Partner-Specific HIV Risk Reduction for Drug Using Incarcerated Adolescents

描述(由申请人提供)：被监禁的青少年代表与危险的性行为相关的健康后果的高风险群体。他们报告说，与未被拘留的青少年同龄人相比，他们更多地参与了一些性危险行为(包括与吸毒有关的性风险)，性传播疾病(STDS)和怀孕的比率更高。青少年，包括被监禁的青少年，报告与与之有关系的伴侣(主要伴侣)和可能与之有朋友或只有一位熟人的伴侣(非主要伴侣)发生性行为。避孕套的使用在非主要性伴中比在主要性伴中更为普遍，与性风险相关的物质使用似乎也因伴侣类型而异。这项研究计划的长期目标是通过开发和建立干预的有效性来减少参与刑事司法系统的青少年中滥用非注射药物的艾滋病毒风险行为，该干预包括通过提供相关信息来特别关注特定于伴侣的决策和行为，增强预防动机，提供学习和实践更安全的性行为技能的机会，以及结合药物使用做出性决策。此外，我们寻求增进对干预措施减少艾滋病毒危险行为的行动机制的了解。在本申请中，我们建议为报告滥用药物的被监禁青少年开发和试点测试针对伴侣的特定艾滋病毒风险降低干预措施。在研究的第一阶段，我们将对20名被监禁的青少年进行干预试验，并收集他们对干预的经验和看法的反馈。在改进干预措施后，我们将进行一项小型随机试验(n=60)，以检验干预相对于健康生活方式心理教育干预(HLS)的有效性。我们预计，相对于CBT-SA)，随机进入干预条件的参与者与性相关的艾滋病毒风险行为和与性风险相关的物质使用水平将较低。我们还将研究干预措施减少健康危险行为的潜在机制。如果被证明是有效的，这种干预措施将有助于减少被监禁青少年感染艾滋病毒的机会。

DESCRIPTION (provided by applicant): Incarcerated adolescents represent a group at high risk for health consequences associated with risky sexual behaviors. They report greater participation in a number of sexual risk behaviors (including sexual risk in conjunction with drug use), higher rates of sexually transmitted diseases (STDs) and pregnancy than their non-detained adolescent peers. Adolescents, including incarcerated teens, report sexual behavior both with partners with whom there is a relationship (main partners) and partners with whom there may be a friendship or only an acquaintance (non-main partners). Condom use is more common with non-main than main sex partners and substance use in conjunction with sexual risk also appears to vary by partner type. The long-term objective of this research program is to reduce HIV risk behavior among adolescents involved in the criminal justice system who abuse non-injection drugs by developing and establishing the efficacy of an intervention that includes a specific focus on partner-specific decision-making and behavior through presenting relevant information, enhancement of prevention motivation, opportunities to learn and -practice safer sex behavioral skills, and sexual decision-making in conjunction with substance use. Furthermore, we seek to advance knowledge of the mechanisms of action by which interventions reduce HIV risk behavior. In the present application, we propose to develop and pilot test a partner-specific HIV risk reduction intervention for incarcerated adolescents who report substance abuse. In the first phase of the study we will pilot the intervention with 20 incarcerated adolescents and elicit their feedback regarding their experiences and perceptions of the intervention. Following refinement of the intervention, we will conduct a small randomized trial (n=60) to examine the efficacy of the intervention relative to a healthy lifestyles psychoeducation intervention (HLS). We expect that, relative to CBT-SA), participants randomized to the intervention condition will have lower levels of sex-related HIV risk behavior and of substance use in conjunction with sexual risk. We will also examine the potential mechanisms by which the intervention produces a reduction in health risk behaviors. If found to be efficacious, this intervention will help to reduce the acquisition of HIV among substance using incarcerated adolescents.