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

描述(申请人提供)：在南非，有500万人携带艾滋病毒，其中包括许多青少年。流行率在整个南非都在上升，最严重的是西开普省，也就是我们建议进行研究的地点。然而，通过国家运动、大众媒体和学校减少南非青年感染艾滋病毒的努力收效甚微。南非的青少年预防方案一般没有家长的参与，尽管家长有可能通过沟通、监督和参与来预防青少年的性风险。我们建议试行一项基于工作场所的多时段计划，以帮助父母学习如何在养育性健康的年轻人方面发挥积极作用。我们将在文化上调整我们由美国国立卫生研究院资助的、基于工作场所的育儿计划，对话父母，健康青少年，用于南非。这项计划在改善父母与青少年之间有关性行为的沟通方面产生了实质性的效果，这种效果一直持续到9个月的跟踪调查；令人惊讶的是，在即时调查和3个月和9个月的跟踪调查之间，一些效果变得更强。这样的交流有可能调解更长期的性行为结果。工作地点的设置对父母来说很方便，对南非雇主来说也是可持续的。虽然我们计划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相关的态度和行为。由于受到耻辱，南非成年人往往不愿参加艾滋病毒预防计划，但以青少年为重点的计划可能会吸引父母，促进两代人的健康。我们的具体目标是：(1)使美国为青少年父母开发的基于工作现场的计划适应南非的背景；(2)检查基于工作地点的计划是否改善了亲子关系，包括父母和青少年所认为的一般亲子沟通和关于性健康和降低艾滋病毒风险的沟通；(3)探索计划对父母艾滋病毒检测和性行为的影响；以及(4)探索程序对理论上重要的行为变化的心理社会中介的影响(例如，拒绝性行为和使用避孕套的更高自我效能感，以及更多意识到无保护措施的性行为的缺点)。拟议的研究是一个独特的机会，可以调整和试行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的健康。 公共卫生相关性：在南非，青少年艾滋病毒流行率很高。目前南非青年预防艾滋病毒的努力收效甚微。我们建议调整和试行一个基于工作场所的多时段计划，以帮助SA父母促进健康的青春期性发展。该项目将基于我们成功的NIH资助的美国工作场所项目，该项目对亲子关于性的交流产生了重大影响。

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.