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

描述（由申请人提供）：在南非，有150万人感染艾滋病毒，其中包括许多青少年。整个南非的患病率都在上升，最急剧的是在西开普省，我们建议的研究地点。然而，通过全国运动、大众媒体和学校来减少南非青年中艾滋病毒的努力收效甚微。南非的青少年预防项目通常没有父母参与，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。我们建议试行一项以工作场所为基础的多阶段方案，以帮助父母学习如何在培养性健康青年方面发挥积极作用。我们将在文化上调整我们由美国国立卫生研究院资助的、以美国工作场所为基础的育儿项目——“会说话的父母，健康的青少年”，以便在南非使用。该项目在改善父母与青少年关于性的交流方面有实质性的效果，并持续到9个月的随访调查；引人注目的是，在第一时间和第3个月和第9个月的随访期间，一些效果变得更强。这种交流有可能调解长期的性行为结果。工作场所的设置方便父母和可持续的南非雇主。虽然我们项目的主要目标是通过父母接触青少年，但我们希望它也能影响父母对艾滋病毒的态度和行为。南非成年人往往不愿意参加艾滋病毒预防项目，因为这是一种耻辱，但一个以青少年为重点的项目可能会吸引父母，促进两代人的健康。我们的具体目标是：(1)将美国为青少年父母开发的基于工作场所的项目适应南非的情况；(2)研究南非的青少年父母工作场所方案是否改善了父母和青少年所认为的亲子关系，包括一般的亲子沟通以及关于性健康和减少艾滋病毒风险的沟通；(3)探讨项目对父母HIV检测和性行为的影响；(4)探索项目对行为改变的理论重要的社会心理中介的影响（例如，拒绝性行为和使用避孕套的更大的自我效能，以及更多未保护的性行为的缺点）。拟议的研究是一个独特的机会，可以在文化上可接受和可持续的环境中促进家庭健康的创新艾滋病毒预防干预措施进行调整和试点测试。

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.