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: 8687997
• 负责人: GERI R DONENBERG
• 金额: $ 38.86万
• 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 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8687997
• 关键词: 17 year old; AIDS/HIV problem; Address; Adolescent; African American; Aftercare; Alcohol consumption; Alcohol or Other Drugs use; Antibiotic Therapy; Attention; Attitude; Awareness; Back; Belief; Biological; Characteristics; Charge; Chicago; Chlamydia; Collaborations; Communities; Consent; Control Groups; County; Decision Making; Development; Disease; Dose; Drug usage; Educational Curriculum; Employment; Enrollment; Feedback; Female; Focus Groups; Freedom; General Population; Gonorrhea; Grant; HIV; HIV risk; 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; Prevalence; Prevention; Prevention program; Procedures; Process; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Risk; Risk Behaviors; Risk-Taking; Safety; 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; 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; sexual risk taking; 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.

描述（由申请人提供）：精神疾病，艾滋病毒/艾滋病/性传播感染和非裔美国人（AA）监禁的高比率反映了显着的健康差距（NIH 2001年战略计划，以消除健康差距），特别是在青年中。青少年司法中的青少年不成比例地AA，与一般人群相比，青少年罪犯（JO）报告了更危险的性行为，毒品和酒精使用，精神障碍，并且更有可能对性传播感染呈阳性。尽管如此，很少有理论支持的，理论驱动的方案存在，以解决他们的负面健康结果。该提案通过测试一项创新的、独特定制的艾滋病毒/艾滋病/性传播感染、心理健康和物质使用方案来解决这些健康差距问题，该方案是为最近被捕的13 - 17岁城市男性和女性（85%为非洲裔美国人，14%为拉丁裔/a）缓刑释放人员设计的，并进行了试点测试（PHAT Life; R34 MH 075628）。PHAT Life是从一个精心策划的过程中衍生出来的，其中包括一个活跃的，多元化的，多学科的咨询委员会，一个青年咨询委员会，焦点小组，两个试点测试，广泛的反馈，以及三年多来的一系列课程修订。R34确立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个月随访时产生了良好的初步结果（例如，增加避孕套使用），以证明有效性试验的合理性。本申请提出了一项双臂随机对照试验，以测试PHAT Life与健康促进计划的对比，其中最近逮捕了13-17岁的男性和女性，主要是在芝加哥缓刑的少数民族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 Life（N=150）或健康促进对照组（N=150），我们将在晚间报告中心以5 - 7名青少年的单一性别组提供干预措施。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个月随访时筛查青少年的三种常见性传播感染（衣原体、淋病、滴虫）。所有性病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生活健康促进对照组青少年危险性行为，物质使用和理论调解人。该提案回应了对创新预防方案的迫切需求，这些方案解决了少年司法中青年人精神疾病和艾滋病毒/艾滋病/性传播感染的交叉健康差异。如果不进行干预，这些青少年在释放后继续从事危险行为，扩大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。26，27对社区福祉，个人就业前景和社区健康的持久影响28是深远的，但有效的方案可以改变这一非常高风险人群的负面发展轨迹29，30并开始纠正现有的健康差距。