Factors Associated with Teens' Non-Responsiveness to HIV Intervention

个人简介(申请人提供)：我致力于HIV/STD预防研究。为了成为一名完全独立的研究员，我正在申请NIMH导师研究科学家发展奖(K01)，以加强我在针对弱势青少年的艾滋病毒/性传播疾病预防研究方面的培训和研究。为了实现这一目标，我将参加课程、研讨会、研讨会和辅导会议，以增强我现有的知识和研究技能，并获得专门针对青少年艾滋病毒/性传播疾病预防计划的设计、实施、适应和评估的新知识和研究技能。我提议的研究计划将在我的导师(主要导师：R.DiClemente，共同导师：G.WinGood和S.Kalichman)的指导下，在佐治亚州亚特兰大的埃默里大学和富尔顿县卫生与健康部门进行，可以在实质性和实用性方面为青少年艾滋病毒预防科学领域做出重大贡献。研究一是根据我的联合导师(卡利希曼博士)进行的研究，采用混合方法进行的研究，旨在：1)确定接触艾滋病毒干预但不改变避孕套使用的非裔美国女性青少年的比例；2)描述在艾滋病毒干预后“未能改变”避孕套使用的个人、行为和心理社会因素。研究1的数据直接为研究2提供信息。在研究2中，我将对我的导师(DiClemente博士和温古德博士)开发的现有有效的性别和文化定制的青少年艾滋病毒干预措施进行调整，以提高其在参与艾滋病毒干预后没有改变避孕套使用情况的非裔美国女性青少年中促进避孕套使用的有效性。适应过程将由WinGood博士和DiClemente博士开发的顺序和系统的适应模型指导，以促进适应过程。研究2也是对适应后的Sihle干预对这一亚群无反应青少年的有效性的初步测试。这两项研究的结果将对我们理解青春期性危险行为和制定有效的艾滋病毒干预措施做出重大贡献，这些干预措施可能会改变难以改变的青少年感染艾滋病毒的风险轨迹。 公共卫生相关性：迫切需要为对性行为无反应的非裔美国青少年女性量身定做的艾滋病毒预防干预措施，因为这些人感染艾滋病毒/性传播疾病的风险特别高。其他卫生部门和以社区为基础的艾滋病服务组织采用调整后的Sihle干预措施，有可能接触到广大受众和受艾滋病毒流行病严重影响的人口。

DESCRIPTION (provided by applicant): I am committed to a career in HIV/STD prevention research. To become a fully independent investigator, I am applying for the NIMH Mentored Research Scientist Development Award (K01) to augment my training and research in HIV/STD prevention research for vulnerable adolescents. Towards this goal, I will participate in courses, workshops, seminars, and mentoring meetings to enhance my existing knowledge and research skills, and acquire new knowledge and research skills specific to the design, implementation, adaptation and evaluation of HIV/STD prevention programs for adolescents. My proposed research plan, to be conducted at Emory University and the Fulton County Department of Health and Wellness, in Atlanta, Georgia, with the guidance of my Mentors (Primary Mentor: R. DiClemente, Co-Mentors: G. Wingood and S. Kalichman), can contribute significantly to the field of adolescent HIV prevention science in substantive and practical ways. Study 1 is a mixed-method study patterned after research conducted by my Co-Mentor (Dr. Kalichman), designed to: 1) identify the proportion of African-American female adolescents exposed to an HIV intervention that do not change their condom use, and 2) describe the personal, behavioral and psychosocial factors associated with "failure to change" condom use following an HIV intervention. Data from Study 1 directly informs Study 2. In Study 2, I will adapt an existing effective gender and culturally tailored adolescent HIV intervention developed by my Mentors (Dr. DiClemente, & Dr. Wingood), to enhance its efficacy for promoting condom use among African-American female adolescents who did not change their condom use after participating in an HIV intervention. The adaptation process will be guided by a sequential and systematic adaptation model, developed by Drs. Wingood and DiClemente, to facilitate the adaptation process. Study 2 is also a pilot test of the effectiveness of the adapted SiHLE intervention for this subgroup of non-responsive adolescents. The findings from the two studies in this application will make significant contributions to our understanding of adolescent sexual risk behavior and the development of effective HIV interventions which could modify the risk trajectory for HIV acquisition in hard-to-change adolescents. PUBLIC HEALTH RELEVANCE: HIV prevention interventions tailored for African-American adolescent females who are non-responsive to sexual behavior risk-reduction interventions are urgently needed as these individuals are at especially high- risk for contracting HIV/STDs. The adoption of the adapted SiHLE intervention by other health departments and community-based AIDS service organizations has the potential to reach a broad audience and a population substantially impacted by the HIV epidemic.