HIV Prevention in the Family Drug Court

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DESCRIPTION (provided by applicant): This Mentored Patient-Oriented Research Career Development Award (K23) will enable the candidate, a clinical psychologist, to become an independent researcher in the area of adolescent risk behaviors, with a focus on family processes, emotion regulation, adolescent substance abuse and HIV risk. The overarching goal of this training award is for the candidate to apply research findings to the development of efficacious HIV prevention and substance abuse interventions for substance abusing juvenile offenders. Juvenile offenders are at elevated risk for substance abuse and HIV risk behaviors secondary to higher rates of psychopathology and emotional distress than their non-offending peers. Higher rates of substance use and psychopathology substantially increase offenders' risk for HIV infection. Although, family-based treatments have demonstrated some efficacy in changing substance use, they have failed to target adolescent sexual risk behavior and have not focused on a construct (emotion regulation) that may be central to long-term behavior change for the entire family. Thus, the research goal for the Award period is to adapt (and test) a current adolescent-only Affect Management HIV Prevention Intervention for Substance-Abusing Juvenile Offenders into an effective Family-Based Affect Management for HIV Prevention Intervention for Substance- Abusing Juvenile Offenders. This study will have three phases. In Phase 1, qualitative data will be collected from 45 adolescent-parent dyads via focus groups and pilot run-throughs of the adapted intervention. In Phase 2, 60 dyads will be randomized to either the Family-Based Affect HIV prevention or General Health Promotion condition with baseline and 3 month follow-up assessments. Differences in intervention response (e.g., changes in adolescent substance use and sexual risk) between subjects in each condition will be examined in order to estimate the effect size of the Family-Based intervention. Phase 3 will involve project summation and data analysis. The candidate will achieve all of the above with five years of rigorous training and strong mentorship in 1) developing clinical trials, 2) treating adolescent substance abuse, 3) developing family-based interventions that address family emotion dysregulation, and 4) working within the juvenile justice system. Future treatment development work for an adolescent population at great risk for HIV infection will be informed by the results of this project.