Preventing HIV/AIDS Among Teens in Juvenile Justice

在少年司法中预防青少年艾滋病毒/艾滋病

• 批准号: 8036923
• 负责人: GERI R DONENBERG
• 金额: $ 38.73万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8036923
• 关键词: 17 year old; AIDS/HIV problem; Address; Adolescent; African American; Aftercare; Alcohol consumption; Alcohol or Other Drugs use; American; Antibiotic Therapy; Attention; Attitude; Awareness; Back; Belief; Biological; Characteristics; Charge; Chicago; Chlamydia; Collaborations; Communities; Consent; Control Groups; County; Decision Making; Development; Disease; Dose; Educational Curriculum; Employment; Enrollment; Feedback; Female; Focus Groups; Freedom; General Population; Gonorrhea; Grant; HIV; Happiness; Health; Health Promotion; Health Services Accessibility; Impairment; Imprisonment; Individual; Infection; Infection prevention; Intervention; Justice; Knowledge; Latino; Life; Long-Term Effects; Mediation; Mediator of activation protein; Mental Health; Mental disorders; Methods; Neighborhoods; Outcome; Parents; Participant; Partner Communications; Personal Satisfaction; Pharmaceutical Preparations; Prevalence; Prevention; Prevention program; Procedures; Process; Public Health; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Risk; Risk Behaviors; Risk-Taking; Safety; Screening procedure; Self Efficacy; Series; Services; Sex Behavior; Sex Characteristics; Sexually Transmitted Diseases; Societies; Staging; Strategic Planning; Teenagers; Testing; Treatment Efficacy; United States National Institutes of Health; Urine; Youth; abstracting; arm; base; condoms; cooking; cost; delay sex; design; efficacy trial; emotion regulation; empowered; ethnic minority population; follow-up; health disparity; high risk; high risk sexual behavior; improved; innovation; juvenile delinquent; juvenile justice system; male; neglect; offender; peer; prevent; probation; programs; safer sex; sex; skills; social; social cognitive theory; tool

DESCRIPTION (provided by applicant): High rates of mental illness, HIV/AIDS/STI, and incarceration among African Americans (AA) reflect significant health disparities (NIH 2001 strategic plan to eliminate health disparities), particularly among youth. Teens in juvenile justice are disproportionately AA, and compared to the general population, juvenile offenders (JO) report more risky sexual behavior, drug and alcohol use, and psychiatric disorders, and are more likely to test positive for STIs. Still, few empirically-supported, theoretically-driven programs exist to address their negative health outcomes. This proposal addresses these health disparities by testing an innovative and uniquely tailored HIV/AIDS/STI, mental health, and substance use program designed for and pilot tested with recently arrested 13 - 17 year-old urban males and females (85% African American, 14% Latino/a) released on probation (PHAT Life; R34MH075628). PHAT Life was derived from a carefully staged process that included an active, diverse, multi-disciplinary advisory board, a youth advisory board, focus groups, two pilot tests, extensive feedback, and a series of curriculum revisions over three years. The R34 established feasibility and acceptability, revealed positive youth and stakeholder feedback, and yielded good preliminary outcomes at 3-month follow-up (e.g., increased condom use) to justify an efficacy trial. This application proposes a 2-arm randomized controlled trial to test PHAT Life versus a health promotion program with recently arrested 13-17 year-old male and female, mostly ethnic minority JO (as representative of Cook County) on probation in Chicago. We will use the procedures and methods established in the developmental study to recruit, enroll, assess, track, and intervene with teens. We will randomly assign youth to PHAT Life (N=150) or a health promotion control group (N=150), and we will deliver the interventions in single sex groups of 5 - 7 teens at Evening Reporting Centers. Assessments will occur at baseline, 6-, and 12-months post-treatment, and we will screen youth for three common STIs (Chlamydia, Gonorrhea, Trichamonas) at baseline and 12-month follow-up. All youth who test positive for an STI will receive single dose antibiotic treatment free of charge. Using an intent-to-treat analysis, we will test and compare PHAT Life to the health promotion control group on adolescent risky sexual behavior, substance use, and theoretical mediators. This proposal answers a compelling need for innovative prevention programs that address the intersecting health disparities of mental illness and HIV/AIDS/STIs among youth in juvenile justice. Without intervention, these teens continue to engage in risk behaviors post-release, amplifying their own and their partner's risk for HIV/AIDS/STIs.26, 27 The lasting effects on community well-being, individual employment prospects, and neighborhood health28 are profound, but effective programs can alter the negative developmental trajectories of this very high-risk population29, 30 and begin to redress existing health disparities. PUBLIC HEALTH RELEVANCE: This application has significant long-term implications for redressing serious health disparities. Juvenile offenders, the vast majority of whom are ethnic minorities, are disproportionately overburdened by HIV/AIDS/STIs, mental illness, and substance use. Few empirically-validated, theoretically-based programs exist for teens in juvenile justice, especially offenders who return to their communities immediately post-arrest, and none address the full range of impairment in these youth. High rates of co-morbid substance use and mental health problems present unique challenges for HIV/AIDS/STI prevention. Unfortunately, most JO return to their communities with undiagnosed and untreated STIs, and these youth continue to engage in risk behaviors post-release, amplifying their own risk, increasing the chances of infecting their partners, placing their neighborhoods at risk, and further fueling well-known health disparities. These negative outcomes have profound long-term effects on community well-being, individual employment prospects, and neighborhood health and safety. This study will begin to redress these concerns; empowered with the right tools, JO will be better equipped to make safer decisions that reduce their risk taking, thereby curbing the spread of HIV/AIDS/STIs in their communities.

