A Couple-Based Relationship Strengthening HIV Intervention for Young Parents

描述（由申请人提供）：本研究旨在开发、实施和评估一项创新的15期夫妻干预措施，以小组形式提供给年轻父母，旨在加强关系并降低艾滋病毒风险。很少有艾滋病毒预防干预措施将情感和关系因素纳入减少风险。利用依恋理论的指导框架和情感聚焦疗法的原则，我们将直接解决情感、亲密关系和关系功能的问题，以创造一种加强浪漫关系和减少艾滋病毒风险行为的干预。我们的干预将与现有的以社区为基础的养育计划相结合。我们干预的最终目标是降低艾滋病毒/性病风险（并发性行为、伴侣数量、无保护的性行为），加强关系，并改善年轻异性恋夫妇的养育方式。这项研究将首先包括干预措施的发展。为此，将开展4个由8-10名年轻育儿男女组成的焦点小组，收集有关干预措施的内容、结构和执行情况的信息。我们还将对临床医生、社会工作者和社区领导人进行8-10次关键信息提供者访谈，以评估实施干预措施的可能障碍，以及有关干预结构的信息。我们将使用焦点小组和关键信息提供者访谈的结果来开发和修改干预内容和交付材料。我们将对六对夫妇进行干预试验，采用严格的定性评估，然后对42对养育子女的夫妇进行小型随机对照试验，随机分为加强关系预防艾滋病毒干预组和主动控制组。我们将在基线、4个月和8个月时评估夫妻的性风险（并发性行为、性伴侣数量、无保护的性行为）和关系功能。我们还将评估干预的可行性、可接受性和保真度。

DESCRIPTION (provided by applicant): This study seeks to develop, implement and assess an innovative 15-session couple-based intervention to be delivered in a group format to young parents that aims to strengthen relationships and reduce HIV risk. Few HIV prevention interventions incorporate emotion and relationship factors into risk reduction. Using the guiding framework of Attachment Theory and the principles of Emotion Focused Therapy, we will directly address issues of emotion, intimacy, and relationship functioning to create an intervention that strengthens romantic relationships and reduces HIV risk behavior. Our intervention will be integrated with an existing community based parenting program. The ultimate goal of our intervention is to reduce HIV/STD risk (concurrency, number of partners, unprotected sex), strengthen relationships, and improve parenting among young parenting heterosexual couples. The study will first consist of the development of the intervention. This will be achieved by conducting 4 focus groups of 8-10 young parenting men and women to gather information about the content, structure and implementation of the intervention. We will also conduct 8-10 key informant interviews of clinicians, social workers, and community leaders to assess possible barriers to intervention implementation, as well as information about intervention structure. We will use the results from the focus groups and key informant interviews to develop and modify intervention content and delivery materials. We will conduct a pilot of the intervention with six couples employing rigorous qualitative evaluation before conducting a small pilot randomized controlled trial of 42 parenting couples randomized to either the relationship strengthening HIV prevention intervention or an active control. We will assess couples at baseline, 4-months, and 8-months on sexual risk (concurrency, number of sex partners, unprotected sex) and relationship functioning. We will also assess the feasibility, acceptability and fidelity of the intervention.