HIV PREVENTION AMONG ALTERNATIVE SCHOOL YOUTH

四分之一的新艾滋病毒感染者是年龄在13至21岁之间的年轻人。虽然许多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触及那些感染艾滋病毒风险最高的学生。接触高风险学生群体的一种可能方法是在替代学校实施项目。另类教育环境中的学生所从事的行为使他们感染艾滋病毒的风险非常高。我们的数据表明，在德州另类高中就读的九年级学生有性经验的可能性是在普通学校就读的九年级学生的两倍以上，但在性交时采取保护措施的可能性要小得多。虽然针对主流学校学生的有效项目相对较少，但在就读另类学校的高危青少年中，没有一个项目进行过调整和评估。为了满足这一需求，我们建议调整、实施和评估一种基于理论的、多成分的艾滋病干预措施，名为“更安全的选择”。“更安全的选择”是少数几个被证明能有效减少青少年性冒险行为的项目之一。干预措施的目的是通过减少主动性交的青少年人数和在性活跃的学生中增加避孕套的使用，减少从事无保护性交的高危青少年人数。社会认知理论和社会影响过程构成了该计划的主要框架。青年发展部分还运用了社会资源理论和社会联系模型。本研究建议的干预成分包括：1)课程；2)家长教育；3)同伴资源；4)青少年发展；5)社区联系与资源。我们将在德克萨斯州休斯敦市非公立学校的九年级学生中进行分组随机干预试验，对该项目进行评估。主要的因变量是无保护的性行为、性伴侣的数量和在过去三个月内发生过性行为的比例。9年级学生（n=1000）将从德克萨斯州休斯顿的10所另类学校招募。

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.