Developing a Dyadic Intervention for STI/HIV Prevention in Youth

摘要 虽然公共卫生项目在减少青少年和 尽管艾滋病毒/性传播感染的风险很高，但在健康方面仍然存在着巨大的差距。性传播感染/艾滋病毒的风险并不统一 在AYA。居住在性传播感染率高、性关系复杂的隔离城市社区的青少年 网络面临着更大的疾病和相关并发症风险。额外的支持设计， 迫切需要增加对护理的参与，减少性传播感染的获得和传播， 国家的性健康和生殖健康目标。绝大多数情况下，AYA性病预防干预措施 有针对性的个人和个人层面的因素。这些干预措施虽然有效， 解决影响AYA感染STI/HIV风险的其他重要影响因素，如伴侣或关系对 性决策和性行为。伴侣通知和治疗是疾病控制的关键策略 之前曾在成人中进行过性病/艾滋病预防工作的测试，但尚未进行AYA评估。 我们之前的研究表明，患有复杂性传播感染的AYA可能会通知他们的伴侣寻求 治疗（88-92%）;然而，接受短暂行为干预的AYA，相对于那些接受 标准护理的人成功安排伴侣治疗的可能性高出3倍。因此，在本发明中， 伴侣的干预可能有希望利用关系动力的力量来提高性能力， 决策、沟通和随后的健康行为。我们建议对一种干预措施进行试点测试 旨在通过了解伴侣和学习环境来改变性健康结果， 通过同时提供两种基于证据的性传播感染/艾滋病毒预防干预措施， 对姐妹青少年和关注未来。将加强同时提供有效干预措施 与合作伙伴共同举办健康教育咨询会议，重点是加强沟通和谈判 安全的性行为如果成功，这一试点将支持发展一个更大的 一项旨在评价这种方法在忙碌初级保健环境中的有效性的试验， 有证据表明，AYA能够并将安全地让他们的伴侣参与支持性的初级保健环境， 由健康教育工作者提供高质量治疗和基于证据的性病/艾滋病毒预防干预措施 团队

ABSTRACT While public health programs have demonstrated modest success in reducing the adolescent and young adult (AYA) risk for STI/HIV, significant health disparities remain. The risk of STI/HIV is not uniform among AYA. AYA residing in segregated urban communities with high STI prevalence and complicated sexual networks face even greater risk for disease and associated complications. Additional supports designed to increase engagement in care and reduce STI acquisition and transmissions are urgently needed to meet the sexual health and reproductive health goals for the nation. Overwhelmingly, AYA STI prevention interventions have targeted individuals and individual-level factors. While effective, these interventions do not adequately address other important influences affecting AYA risk for STI/HIV, such as partner or relationship influences on sexual decision-making and behavior. Partner notification and treatment is a key strategy for disease control and has previously been tested among adults for STI/HIV prevention work but has yet to be evaluated for AYA. Our prior research demonstrates that AYAs with complicated STIs are likely to notify their partners to seek treatment (88-92%); however, AYAs receiving brief behavioral interventions, relative to those receiving standard of care were 3 times more likely to be successful in arranging for their partner's treatment. Thus, partner interventions may hold promise for harnessing the power of relationship dynamics to enhance sexual decision-making, communication, and subsequent health behaviors. We propose to pilot test an intervention designed to change sexual health outcomes by understanding partners and the learning environment related to sex [COUPLES] by simultaneously delivering two evidence-based STI/HIV prevention interventions Sister- to-Sister Teen and Focus on the Future. The simultaneous delivery of effective interventions will be augmented with a joint partner health education counseling session focused on enhancing communication and negotiation of safe sexual practices within the relationship. If successful, this pilot will support the development of a larger trial designed to evaluate the effectiveness of this approach in the busy primary care setting by providing evidence that AYA can and will safely engage their partners in a supportive primary care setting that integrates high quality treatment with evidence-based STI/HIV prevention interventions delivered by health educator teams.