A Multilevel HIV-Prevention Strategy for High-Risk Youth

描述（由申请人提供）：这个多地点项目为高危青少年提供了一个独特的多级艾滋病/性病预防策略测试。共有1600名12-16岁的非裔美国青少年将通过cbo在4个城市招募，其中两个在东北部（普罗维登斯和锡拉丘兹），两个在东南部（哥伦比亚和梅肯），参加这项预防艾滋病毒/性病的试验。青少年将完成一项ACASI管理的基线调查，以评估他们的态度、信仰和性行为，并提供尿液样本用于检测三种流行的性传播疾病。在基线评估之后，所有青少年将被随机分配接受“关注儿童艾滋病毒预防干预”或“一般健康促进控制”。随后，将对青少年进行纵向随访，并在6个月、12个月和18个月的随访中完成类似的评估。第二级干预包括通过当地大众媒体提供有针对性的艾滋病毒/性病预防信息。每个区域城市对中的一个城市将被随机分配接受艾滋病毒预防媒体宣传活动，而另一个城市将作为对照城市（没有媒体宣传活动）。因此，媒体信息将只针对每个地理区域两个城市中的一个的非裔美国青年。该媒体项目将传播具有文化敏感性和适龄性的艾滋病预防信息；这些项目将促进禁欲和降低风险的做法。在接受媒体宣传活动的两个城市和两个媒体控制城市，将对1200名非洲裔美国青年进行横断面调查，采用随机数字拨号电话采访，为期30个月，以确定艾滋病毒媒体宣传活动在社区范围内的影响。这一设计将对参加小组干预的青少年进行为期18个月的随访，以测试两种干预措施的联合效果和单独效果。此外，与非媒体控制城市的青少年相比，媒体运动预计将在社区范围内独立地提高青少年对艾滋病毒预防态度、信念和行为的接受程度。将采用因果模型方法来评估两个层次干预的效果，并确定通过媒体和同伴收到的支持信息的作用，这些信息预计将在青少年成熟时保持更安全的性行为。

DESCRIPTION (provided by applicant): This multisite project provides a unique test of a multilevel HIV/STD prevention strategy for high-risk youth. A total of 1600 African American adolescents, ages 12-16, will be recruited through CBOs in 4 cities, two in the Northeast (Providence and Syracuse) and two in the Southeast (Columbia and Macon), to participate in this HIV/STD prevention trial. Adolescents will complete a baseline ACASI administered survey to assess their attitudes, beliefs and sexual behaviors, and provide a urine specimen for detection of three prevalent STDs. Following baseline assessment, all adolescents will be randomly assigned to receive either the Focus on Kids HIV-prevention intervention or a General Health Promotion control. Subsequently, adolescents will be followed longitudinally and complete similar assessments at 6-, 12- and 18-months follow-up. The second level of intervention involves tailored HIV/STD prevention messages through local mass media. One city in each regional city-pair will be randomly assigned to receive the HIV prevention media campaign while the other city will serve as a control city (no media campaign). Thus, the media messages will be directed to African American youth in only one of the two cities in each geographic region. The media program will deliver HIV-prevention messages that are culturally sensitive and age appropriate; these programs will promote both abstinence and risk reduction practices. Cross-sectional surveys of 1200 African American youth using random-digit-dialing telephone interviews in the two cities that receive the media campaign and the two media control cities will be conducted over a 30-month period to determine the community-wide effects of the HIV media campaign. This design will enable a test of the joint and separate effects of the two interventions over an 18-month follow-up for the youth participating in the small-group interventions. In addition, the media campaign is predicted to independently enhance adolescents' adoption of HIV-preventive attitudes, beliefs and behaviors on a community-wide basis compared to youth in the non-media control cities. Causal modeling methodology will be employed to assess the effects of the two levels of intervention and to identify the role of supportive messages received through the media and from peers that are predicted to maintain safer sexual behavior as adolescents mature.