A Couple-Based Relationship Strengthening HIV Intervention for Young Parents

描述(由申请者提供)：这项研究旨在开发、实施和评估以夫妻为基础的创新型干预措施，以小组形式向年轻父母提供，旨在加强关系和降低艾滋病毒风险。很少有艾滋病毒预防干预措施将情感和关系因素纳入到降低风险中。利用依恋理论的指导框架和以情感为中心的治疗原则，我们将直接解决情感、亲密和关系功能的问题，以创建一个加强浪漫关系和减少艾滋病毒风险行为的干预。我们的干预将与现有的基于社区的育儿计划相结合。我们干预的最终目标是降低HIV/STD风险(合并率、伴侣数量、无保护的性行为)，加强关系，并改善为人父母的年轻异性伴侣的育儿能力。这项研究首先将包括干预措施的发展。这将通过由8-10名年轻育儿男女组成的4个焦点小组收集有关干预的内容、结构和实施情况的信息来实现。我们还将对临床医生、社会工作者和社区领导人进行8-10次关键线人访谈，以评估干预实施可能存在的障碍，以及有关干预结构的信息。我们将利用焦点小组和主要线人访谈的结果来制定和修改干预内容和交付材料。我们将对6对夫妇进行干预试点，采用严格的定性评估，然后对42对育儿夫妇进行小型试点随机对照试验，随机分为关系强化艾滋病预防干预组和积极对照组。我们将在基线、4个月和8个月时评估夫妇的性风险(并存、性伴侣数量、无保护性行为)和关系功能。我们还将评估干预的可行性、可接受性和忠诚度。

DESCRIPTION (provided by applicant): This study seeks to develop, implement and assess an innovative 15-session couple-based intervention to be delivered in a group format to young parents that aims to strengthen relationships and reduce HIV risk. Few HIV prevention interventions incorporate emotion and relationship factors into risk reduction. Using the guiding framework of Attachment Theory and the principles of Emotion Focused Therapy, we will directly address issues of emotion, intimacy, and relationship functioning to create an intervention that strengthens romantic relationships and reduces HIV risk behavior. Our intervention will be integrated with an existing community based parenting program. The ultimate goal of our intervention is to reduce HIV/STD risk (concurrency, number of partners, unprotected sex), strengthen relationships, and improve parenting among young parenting heterosexual couples. The study will first consist of the development of the intervention. This will be achieved by conducting 4 focus groups of 8-10 young parenting men and women to gather information about the content, structure and implementation of the intervention. We will also conduct 8-10 key informant interviews of clinicians, social workers, and community leaders to assess possible barriers to intervention implementation, as well as information about intervention structure. We will use the results from the focus groups and key informant interviews to develop and modify intervention content and delivery materials. We will conduct a pilot of the intervention with six couples employing rigorous qualitative evaluation before conducting a small pilot randomized controlled trial of 42 parenting couples randomized to either the relationship strengthening HIV prevention intervention or an active control. We will assess couples at baseline, 4-months, and 8-months on sexual risk (concurrency, number of sex partners, unprotected sex) and relationship functioning. We will also assess the feasibility, acceptability and fidelity of the intervention.