Maintaining HIV Prevention Gains in Female Adolescents

说明（由申请人提供）：青少年是感染艾滋病毒的女性人数超过男性人数的唯一年龄类别。尽管有这些数据，但只有四项随机对照试验评估了针对不同性别的青少年女性降低艾滋病毒风险项目的效果。这项拟议的研究旨在解决艾滋病预防科学方面的这一空白，并将评估一种针对青春期女孩的艾滋病预防干预措施的短期和长期效果。我们将从计划生育诊所招募640名年龄在15至19岁之间的青春期女性，并将她们随机分配到两种情况中的一种：(a)基于信息-动机-行为技能（IMB）模型的艾滋病毒风险降低干预（Fisher & Fisher, 1992）；或(b)在结构上相同的健康促进对照组（CTL），均在3个月和6个月时辅以强化课程。在短期（三个月）的随访中，我们假设IMB参与者会增加与HIV相关的知识、动机和行为技能，并且相对于CTL参与者减少危险性行为的频率。我们将在6个月和12个月时对所有参与者进行重新评估，以评估干预措施的长期疗效。在这些长期随访中，我们假设IMB参与者将表现出更高水平的艾滋病毒知识、动机和行为技能；危险性行为减少；与CTL参与者相比，性传播疾病（衣原体、淋病）的发病率也有所下降。本研究的最终目的是确定信息-动机-行为技能（IMB）模型（Fisher & Fisher, 1992）中的结构是否可以解释艾滋病相关行为的可变性。我们假设6个月和12个月的预防行为将是参与者在3个月随访时艾滋病毒相关信息、动机和行为技能的函数，并且行为技能将部分介导信息和动机，从而影响艾滋病毒预防行为的开始和维持。拟议研究的长期目的是制定一项可被社区卫生组织用于降低青春期女性感染艾滋病毒风险的降低风险方案。

DESCRIPTION (provided by applicant): Adolescence is the only age category where the number of females becoming infected with HIV outnumber the number of males. Despite these data, only four randomized controlled trials have evaluated the efficacy of a gender-specific HIV-risk reduction program for adolescent females. The proposed research aims to address this gap in HIV prevention science, and will evaluate the short and longer-term efficacy of an HIV prevention intervention for adolescent girls. We will recruit 640 adolescent females aged 15 to 19 years from family planning clinics and randomly assign them to one of two conditions: (a) an HIV-risk reduction intervention based on the Information-Motivation-Behavioral Skills (IMB) model (Fisher & Fisher, 1992); or, (b) a structurally equivalent health promotion control group (CTL), both supplemented by booster sessions at three and six months. At a short-term (three-month) follow up, we hypothesize that IMB participants will increase HIV related knowledge, motivation, and behavioral skills, and decrease the frequency of risky sexual practices relative to CTL participants. We will reassess all participants at six and 12 months to evaluate the longer-term efficacy of the interventions. At these longer-term follow-ups, we hypothesize that IMB participants will demonstrate higher levels of HIV knowledge, motivation, and behavioral skills; decreased risky sexual practices; and decreased rates of STDs (chlamydia, gonorrhea) relative to the CTL participants. The final aim of the proposed research is to determine whether the constructs in the Information-Motivation-Behavioral Skills (IMB) Model (Fisher & Fisher, 1992), can account for variability in HIV-related behavior. We hypothesize that preventive behavior at six and 12 months will be a function of a participant's HIV-related information, motivation, and behavioral skills at the three-month follow up, and that information and motivation will be partially mediated by behavioral skills to influence the initiation and maintenance of HIV preventive behavior. The long-term intent of the proposed research is to develop a risk reduction program that can be used by community-based health organizations to reduce the risk of HIV infection among adolescent females.