Live Smart Live Safe: HIV Prevention for Youth with Intellectual Disabilities

描述（由申请人提供）：本申请的目的是为智障青年（智商约55至70）开发和评估一个互动式、基于网络的艾滋病预防课程的可行性。最近一项针对男女残疾青年的纵向研究报告称，到18岁或18岁以上（即18-21岁）时，73%的人报告说他们有过性行为2 .许多残疾青年没有得到性健康方面的指导这一阶段将侧重于健康的关系发展和基本的艾滋病毒知识。第一阶段项目“为有身份证的青少年预防艾滋病毒”将根据年龄（11-14岁）、性别和性取向量身定制。在第一阶段原型中将开发四个内容部分：1)使性行为和性健康正常化的青少年动机部分，a)健康的关系发展，b)与禁欲有关的做法，以及c)通过高危体液传播艾滋病毒。该项目符合国家精神卫生研究所艾滋病研究部的使命，该部门支持旨在防止艾滋病毒在高危人群中传播的建议。智力残疾者（ID）感染艾滋病毒的预测风险因素有：a)性虐待3,4和性侵犯发生率高，5)信息处理困难，6和c)识字率低。7 .在第一阶段，将使用教师和服务提供者的形成程序（即电话访谈）来确定青少年对健康关系、禁欲和有身份证件的青少年特有的艾滋病毒风险问题的了解（例如，缺乏知识、社会适当的反应、不稳定的关系），以便为节目内容、脚本编写和框架提供信息。共有十位教师和服务提供者将完成电话访谈。将对有性取向障碍的青年（n= 8名女性和n=8名男性）进行焦点小组，以确定与健康关系发展、禁欲做法和艾滋病毒传播相关的知识和技能缺陷。该项目将以10名有身份证的青少年为对象进行试点。为了证明我们的方法的可行性，第一阶段的项目将在有ID的青少年中进行评估（n=20名女孩和n=20名男孩）。此外，教师和服务提供者（n=15）将审查该计划，并就消费者满意度的六个方面提供反馈：易用性、实用性、趣味性、可理解性、可接受性和说服力。在第二阶段，该计划将扩大到对避孕套使用的责任（即，避孕套是什么，在哪里购买，如何将避孕套放在手边，如何将避孕套戴在阴茎上），基于关系的艾滋病毒预防策略以及接受艾滋病毒检测。此外，将开发一份教学指南，以配合第二阶段的最终产品。第二阶段的产品将是一个可下载的基于网络的程序，适用于个人电脑、iPad(R)和其他基于平板电脑的技术，适合具有身份证的青少年使用。

DESCRIPTION (provided by applicant): The purpose of this application is to develop and evaluate the feasibility of an interactive, web-based HIV prevention curriculum for youth with intellectual disabilities (ID) (I.Q. approximately 55 through 70). A recent longitudinal study of male and female youth with disabilities reports that, by the time they were 18 or older (i.e., 18-21), 73% reported they had had sexual intercourse.1 Many youth with disabilities do not receive instruction on sexual health.2 This Phase I will focus on healthy relationship development and basic HIV knowledge. The Phase I program, "HIV Prevention for Youth with ID" will be tailored by age (11-14), gender, and sexual preference. Four content segments will be developed in Phase I prototype: 1) motivational segment for adolescents that normalizes sexuality and sexual health, a) healthy relationship development b) practices associated with abstinence, and c) transmission of HIV through high-risk body fluids. This project is consistent with the mission of the National Institute of Mental Health Division of AIDS Research (DAR), which supports proposals designed to prevent HIV transmission among at-risk populations. The predictive risk factors for HIV infection among people with intellectual disabilities (ID) are: a) high rates of sexual abuse3, 4 and sexual assault,5 b) information processing difficulties,6 and c) low literacy rates. 7 In Phase I, formative procedures with teachers and service providers (i.e., telephone interviews) will be used to identify youth knowledge of healthy relationships, abstinence, and HIV risk issues unique to youth with ID (e.g., lack of knowledge, socially-appropriate responding, unstable relationships) to inform program content, scriptwriting, and framing. A total of ten teachers and service providers will complete the telephone interviews. Focus groups with youth with ID (n= 8 females and n=8 males) will be conducted to identify knowledge and skill deficits associated with healthy relationship development, abstinence practices, and HIV transmission. The program will be pilot-tested with 10 youth with ID. To demonstrate the feasibility of our approach, the Phase I program will be evaluated with youth with ID (n=20 girls and n=20 boys). In addition, teachers, and service providers (n=15) will review the program to provide feedback on six areas of consumer satisfaction: ease of use, usefulness, interest, comprehensibility, acceptability, and persuasiveness. At Phase II, the program will be expanded to address taking responsibility for condom usage (i.e., what a condom is, where to purchase them, keeping them handy, how to put a condom on a penis), relationship-based HIV avoidance strategies and getting tested for HIV. In addition, a teaching guide will be developed to accompany the final Phase II product. The Phase II product will be a downloadable web-based program for use on personal computers, iPad(R), and other tablet based technologies, suitable for use by adolescents with ID.