Partner-Specific HIV Risk Reduction for Drug Using Incarcerated Adolescents

描述（由申请人提供）：被监禁的青少年代表了与危险的性行为相关的健康后果的高风险群体。他们报告说，与未被拘留的青少年同龄人相比，他们更多地参与了一些性危险行为（包括与吸毒相结合的性危险行为），性传播疾病（性病）和怀孕的发病率更高。青少年，包括被监禁的青少年，报告与有关系的伴侣（主要伴侣）和可能有友谊或只有熟人的伴侣（非主要伴侣）发生性行为。非主要性伴侣比主要性伴侣更常使用避孕套，与性风险相关的药物使用似乎也因伴侣类型而异。该研究项目的长期目标是通过开发和确立干预措施的有效性，包括通过提供相关信息、增强预防动机、学习和实践更安全的性行为技能，特别关注针对伴侣的决策和行为，从而降低滥用非注射药物的刑事司法系统中的青少年的艾滋病毒风险行为。以及与药物使用有关的性决策。此外，我们寻求通过干预措施减少艾滋病毒风险行为的作用机制的知识。在目前的应用中，我们建议为报告药物滥用的被监禁青少年开发和试点测试一种针对伴侣的降低艾滋病毒风险的干预措施。在研究的第一阶段，我们将对20名被监禁的青少年进行试点干预，并就他们的经历和对干预的看法征求他们的反馈。在改进干预措施后，我们将进行一项小型随机试验（n=60），以检验相对于健康生活方式心理教育干预（HLS）的干预效果。我们预计，相对于CBT-SA，随机分配到干预条件的参与者将有较低水平的与性相关的艾滋病毒风险行为和与性风险相关的药物使用。我们还将研究干预产生减少健康风险行为的潜在机制。如果发现是有效的，这种干预将有助于减少吸毒的被监禁青少年感染艾滋病毒。

DESCRIPTION (provided by applicant): Incarcerated adolescents represent a group at high risk for health consequences associated with risky sexual behaviors. They report greater participation in a number of sexual risk behaviors (including sexual risk in conjunction with drug use), higher rates of sexually transmitted diseases (STDs) and pregnancy than their non-detained adolescent peers. Adolescents, including incarcerated teens, report sexual behavior both with partners with whom there is a relationship (main partners) and partners with whom there may be a friendship or only an acquaintance (non-main partners). Condom use is more common with non-main than main sex partners and substance use in conjunction with sexual risk also appears to vary by partner type. The long-term objective of this research program is to reduce HIV risk behavior among adolescents involved in the criminal justice system who abuse non-injection drugs by developing and establishing the efficacy of an intervention that includes a specific focus on partner-specific decision-making and behavior through presenting relevant information, enhancement of prevention motivation, opportunities to learn and -practice safer sex behavioral skills, and sexual decision-making in conjunction with substance use. Furthermore, we seek to advance knowledge of the mechanisms of action by which interventions reduce HIV risk behavior. In the present application, we propose to develop and pilot test a partner-specific HIV risk reduction intervention for incarcerated adolescents who report substance abuse. In the first phase of the study we will pilot the intervention with 20 incarcerated adolescents and elicit their feedback regarding their experiences and perceptions of the intervention. Following refinement of the intervention, we will conduct a small randomized trial (n=60) to examine the efficacy of the intervention relative to a healthy lifestyles psychoeducation intervention (HLS). We expect that, relative to CBT-SA), participants randomized to the intervention condition will have lower levels of sex-related HIV risk behavior and of substance use in conjunction with sexual risk. We will also examine the potential mechanisms by which the intervention produces a reduction in health risk behaviors. If found to be efficacious, this intervention will help to reduce the acquisition of HIV among substance using incarcerated adolescents.