DEVELOPMENT AND TESTING OF A JAMAICAN MOTHER-DAUGHTER HIV RISK-REDUCTION PROGRAM

描述（由申请人提供）：包括牙买加在内的加勒比国家的艾滋病毒感染率仅次于撒哈拉以南非洲。由于许多文化因素、性别规范、与年长男性伴侣合作以及缺乏与拒绝性行为和预防艾滋病毒有关的知识和技能，牙买加的年轻妇女和少女面临的风险特别高。美国的研究表明，母亲可能会对女儿的性风险观念和行为产生关键影响。然而，在美国之外，没有研究记录这些影响，也没有研究评估牙买加少女及其母亲的艾滋病毒风险降低干预措施。因此，拟议项目的目的是与西印度群岛大学、牙买加社区组织（cbo）和家庭合作，在随机试点现场实验中开发和测试一种针对特定文化的母女减少艾滋病毒风险干预措施。具体而言，我们建议测试针对牙买加少女及其母亲的文化特异性、基于理论的技能培养干预是否可以直接和/或间接减少这些女孩与艾滋病毒风险相关的性行为。将从社区卫生组织招募14-18岁的牙买加女孩及其母亲/女性监护人，并随机分配到：(a)母女艾滋病毒风险降低干预组或(b)“无干预”对照组。减少艾滋病毒风险的干预措施包括8个模块，安排在2天内完成，由从中央预算办公室工作人员中征聘的受过训练的牙买加成年妇女执行。母亲部分旨在增加与减少青少年性冒险相关的养育行为（例如，父母监督、亲子性交流[PCSC]）；青少年部分旨在提高女孩在节欲、性谈判和使用避孕套方面的信念和技能。正在采用“不干预”控制条件，因为拟议的项目是减少艾滋病毒风险干预的试点研究。主要结果包括母亲/女儿对养育行为的报告和女儿对性危险行为（性交、无保护的性行为、使用安全套、伴侣数量）的自我报告。次要结果包括母亲对养育行为的信念和女儿对性危险行为的信念-干预效果的理论中介。这项研究的结果将有助于为牙买加少女和年轻妇女制定有效的艾滋病毒风险降低方案。

DESCRIPTION (provided by applicant): Caribbean nations, including Jamaica, exhibit HIV rates that are second only to sub-Saharan Africa. Jamaican young women and adolescent girls are at particularly high risk due to a number of cultural factors, gender norms, partnering with older male partners, and lack of knowledge and skills related to sexual refusal and HIV prevention. U.S. studies have shown that mothers may act as a key influence of their daughters' sexual risk beliefs and behaviors. However, no studies have documented these effects outside of the U.S. and no studies have evaluated HIV risk-reduction interventions with Jamaican adolescent girls and their mothers. Hence, the purpose of the proposed project is to partner with the University of the West Indies, Jamaican community based organizations (CBOs) and families in order to develop and test a culture-specific mother-daughter HIV risk-reduction intervention in a randomized pilot field experiment. Specifically, we propose to test whether a culture-specific, theory-based, skill-building intervention with Jamaican adolescent girls and their mothers can directly and/or indirectly reduce these girls' HIV risk-associated sexual behaviors. Jamaican girls, ages 14-18, and their mothers/female guardians will be recruited from CBOs and randomly assigned to either: (a) a mother-daughter HIV risk-reduction intervention condition or (b) a "no intervention" control condition. The HIV risk-reduction intervention includes 8 modules scheduled over 2 days and implemented by trained adult Jamaican women recruited from among CBO staff. The mother component is designed to increase parenting behaviors (e.g., parental monitoring, parent-child sexual communication [PCSC]) associated with reduced adolescent sexual risk-taking; the teen component is designed to improve girls' beliefs and skills related to abstinence, sexual negotiation and condom use. A "no intervention" control condition is being employed as the proposed project is a pilot study of the HIV risk-reduction intervention. Primary outcomes include mothers'/daughters' reports of parenting behaviors and daughters' self-reports of sexual risk behaviors (sexual intercourse, unprotected sex, condom use, number of partners). Secondary outcomes include mothers' beliefs regarding parenting behaviors and daughters beliefs regarding sexual risk behaviors-the theoretical mediators of intervention effects. Findings from this study will contribute to the development of effective HIV risk-reduction programs for Jamaican adolescent girls and young women.