Preventing HIV/AIDS in Treatment-Resistant Drug-Abusing Youth

描述（由申请人提供）：青少年药物滥用者感染艾滋病毒/艾滋病的风险特别高。因此，药物滥用治疗为干预这一人群的艾滋病毒/艾滋病风险行为提供了一个绝佳的机会。不幸的是，在美国，很少有滥用或依赖毒品的年轻人接受治疗。这些未得到治疗的青年构成了青少年保健方面的巨大“治疗缺口”，使阳痿成为预防艾滋病毒/艾滋病的潜在重要途径。虽然少年司法制度是将吸毒青少年与治疗服务联系起来的一条重要途径，但其缺点在于，每年需要治疗的青少年中只有五分之一被法律制度逮捕。结果，大量需要治疗的青年没有通过最典型的进入系统的方式被发现。此外，大多数青少年药物滥用者缺乏治疗动机的特点大大降低了这些青少年接受治疗的可能性，这阻碍了法律系统或其他社会机构的授权。这些青少年代表了一个相当大的，迄今为止被忽视的治疗难以捉摸的青年群体。鉴于有效预防艾滋病毒/艾滋病感染和伴随的青少年药物滥用治疗要求我们首先成功地使这些青少年参与治疗，目前的建议提出了两个不同但相关的研究。研究1通过对140名家长的随机分配，评估了一种有前途的参与方法——社区强化训练与“照常参与”的效果。研究2将评估嵌入以家庭为基础的药物滥用治疗的艾滋病毒/艾滋病预防干预成功影响通过研究1成功参与的青少年的健康相关结果的效果。本研究通过检查HIV和家庭干预的组成部分如何在临床上相互作用，以及它们如何结合起来以增强其相对于青少年HIV/ aids风险行为的效力，进一步解决了一个重要的优先事项。了解家庭和艾滋病毒干预的核心机制如何协同工作，将为正在进行的改进和整合针对青少年吸毒和艾滋病毒/艾滋病风险行为的干预措施提供启发价值。

DESCRIPTION (provided by applicant): Adolescent drug abusers are particularly at high risk for HIV/AIDS infection. Therefore substance abuse treatment provides a prime opportunity for intervention on HIV/AIDS risk behaviors within this population. Unfortunately, very few youth with drug abuse or dependence in the United States receive treatment. This population of untreated youth represents a massive "treatment gap" in adolescent health care that renders impotent a potentially important avenue for preventing HIV/AIDS. While the juvenile justice system represents a prominent path linking drug-abusing adolescents with treatment services, its shortcoming lies in the fact that only one fifth of the adolescents who need treatment each year are apprehended by the legal system. As a result, large numbers of youth in need of treatment go undetected by the most typical entry way into the system. Moreover, the lack of motivation for treatment characterizing most adolescent drug abusers significantly decreases the likelihood these youth will enter treatment, barring mandates from the legal system or other social institutions. These adolescents represent a sizeable and, heretofore, overlooked population of treatment-elusive youth. Given that effective prevention of HIV/AIDS infection and concomitant adolescent substance abuse treatment require that we first successfully engage these youth in treatment, the current proposal puts forth two distinct, but related, studies. Study 1 evaluates, through random assignment of 140 parents, the efficacy of a promising engagement approach, Community Reinforcement Training, versus Engagement As Usual. Study 2 will evaluate the efficacy by which an HIV/AIDS preventive intervention, embedded in a family-based drug abuse treatment, successfully affects both health-related outcomes for youths successfully engaged through Study 1. This study further addresses an important priority by examining how the components of the HIV and family interventions interact clinically, and how they might be combined in ways that enhance their potency relative to adolescent HIV/AIDS-risk behaviors. Understanding how the core mechanisms of the family and HIV interventions work together will provide heuristic value by informing ongoing efforts to refine and integrate interventions for the drug use and HIV/AIDS risk behaviors of adolescents.