Maintaining Abstinence and Reducing HIV Risk in Adolescent Girls

描述（由申请人提供）：HIV/AIDS的面孔正变得越来越女性、非裔美国人和年轻人；青春期女孩感染艾滋病毒的风险越来越大，主要是由于性行为。性节制的女孩是青少年人口中一个重要的亚群体，最近的数据表明，超过50%的14-19岁女性从未有过阴道性交。至关重要的是要在少女性活跃之前预防艾滋病毒/艾滋病；干预措施应有助于(a)推迟开始性行为的时间，(b)使女孩在性行为活跃时做好降低风险的准备。在为社区少女制定的少数小群体减少性风险干预措施中，没有一个是专门针对性禁欲的女孩的。本申请中提出的研究旨在解决艾滋病预防科学中的这一空白。具体来说，我们将评估一种干预的可行性，这种干预旨在保持禁欲，并减少性禁欲女孩未来的性风险行为。本提案的目的是通过形成性研究来确定和明确禁欲女孩的具体需求，然后试点测试一种针对性别的“禁欲加（AbsPlus）”干预措施，旨在维持禁欲并减少未来的风险行为。具体来说，我们将对18名14-19岁的性禁欲女孩进行焦点小组调查，以深入了解性禁欲的背景，并确定这一人群中自我保护行为的潜在决定因素；我们还将确定如何定制基于群体的干预（先前开发用于性活跃的女孩），以保持禁欲，延迟性活动的发生，并在第一次和随后的性接触中促进自我保护。然后，我们将使用随机、两组（对照）实验设计来评估AbsPlus干预对性禁欲女孩的可行性。这种设计将使我们能够估计风险行为的理论前因和实际行为结果的效应大小。我们将从青少年发展项目中招募60名年龄在14至19岁之间的青春期女性，并随机分配两组：(a)基于信息-动机-行为技能模型的性风险降低干预组（Fisher & Fisher, 1992）或(b)结构等效的健康促进对照组（CTL）。小组将由训练有素的成年女性领导人使用激励增强风格来促进。在近期和短期（3个月）随访评估中，我们预计参加AbsPlus干预的女孩将增加她们的艾滋病相关知识、动机和行为技能；我们还预计，与CTL参与者相比，接受干预的女孩更有可能保持禁欲，并减少相关风险行为的频率。这项研究的长期目标是开发一种有效的干预措施，以延长禁欲，并降低14-19岁女孩未来的艾滋病毒风险。

DESCRIPTION (provided by applicant): The face of HIV/AIDS is becoming increasingly female, African American, and young; adolescent girls, are at increasing risk for HIV infection primarily due to sexual behavior. Sexually abstinent girls represent a significant subgroup of the adolescent population, with recent data indicating that more than 50% of females ages 14-19 have never had vaginal intercourse. It is crucial to address prevention of HIV/AIDS prior to when adolescent girls become sexually active; interventions should help (a) to delay sexual initiation and (b) to prepare girls for risk reduction when they do become sexually active. Of the small number of small-group sexual risk reduction interventions developed for adolescent girls in the community, none has focused solely on sexually abstinent girls. The research proposed in this application aims to address this gap in HIV prevention science. Specifically, we will evaluate the feasibility of an intervention designed to maintain abstinence and to reduce future sexual risk behavior in sexually abstinent girls. The purposes of this proposal are to identify and clarify the specific needs of abstinent girls through formative research and then to pilot test a gender specific "abstinence-plus (AbsPlus)" intervention designed to maintain abstinence and reduce future risk behaviors. Specifically, we will conduct focus groups with 18 sexually abstinent girls ages 14-19 to gain insight into the context of sexual abstinence and identify potential determinants of self- protective behavior in this population; we will also determine how to tailor a group-based intervention (developed previously for use with sexually active girls) to maintain abstinence, delay onset of sexual activity, and promote self-protection at the first and subsequent sexual contact. We will then assess the feasibility of the AbsPlus intervention with sexually abstinent girls using a randomized, two-group (controlled) experimental design. This design will allow us to estimate the effect sizes for both the theoretical antecedents of risk behavior and actual behavioral outcomes. We will recruit 60 adolescent females aged 14 to 19 years from youth development programs and randomly assign groups to one of two conditions: (a) a sexual risk reduction intervention based on the Information-Motivation-Behavioral Skills model (Fisher & Fisher, 1992) or (b) a structurally equivalent health promotion control group (CTL). Groups will be facilitated by trained adult female leaders using a motivational enhancement style. At immediate and short-term (3- month) follow up assessments, we expect that girls enrolled in the AbsPlus intervention will increase their HIV-related knowledge, motivation, and behavioral skills; we also expect that girls who receive the intervention will be more likely to maintain abstinence and to decrease the frequency of related-risk behaviors relative to CTL participants. The long-term goal of this study is to develop an effective intervention to prolong abstinence and decrease future HIV risk in girls ages 14-19.