描述（由申请人提供）：非洲裔美国人（AA）中精神疾病、艾滋病毒/艾滋病/性传播疾病和监禁的高发率反映了显著的健康差距（美国国立卫生研究院2001年消除健康差距战略计划），特别是在年轻人中。青少年司法机构的青少年是不成比例的AA，与一般人群相比，青少年罪犯（JO）报告更危险的性行为，吸毒和酗酒，精神疾病，更有可能检测出性传播感染阳性。然而，很少有经验支持的、理论驱动的项目存在，以解决他们的负面健康后果。该提案通过测试一项创新的、量身定制的艾滋病毒/艾滋病/性传播感染、精神健康和药物使用方案来解决这些健康差异，该方案专为最近被捕的13 - 17岁城市男性和女性（85%非裔美国人，14%拉丁裔/a）设计，并对其进行试点测试（PHAT Life; R34MH075628）。PHAT Life是一个精心设计的过程，包括一个积极的、多样化的、多学科的咨询委员会，一个青年咨询委员会，焦点小组，两次试点测试，广泛的反馈，以及三年多来的一系列课程修订。R34确定了可行性和可接受性，揭示了积极的青年和利益相关者反馈，并在3个月的随访中产生了良好的初步结果（例如，增加了安全套的使用），以证明有效性试验是合理的。本应用程序提出了一项两组随机对照试验，以测试PHAT Life与健康促进计划，其中包括最近在芝加哥被捕的13-17岁男性和女性，主要是少数民族JO（作为库克县的代表）。我们将使用发展研究中建立的程序和方法来招募、登记、评估、跟踪和干预青少年。我们将随机将青少年分配到PHAT生活组（N=150）或健康促进对照组（N=150），我们将在夜间报告中心对5 - 7名青少年进行单一性别组的干预。评估将在基线、治疗后6个月和12个月进行，我们将在基线和12个月随访时对青少年进行三种常见性传播感染（衣原体、淋病、滴虫）筛查。所有性传播感染检测呈阳性的青年将免费接受单剂量抗生素治疗。使用意向治疗分析，我们将测试和比较PHAT生活与健康促进对照组在青少年危险性行为，物质使用和理论中介。这项提案回应了一个迫切需要创新的预防项目，解决青少年司法中精神疾病和艾滋病毒/艾滋病/性传播感染的交叉健康差异。如果没有干预，这些青少年在释放后继续从事危险行为，增加了他们自己和他们的伴侣感染艾滋病毒/艾滋病/性传播感染的风险。对社区福祉、个人就业前景和邻里健康的持久影响是深远的，但有效的计划可以改变这一高危人群的消极发展轨迹，并开始纠正现有的健康差距。