HIV Prevention Maintenance for African American Teens

非裔美国女性青少年人群是艾滋病毒感染的高危人群。最近的研究结果表明，在文化和性别方面，适当的艾滋病毒干预措施可以显著提高这一弱势群体的避孕套使用率。然而，表现出短期行为变化的是，干预效果的衰退通常在干预后一年内就可以观察到。因此，制定和评估旨在加强长期维持预防艾滋病毒的性行为的创新战略仍然是公共利益的优先事项。这项拟议的研究是一个令人兴奋的机会，可以利用我们研究的经验和多学科专业知识学习设计一项随机控制的补充治疗试验，以评估由Mephone提供的创新艾滋病毒预防维持干预在18个月的随访期内维持避孕套保护性行为的有效性和成本效益。亚特兰大计划生育组织将招募700名14-18岁的非裔美国女性青少年作为样本。在评估他们的资格并完成同意后，青少年将被重新联系并邀请他们返回计划 为人父母完成一项基线评估。在基线阶段，青少年将完成ACASI访谈，该访谈源于社会认知理论和性别与权力理论，评估社会人口特征、艾滋病毒危险行为和关键媒介 与艾滋病毒预防行为有关。随后，青少年将被随机分为实验条件或对照条件。在实验条件下的青少年接受“初级”治疗，即多疗程、团体分娩 Sihle艾滋病毒干预，这在18个月的随访期内证明了在加强避孕套保护的性行为和艾滋病毒预防的关键媒介方面的有效性，以及补充干预，即个性化电话提供的艾滋病毒预防维持干预(Sihle+HIVPMI)。随机接受这种情况的青少年每两个月收到九个个性化的电话联系人，旨在加强Sihle HIV干预中涵盖的主题，但针对每个青少年的个人情况进行个性化 保持安全性行为的态度、关系、技能和环境障碍。青少年在对照条件下接受初级治疗，不进行HIV预防维持干预。然而，在这种情况下，青少年接受结构相同的个性化电话传递的营养教育干预(SIHLE+NED)，旨在构成一个时间和剂量相等的注意控制比较条件。被随机分配到对照组的青少年每两个月接受九次个性化的营养教育电话联系。两种情况下的青少年在基线、6个月、12个月和18个月的随访中完成相似的ACASI评估。一项意向治疗分析，使用广义估计方程，将评估Sihle+HIV PMI相对于Sihle+Nei在18个月的随访期内维持青少年避孕套保护的性行为的有效性和成本效益。因此，提高艾滋病毒预防方案的可持续性可能会对非裔美国女性青少年中交叉流行的艾滋病毒和性传播疾病产生重大影响。

African-American female adolescent population at high risk for HIV infection. Recent findings that culturally and gender are a suggest propriate HIV interventions can significantly enhance condom use among this vulnerable population. However, demonstrating short-term havior change, decay of intervention effects is usually observable within one-year post-intervention. Thus, the development and aluation of innovative strategies designed to enhance the long-term maintenance of HIV-preventive sexual behaviors remains a public alth priority. The proposed study is an exciting opportunity to harness the experience and multidisciplinary expertise of our research Learn to design a randomized controlled, supplementary treatment trial, to evaluate the efficacy and cost-effectiveness of an innovative Mephone-delivered HIV prevention maintenance intervention in sustaining condom protected sexual intercourse over an 18-month follow-up period. A sample of 700 African-American female adolescents, 14-18 years of age, will be recruited at Planned Parenthood, Atlanta. Subsequent to assessing their eligibility and completing consent, adolescents will be re-contacted and invited to return to Planned Parenthood to complete a baseline assessment. At baseline, adolescents will complete ACASI interview, derived from Social Cognitive theory and the Theory of Gender and Power, that assesses sociodemographic characteristics, HIV risk behaviors and key mediators associated with HIV preventive behaviors. Subsequently, adolescents will be randomized to either the experimental condition or the comparison condition. Adolescents in the experimental condition receive the "primary" treatment, the multi-session, group-delivered SiHLE HIV intervention, that has demonstrated efficacy in enhancing condom protected sexual intercourse and key mediators of HIV prevention over an 18-month follow-up period, and the supplemental intervention, an individualized telephone-delivered HIV Prevention Maintenance Intervention (SiHLE + HIVPMI). Adolescents randomized to this condition receive nine bimonthly individualized telephonc contacts designed to reinforce topics covered in the SiHLE HIV intervention, but are individualized to address each adolescent's personal attitudinal, relational, skills and environmental barriers to maintaining safer sex practices. Adolescents in the comparison condition receive the primary treatment, the SiHLE HIV intervention without the HIV prevention maintenance intervention. However, adolescents in this condition receive a structurally equivalent individualized telephone-delivered nutrition education intervention (SiHLE + NED that is designed to constitute a time- and dose-equivalent attention control comparison condition. Adolescents randomized to the comparisor condition receive nine bimonthly individualized telephone contacts on nutrition education. Adolescents in both conditions complete similm ACASI assessments at baseline, 6-, 12-, and 18-month follow-up. An intent-to-treat analysis, using generalized estimating equations, will assess the efficacy and cost-effectiveness of SiHLE + HIV PMI relative to SiHLE + NEIin maintaining adolescents' condom protected sexual intercourse over an 18-month follow-up period. Consequently, improving the sustainability of HIV prevention programs could have a substantial impact on the intersecting HIV and STD epidemics among African-American female adolescents.