Maintaining HIV Prevention Gains in Female Adolescents

说明(申请人提供)：青春期是感染艾滋病毒的女性人数超过男性人数的唯一年龄段。尽管有这些数据，但只有四个随机对照试验评估了针对青春期女性的针对性别的艾滋病毒风险降低计划的有效性。这项拟议的研究旨在解决艾滋病毒预防科学方面的这一空白，并将评估对青春期女孩进行艾滋病毒预防干预的短期和长期效果。我们将从计划生育诊所招募640名15至19岁的青春期女性，并随机将她们分配到两种情况之一：(A)基于信息-动机-行为技能(IMB)模式的艾滋病毒风险降低干预(Fisher&Fisher，1992)；或(B)结构相同的健康促进控制组(CTL)，两者都在3个月和6个月时辅以强化会议。在短期(三个月)的随访中，我们假设与CTL参与者相比，IMB参与者将增加与HIV相关的知识、动机和行为技能，并减少危险的性行为频率。我们将在6个月和12个月后重新评估所有参与者，以评估干预措施的长期效果。在这些较长期的随访中，我们假设与CTL参与者相比，IMB参与者将表现出更高的艾滋病毒知识、动机和行为技能水平；更少的危险性行为；以及更低的性病(衣原体、淋病)发病率。这项研究的最终目的是确定信息-动机-行为技能(IMB)模型(Fisher&Fisher，1992)中的结构是否能够解释HIV相关行为的变异性。我们假设，6个月和12个月的预防行为将是参与者在3个月的随访中与艾滋病毒相关的信息、动机和行为技能的函数，信息和动机将部分通过行为技能来调节，以影响艾滋病毒预防行为的启动和维持。这项拟议研究的长期目的是开发一种可供社区卫生组织使用的风险降低计划，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.