Preventing HIV through Affect Management for High-Risk Early Adolescents

描述（由申请人提供）：由于在这一发育时期开始的危险行为（例如，无保护的性行为、药物滥用），早期青少年面临感染艾滋病毒的风险，延迟开始这种风险可能对青少年未来的健康产生重大影响。由于情绪、行为和物质使用因素，许多早期青少年感染艾滋病毒的风险很高。所有这些问题的根本是影响监管方面的困难。情绪反应似乎会干扰在传统健康教育或艾滋病毒预防项目中学习到的认知技能的使用，最近的证据强调了情绪失调在增加青少年性风险行为可能性方面的作用。此外，青春期早期是青少年发展对情绪的理解和调节情绪能力的时期。这些发现表明，为了减少艾滋病毒风险行为，干预措施可以发挥重要作用，可以接触到脆弱的早期青少年，以解决与风险情况相关的情感因素，例如涉及性、酒精和毒品的情绪因素。该项目以《艾滋病毒风险行为的社会个人框架》为指导，将针对罗德岛普罗维登斯县城市初中的高危早期青少年（那些表现出情感、行为或物质使用风险的人）。这项随机对照试验将评估影响管理技能干预与控制条件（一般健康促进）在减少风险行为方面的效果，432名高危七年级学生将被跟踪三年。干预在减少性风险方面的效果将取决于更少的自我报告性行为，改善情绪调节技能，以及弱势早期青少年对艾滋病毒和禁欲相关态度的差异。在这个项目中获得的信息将提高我们对如何防止青少年参与艾滋病毒风险行为的理解。该项目代表了艾滋病毒预防方面的一项创新进展，在学校环境中实施对各地的早期青少年具有可持续性和相关性的巨大潜力。

DESCRIPTION (provided by applicant): Early Adolescents are at risk for HIV due to risk behaviors (e.g., unprotected sex, substance abuse) initiated during this developmental period, and delaying initiation into this risk can have a significant impact on an adolescent's future health. Many early adolescents are at high risk for contracting HIV due to emotional, behavioral, and substance use factors. Underlying all of these problems are difficulties with affect regulation. Emotional reactivity appears to interfere with the use of cognitive skills learned in traditional health education or HIV prevention programs, and recent evidence highlights the role of affect dysregulation in increasing the likelihood of sexual risk behaviors among adolescents. Also, early adolescence is a time when teens are developing their understanding of emotions and their ability to regulate affect. These findings suggest an important role for an intervention that can reach vulnerable early adolescents to address emotional factors associated with risk situations, such as those involving sex, alcohol, and drugs, in order to reduce HIV risk behaviors. This project, guided by the Social Personal Framework of HIV Risk Behavior, will target high-risk early adolescents (those who exhibit emotional, behavioral, or substance use risks) at urban junior high schools in Providence County, Rhode Island. This randomized, controlled trial will evaluate the efficacy of an Affect Management skills intervention in comparison to a control condition (General Health Promotion) for reducing risk behaviors with 432 high-risk seventh graders who will be followed for three years. The efficacy of the intervention in reducing sexual risk will be determined by less self-reported sexual behavior, improved emotion regulation skills, and differences in HIV- and abstinence-related attitudes among vulnerable early adolescents. The information gained in this project will improve our understanding of how to prevent early teens from engaging in HIV risk behaviors. This project represents an innovative progression in HIV prevention whose implementation in school settings has great potential for sustainability and relevance for early adolescents everywhere. PUBLIC HEALTH RELEVANCE: The information gained in this project will improve our understanding of how to prevent early teens from engaging in HIV risk behaviors.