Maintaining HIV Prevention Gains in Female Adolescents

描述（由申请人提供）：青少年是唯一一个感染艾滋病毒的女性人数超过男性人数的年龄类别。 尽管有这些数据，但只有四项随机对照试验评估了针对青少年女性的性别特异性艾滋病毒风险降低计划的有效性。 拟议的研究旨在解决艾滋病毒预防科学的这一差距，并将评估艾滋病毒预防干预措施对少女的短期和长期有效性。 我们将从计划生育诊所招募640名15至19岁的青少年女性，并将她们随机分配到以下两个条件之一：（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）结构上等同的健康促进对照组（CTL），两者均在3个月和6个月时通过加强阶段补充。 在短期（3个月）随访中，我们假设IMB参与者将增加HIV相关知识、动机和行为技能，并降低相对于CTL参与者的危险性行为频率。 我们将在6个月和12个月时重新评估所有参与者，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;减少危险的性行为;相对于CTL参与者，性病（衣原体，淋病）的发病率降低。 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HIV相关行为的变异性。 我们假设，在6个月和12个月的预防行为将是一个功能的参与者的艾滋病毒相关的信息，动机和行为技能在3个月的随访，信息和动机将部分介导的行为技能，影响启动和维持艾滋病毒预防行为。 拟议研究的长期目的是制定一项风险降低计划，可供社区卫生组织使用，以降低青少年女性感染艾滋病毒的风险。

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.