Preventing Drug Abuse and HIV in Hispanic First Offenders

少年司法系统中的西班牙裔青年感染艾滋病毒和使用非法药物的风险增加。 这项拟议的研究的总体目标是减少种族之间在非法药物使用和艾滋病毒方面的差异， 刑事司法系统中的西班牙裔和非西班牙裔青年。拟议的两年期研究将以四个目标为指导。目的1是评估家庭团结的有效性，相对于治疗作为预防非法药物使用的西班牙裔青年初犯的样本;目的2是评估家庭团结的有效性，相对于治疗作为预防不安全的性行为;目的3是评估家庭团结的有效性，相对于治疗作为预防随后的刑事犯罪的数量;目的4是评估家庭功能在多大程度上介导了干预对非法药物使用、不安全性行为和随后的刑事犯罪的影响。240名西班牙裔青少年初犯者（年龄在13至17岁之间）及其父母将被随机分配到Familias Unidas或治疗作为家庭。青少年和家长参与者将在基线、干预后（即，6-基线后12个月）和基线后12个月。 在两项随机试验中，对Familias Unidas干预进行了评估，发现其有效。在第一项研究中（Pantin等人，2003年），Familias Unidas被证明是有效的相对于无干预控制条件，在增加家庭功能和减少行为问题。在第二个随机试验中（普拉多等人，2007），Familias Unidas被发现是有效的，相对于两个注意力控制条件，在减少非法药物使用和无保护的性行为在最后性交。在这两项试验中，都发现家庭功能可以调解条件对结果的影响。分层线性模型（HLM）将用于检验：（H1）在减少非法药物使用方面，Familias Unidas比Treatment as Pastal更有效;（H2）在减少无保护性行为使用方面，Familias Unidas比Treatment as Pastal更有效;（H3）在预防随后的刑事犯罪方面，Familias Unidas比Treatment as Pastal更有效。此外，HLM还将用于确定（H1a）Familias Unidas对非法药物使用的影响是否部分由家庭功能介导;（H2a）Familias Unidas对无保护性行为的影响是否部分由家庭功能介导;以及（H3a）Familias Unidas对后续刑事犯罪的影响是否部分由家庭功能介导。

Hispanic youth in the juvenile justice system are at increased risk of HIV infection and of using illicit drugs. The proposed study’s overarching goal is to reduce the ethnic disparities in illicit drug use and HIV between Hispanic and non-Hispanic youth in the criminal justice system. The proposed 2-year study will be guided by four aims. AIM 1 is to evaluate the efficacy of Familias Unidas, relative to Treatment as Usual in preventing illicit drug use in a sample of Hispanic youth first offenders; AIM 2 is to evaluate the efficacy of Familias Unidas, relative to Treatment as Usual in preventing unsafe sexual behavior; AIM 3 is to evaluate the efficacy of Familias Unidas, relative to Treatment as Usual in reducing the number of subsequent criminal offenses; and AIM 4 is to assess the extent to which family functioning mediates the effects of the intervention on illicit drug use, unsafe sexual behavior, and subsequent criminal offenses. 240 Hispanic adolescent first offenders (age range 13 to 17) and their parents will be randomized to either Familias Unidas or Treatment as Usual. Youth and parent participants will be assed at baseline, post-intervention (i.e., 6-months post baseline), and 12-months post baseline. The Familias Unidas intervention has been evaluated and found to be efficacious in two randomized trials. In the first study (Pantin et al., 2003), Familias Unidas was shown to be efficacious relative to a no intervention control condition in increasing family functioning and reducing behavior problems. In the second randomized trial (Prado et al., 2007), Familias Unidas was found to be efficacious, relative to two attention control conditions, in reducing illicit drug use and unprotected sexual behavior at last sexual intercourse. In both trials, family functioning was found to mediate the effects of condition on the outcomes. Hierarchical Linear Modeling (HLM) will be used to test: (H1) Familias Unidas will be more efficacious than Treatment as Usual in reducing illicit drug use over time; (H2) Familias Unidas will be more efficacious than Treatment as Usual in reducing unprotected sexual behavior use over time; and (H3) Familias Unidas will be more efficacious than Treatment as Usual in preventing subsequent criminal offenses. Additionally HLM will be used to determine whether (H1a) the effect of Familias Unidas on illicit drug use will be partially mediated by family functioning; (H2a) the effect of Familias Unidas on unprotected sexual behavior will be partially mediated by family functioning and (H3a) the effect of Familias Unidas on subsequent criminal offenses will be partially mediated by family functioning.