A South African Pilot Worksite Parenting Program to Prevent HIV Among Adolescents

描述（由申请人提供）：在南非，超过500万人，包括许多青少年，感染艾滋病毒。在整个南非，流行率正在上升，在我们拟议研究的地点西开普省最为急剧。然而，通过全国运动、大众媒体和学校减少南非青年艾滋病毒感染的努力成效有限。南非的青少年预防计划一般没有父母参与，尽管父母有可能通过沟通、监督和参与来预防青少年的性风险。我们建议试点测试一个多阶段的工作场所为基础的计划，以帮助父母学习如何采取积极的作用，在养育性健康的青年。我们将在文化上调整我们的NIH资助的，美国工作场所为基础的育儿计划，谈话的父母，健康的青少年，在南非使用。该计划对改善父母与青少年关于性的沟通产生了实质性影响，这种影响一直持续到9个月的随访调查;引人注目的是，一些影响在立即随访以及3个月和9个月的随访之间变得更强。这种沟通有可能调解长期的性行为结果。工作场所的环境对父母来说很方便，对南非雇主来说也是可持续的。虽然我们方案的主要目标是通过父母接触青少年，但我们预计它也将影响父母与艾滋病毒有关的态度和行为。南非成年人往往不愿意参加艾滋病毒预防计划，由于耻辱，但一个计划，重点是青少年可能会吸引父母，促进两代人的健康。我们的具体目标是：（1）根据南非的情况调整美国为青少年父母制定的基于工作场所的方案;（2）检查南非青少年父母基于工作场所的方案是否改善了父母与子女的关系，包括父母和青少年认为的一般父母与子女的沟通以及关于性健康和减少艾滋病毒风险的沟通;（3）探索计划对父母的艾滋病毒检测和性行为的影响;（4）探索计划对理论上重要的行为改变的心理社会中介的影响（例如，拒绝性行为和使用避孕套的自我效能更高，以及更明显的无保护性行为的不利因素）。拟议的研究是一个独特的机会，可以调整和试点测试一种创新的艾滋病毒预防干预措施，在文化上可接受和可持续的环境中促进家庭健康。 公共卫生相关性：在南非（SA），青少年艾滋病毒感染率很高。目前南非青年艾滋病毒预防工作取得的成功有限。我们建议调整和试点测试多会话工作场所为基础的计划，以帮助SA父母促进健康的青少年性发育。该计划将基于我们成功的NIH资助的美国工作场所计划，该计划对亲子关于性的沟通产生了重大影响。

DESCRIPTION (provided by applicant): In South Africa, >5 million people, including many adolescents, are living with HIV. Prevalence is increasing throughout South Africa, most precipitously in the Western Cape, the site of our proposed study. However, efforts to reduce HIV among South African youth through national campaigns, mass media, and schools have had limited success. South African youth prevention programs have generally not involved parents, though parents have the potential to prevent adolescent sexual risk through communication, supervision, and involvement. We propose to pilot test a multisession worksite-based program to help parents learn how to take an active role in rearing sexually healthy youth. We will culturally adapt our NIH-funded, US worksite-based parenting program, Talking Parents, Healthy Teens, for use in South Africa. This program had substantial effects on improving parent-adolescent communication about sex that have persisted to the 9- month follow-up survey; strikingly, some effects became stronger in between the immediate and the 3- and 9- month follow-ups. Such communication has the potential to mediate longer-term sexual behavior outcomes. The worksite setting is convenient for parents and sustainable for South African employers. Although our program's main goal will be to reach adolescents through parents, we expect that it will also influence parents' HIV-related attitudes and behaviors. South African adults tend to be reluctant to attend HIV prevention programs due to stigma, but a program focused on adolescents may attract parents, promoting the health of both generations. Our specific aims are to: (1) Adapt a US-developed worksite-based program for parents of adolescents to the South African context; (2) Examine whether a worksite-based program for parents of adolescents in South Africa improves the parent-child relationship, including general parent-child communication and communication about sexual health and HIV risk-reduction, as perceived by parents and adolescents; (3) Explore program effects on parents' HIV testing and sexual behaviors; and (4) Explore program effects on theoretically important psychosocial mediators of behavior change (e.g., greater self- efficacy for refusing sex and using condoms, and more perceived disadvantages of unprotected sex). The proposed research is a unique opportunity to adapt and pilot test an innovative HIV prevention intervention that promotes the health of families in a culturally acceptable and sustainable setting. PUBLIC HEALTH RELEVANCE: In South Africa (SA), adolescent HIV prevalence is high. Current SA youth HIV prevention efforts have had limited success. We propose to adapt and pilot test a multisession worksite-based program to help SA parents promote healthy adolescent sexual development. The program will be based on our successful NIH- funded US worksite program, which had substantial effects on parent-child communication about sex.