A South African Pilot Worksite Parenting Program to Prevent HIV Among Adolescents

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DESCRIPTION (provided by applicant): In South Africa, >5 million people, including many adolescents, are living with HIV. Prevalence is increasing throughout South Africa, most precipitously in the Western Cape, the site of our proposed study. However, efforts to reduce HIV among South African youth through national campaigns, mass media, and schools have had limited success. South African youth prevention programs have generally not involved parents, though parents have the potential to prevent adolescent sexual risk through communication, supervision, and involvement. We propose to pilot test a multisession worksite-based program to help parents learn how to take an active role in rearing sexually healthy youth. We will culturally adapt our NIH-funded, US worksite-based parenting program, Talking Parents, Healthy Teens, for use in South Africa. This program had substantial effects on improving parent-adolescent communication about sex that have persisted to the 9- month follow-up survey; strikingly, some effects became stronger in between the immediate and the 3- and 9- month follow-ups. Such communication has the potential to mediate longer-term sexual behavior outcomes. The worksite setting is convenient for parents and sustainable for South African employers. Although our program's main goal will be to reach adolescents through parents, we expect that it will also influence parents' HIV-related attitudes and behaviors. South African adults tend to be reluctant to attend HIV prevention programs due to stigma, but a program focused on adolescents may attract parents, promoting the health of both generations. Our specific aims are to: (1) Adapt a US-developed worksite-based program for parents of adolescents to the South African context; (2) Examine whether a worksite-based program for parents of adolescents in South Africa improves the parent-child relationship, including general parent-child communication and communication about sexual health and HIV risk-reduction, as perceived by parents and adolescents; (3) Explore program effects on parents' HIV testing and sexual behaviors; and (4) Explore program effects on theoretically important psychosocial mediators of behavior change (e.g., greater self- efficacy for refusing sex and using condoms, and more perceived disadvantages of unprotected sex). The proposed research is a unique opportunity to adapt and pilot test an innovative HIV prevention intervention that promotes the health of families in a culturally acceptable and sustainable setting. PUBLIC HEALTH RELEVANCE: In South Africa (SA), adolescent HIV prevalence is high. Current SA youth HIV prevention efforts have had limited success. We propose to adapt and pilot test a multisession worksite-based program to help SA parents promote healthy adolescent sexual development. The program will be based on our successful NIH- funded US worksite program, which had substantial effects on parent-child communication about sex.