Online education for high school students to reduce HIV and related sexual behavior risk

项目摘要/摘要 人类免疫缺陷病毒(HIV)和性传播感染(STI)给年轻人带来了巨大的负担14- 18岁在美国(美国)。青少年感染艾滋病毒/性传播疾病的风险增加是由于 部分原因是美国的性健康教育不足(即“性教育”)。一些年轻人缺乏获得准确和 关于性和艾滋病毒/性传播感染预防的相关信息，并转向性露骨媒体(SEM)了解如何 去做爱。主流扫描电子显微镜经常描绘高危性行为，包括无避孕套的性行为和具有侵略性的性行为 没有同意谈判。因此，2020年版的K-12年性教育国家性教育标准 建议美国学校对学生进行有关扫描电子显微镜的教育。尽管如此，没有基于证据的扫描电子显微镜教育 程序是存在的。该项目的合作绩效指标测试了针对青少年的SEM教育计划，但他们现有的 节目要么是专门为性少数族裔男性青年设计的，要么是专注于扫描电子显微镜而不是 内置艾滋病毒/性传播感染教育。本项目将通过两个先前的扫描电子显微镜教育的要素提供信息 计划并制作一个新的、基于理论的在线SEM教育模块，供所有高中生使用 作为学校性教育的一部分。新的在线模块将专注于扫描电子显微镜和 预防艾滋病毒/性传播感染，并纳入关于性同意和约会暴力的教育。具体来说，我们的目标是 1形成性研究和干预发展过程将：(1)包括深入的形成性访谈 结构管理教育的目标最终用户和管理人员，包括40名青年(14-18岁)、10所学校- 以健康教育者为基础，从我们的伙伴学校系统招聘10名学校管理人员；(2)使用 访谈结果指导我们从以前的SEM教育计划中选择内容元素，并定制 针对新人群和设置的内容；以及(3)使用Delphi改进模块内容选择和视觉效果 与5名国家认可的性教育和扫描电子显微镜专家进行合作。对于目标2，我们将试行测试其可行性和 14-18岁青少年(N=40)在线结构方程模型的可接受性 伙伴学校系统。青年将在家中自行管理SEM模块，并完成前后测试 调查。20人中的随机一组也将就干预内容和过程接受采访。主要 结果与可行性和可接受性有关，包括(A)用户满意度；(B)干预保持； 和(C)研究保留。我们还将通过比较治疗前后的疗效来产生初步的疗效估计。 关于行为结果的测试分数(避孕套使用、艾滋病毒/性传播感染检测、约会暴力)、行为意图 结果(使用避孕套的意图)和知识结果(艾滋病毒/性传播感染相关知识、扫描电子显微镜相关知识 知识)。根据美国国立卫生研究院艾滋病毒相关研究战略计划中规定的优先事项，拟议的 研究构成了性健康框架内一种新的创新的艾滋病毒预防方法 (例如，性教育)，这将有助于与社区合作伙伴(即，学校系统)建立联系，以防止 青少年中新的艾滋病毒感染。

PROJECT SUMMARY/ABSTRACT Human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) substantially burden youth 14– 18 years of age in the United States (US). Heightened risk for HIV/STI acquisition among adolescents is due in part to inadequate sexual health education (i.e., “sex ed”) in the US. Some youth lack access to accurate and relevant information about sex and HIV/STI prevention and turn to sexually explicit media (SEM) to learn how to have sex. Mainstream SEM often depicts high-risk sex including condomless sex and aggressive sex with no consent negotiation. Consequently, the 2020 version of the National Sex Education Standards for K-12 recommends that US schools educate students about SEM. Despite this, no evidence-based SEM education programs exist. The Co-PIs of this project have tested SEM education programs for youth, but their existing programs were either designed exclusively for sexual minority male youth, or focused on SEM but without HIV/STI education built in. The present project will be informed by elements of both prior SEM education programs and produce a new, theory-based, online SEM education module for all high school youth to be used as part of school-based sex ed. The new online module will focus on the unrealistic sex depicted in SEM and HIV/STI prevention and incorporate education about sexual consent and dating violence. Specifically, our Aim 1 formative research and intervention development process will: (1) Include in-depth formative interviews with the intended end-users and administrators of the SEM education, including 40 youth (ages 14-18), 10 school- based health educators, and 10 school administrators recruited from our partner school systems; (2) Use interview results to guide selection of content elements from our prior SEM education programs and tailor the content for the new population and setting; and (3) Refine module content choices and visuals using a Delphi process with 5 nationally-recognized sex ed and SEM experts. For Aim 2, we will pilot test the feasibility and acceptability of the online SEM module with a sample of 14-18 year old youth (N=40) recruited from our partner school systems. Youth will self-administer the SEM module at home and complete pre- and post-test surveys. A random subset of 20 will also be interviewed about intervention content and process. Primary outcomes are related to feasibility and acceptability including (a) user satisfaction; (b) intervention retention; and (c) research retention. We will also generate preliminary estimates of efficacy by comparing pre- and post- test scores on behavioral outcomes (condom use, HIV/STI testing, dating violence), behavioral intention outcomes (intentions to use condoms), and knowledge outcomes (HIV/STI-related knowledge, SEM-related knowledge). Consistent with stated priorities in the NIH Strategic Plan for HIV-Related Research, the proposed research constitutes a new and innovative HIV prevention approach within a sexual health wellness framework (i.e., sex ed) that will help to build connections with community-based partners (i.e., school systems) to prevent new HIV infections among adolescents.