed of high-risk, predominantly Latino youth. Recruited from alternative schools in Los Angeles County, couples will be randomly assigned to the experimental or control condition. The experimental condition consists of a 12-hour HIV prevention program presented in 6 sessions. The curriculum, based on the CDC model "Be Proud! Be Responsible!" is adapted and expanded for the targeted population by using feelings of maternal protectiveness and paternal responsibility to promote safer sexual behaviors. Activities include small group discussions in combined and gender-separated groups, interactive games, skill-building exercises (conflict and sexual negotiation, condom use), and a presentation by an HIV- positive mother. Cultural issues related to gender and power are addressed throughout. The control condition is a 1-hour AIDS education session (videotape followed by a short discussion period). The programs will be offered in community-based settings (e.g., recreational facilities and libraries). Participants will be evaluated on primary outcomes (sexual risk behaviors) and intermediate outcomes (social cognitive factors related to HIV prevention) through individual interviews at baseline, immediately post-intervention, and at 3-, 6-, and 12- month follow-up. It is hypothesized that by addressing issues of gender and power while providing social-cognitive skill-building learning experiences within the context of a romantic relationship, sexual risk-taking will be reduced in adolescent mothers and fathers.