Integrated Prevention of HIV risk and Intimate Partner Violence among Adolescents in South Africa

项目总结/摘要 在青少年时期迫切需要预防性干预措施， (HIV)亲密伴侣暴力（IPV）呈指数级增长。然而，很少有行为干预整合 艾滋病毒-IPV预防和针对青少年的独特年龄和发展需求量身定制。我们利用 青少年发展理论在我们的预防干预策略中的见解， 最大预防收益的发展倾向。青春期呈现出一个理想的年龄和发展- 心理过渡期，以预防艾滋病毒行为风险降低为目标的综合干预措施， 实施IPV，包括性暴力。青春期的发展标志-包括例如， 社会规范在激励行为中的作用，同龄人在塑造行为选择中的重要性，以及 增加责任感的愿望-所有这些都可以用来预防性风险行为， 艾滋病毒感染和参与IPV。例如，我们使用社会规范营销来改变态度， 参与保护性艾滋病毒行为和预防IPV的动机。我们利用积极的同伴压力， 青少年渴望成为负责任的未来领导者，以激励青少年作为旁观者进行干预， 他们的同龄人参与艾滋病毒风险行为或性侵犯和攻击。动机和执行- 这些与预防艾滋病毒和IPV犯罪有关的积极行为发生在一个时期， 当身份形成和终身健康模式被习惯化时，我们的干预方法利用 在青春期形成认同和习惯，以支持长期的预防行为。集成 预防青少年艾滋病毒和IPV的方法尚未得到检验。我们建议进行研究， 调查安全南非的可接受性和可行性，这是一项综合的艾滋病毒-IPV干预措施， 青少年艾滋病毒行为风险和15-17岁男性青少年中IPV的实施。我们工作 在南非，一个艾滋病毒流行最多的国家，也是非洲IPV发病率最高的国家。 世界我们提出以下具体目标：（1）发展目标-创建安全的南非， 男性青少年HIV危险行为和IPV实施的预防性干预;（2）可接受性目标-评估- 通过对N=100名男性和女性青少年的调查，评估HIV和IPV风险的社会生态学，并测试 通过在N=20名男性青少年中进行的开放性试点试验，确定安全南非的可接受性;（3）可行性目标 - 在N=60例男性青少年样本中进行随机对照初探性试验，随访1个月和6个月 以评估未来完全功效试验和递送保真度的可行性。调查结果将提前预防- 在高影响环境中为艾滋病毒和IPV高危青年提供积极的干预科学。

PROJECT SUMMARY/ABSTRACT Preventive interventions are urgently needed during adolescence when risk for human immunodeficiency virus (HIV) and intimate partner violence (IPV) increases exponentially. Yet, few behavioral interventions integrate HIV-IPV prevention and are tailored for the unique age and developmental needs of adolescents. We utilize the insights of adolescent development theory in our preventive intervention strategy by capitalizing on adolescents’ developmental propensities for maximum prevention gains. Adolescence presents an ideal age and develop- mental transition period for an integrated intervention targeting prevention of HIV behavioral risk reduction and perpetration of IPV including sexual violence. Developmental hallmarks of adolescence – including for example, the role of social norms in motivating behaviors, the importance of peers in shaping behavioral choices, and the desire for increased responsibility – can all be leveraged for prevention of sexual risk behavior driving acquisition of HIV infection and engagement in IPV. For example, we use social norms marketing to shift attitudes and motivations to engage in protective HIV behaviors and prevent IPV. We use positive peer pressure and tap into adolescents’ desire to be responsible future leaders to motivate adolescents to intervene as bystanders when their peers are involved in HIV risk behaviors or sexual assault and aggression. The motivation and implemen- tation of these positive behaviors relating to prevention of HIV and IPV perpetration are occurring in a period when identity formation and life-long health patterns are being habituated; our intervention approach leverages the formation of identity and habits during adolescence to support long term prevention behaviors. An integrated approach for prevention or adolescent HIV and IPV perpetration has not yet been tested. We propose a study to investigate the acceptability and feasibility of Safe South Africa, an integrated HIV-IPV intervention to prevent adolescent HIV behavioral risk and perpetration of IPV among male adolescents 15-17 years of age. We work in South Africa, a country with the largest HIV epidemic and some of the highest rates of IPV perpetration in the world. We propose the following specific aims: (1) development aim - create Safe South Africa, an integrated male adolescent preventive intervention for HIV risk behavior and IPV perpetration; (2) acceptability aim – eval- uate social ecology of HIV and IPV risk with a survey of N=100 male and female adolescents, and test the acceptability of Safe South Africa through an open pilot trial with N=20 male adolescents; and (3) feasibility aim - conduct a randomized controlled pilot trial with 1- and 6-month follow-up in a sample of N=60 male adolescents to assess the feasibility of a future fully powered efficacy trial and delivery fidelity. Findings will advance preven- tive intervention science for young people at elevated risk for HIV and IPV in a high impact setting.