PS07-003, Minority HIV/AIDS Research Initiative (MARI)

描述(由申请人提供)： 这项拟议的研究的总体目标是减少居住在艾滋病毒中心迈阿密-戴德县的西班牙裔和非拉美裔青年之间感染艾滋病毒的种族差异。这一目标将通过两个目标来实现：目标1是开发和制作一个为期一个半月的有效艾滋病毒预防干预措施的简化版本，题为“家庭联盟”；第二个目标是评价简化版本的“家庭联盟”加艾滋病毒预防学校课程的效果，即在预防吸毒和无保护的性行为这两个艾滋病毒感染风险因素方面，与艾滋病毒预防学校课程照常治疗相比，只进行照常治疗。《家庭联盟》旨在通过以下方式防止吸毒和无保护的性行为：(A)增强家庭功能；(B)加强父母对同伴活动的监测；(C)影响青少年对吸毒和不安全性行为的社会认知机制。对240名拉美裔9年级青少年及其主要照顾者的抽样调查将被随机分成两种情况之一：家庭联合方案加艾滋病毒学校课程照常治疗(下称家庭联合方案)，或仅艾滋病毒预防学校课程照常治疗。两项研究证明了9至12个月强化版的Familias Unidas的效果。在第一项研究中，与非干预控制条件相比，Familias Unidas被证明在提高家庭功能方面是有效的。在第二项研究中，与两种注意力控制条件相比，Familias Unidas在预防药物使用和不安全性行为方面被发现是有效的。将使用分层线性模型(HLM)来检验：(1)随着时间的推移，家庭联盟在预防青少年吸毒方面将比通常的艾滋病毒预防学校课程治疗更有效；(2)随着时间的推移，家庭联盟在预防青少年无保护措施的性行为方面将比通常的艾滋病毒预防学校课程治疗更有效。此外，HLM将用于确定(H1a)家庭联盟对药物使用的影响是否将部分地通过(1)家庭功能；(2)父母对同伴的监测；(3)关于药物使用的社会认知机制；以及(H2a)家庭联盟对无保护的性行为的影响将部分地通过(1)家庭功能；(2)父母对同伴的监测；(3)关于无保护性行为的社会认知机制；和(4)药物使用。这项拟议研究的目标是减少拉美裔人群中艾滋病毒感染的健康差距。预期从这项研究中获得的知识将有助于制定干预措施，以减少拉美裔青少年的药物使用、无保护的性行为和艾滋病毒。

DESCRIPTION (provided by applicant): The proposed study's overarching goal is to reduce the ethnic disparities in HIV infection between Hispanic and non-Hispanic youth living in Miami-Dade County, an HIV epicenter. This goal will be accomplished by two aims: AIM 1 is to develop and manualize a one-and-a-half- month streamlined version of an efficacious HIV preventive intervention entitled Familias Unidas; and AIM II is to evaluate the efficacy of the streamlined version of Familias Unidas plus an HIV Prevention School CurriculumTreatment as Usual, relative to the HIV Prevention School Curriculum Treatment as Usual only, in preventing drug use and unprotected sexual behavior, two risk factors for HIV infection. Familias Unidas aims to prevent drug use and unprotected sexual behavior by (a) increasing family functioning, (b) increasing parental monitoring of peer activities, and (c) influencing adolescent social cognitive mechanisms regarding drug use and unsafe sexual behavior. A sample of 240 Hispanic 9th grade adolescents and their primary caregivers will be randomized to one of two conditions: Familias Unidas plus the HIV School Curriculum Treatment as Usual (hereafter refererred to as Familias Unidas) or the HIV Prevention School Curriculum Treatment as Usual only. Two studies have demonstrated the efficacy of an intensive, 9 to 12 month version of Familias Unidas. In the first study, Familias Unidas was shown to be efficacious relative to a no- intervention control condition in increasing family functioning. In the second study, Familias Unidas was found to be efficacious in preventing drug use and unsafe sexual behavior relative to two attention control conditions. Hierarchical Linear Modeling (HLM) will be used to test: (H1) Familias Unidas will be more efficacious than the HIV Prevention School Curriculum Treatment as Usual in preventing adolescent drug use over time and (H2) Familias Unidas will be more efficacious than the HIV Prevention School Curriculum Treatment as Usual in preventing adolescent unprotected sexual behavior over time. Additionally HLM will be used to determine whether (H1a) the effect of Familias Unidas on drug use will be partially mediated by (1) family functioning; (2) parental monitoring of peers; and (3) social cognitive mechanisms regarding drug use; and (H2a) the effect of Familias Unidas on unprotected sexual behavior will be partially mediated by (1) family functioning; (2) parental monitoring of peers; (3) social cognitive mechanisms regarding unprotected sex; and (4) drug use. The objective of the proposed study is to reduce HIV contraction health disparities in Hispanic populations. The knowledge expected to be gained from this study will aid in the development of interventions to reduce drug use, unprotected sexual behavior, and HIV in Hispanic adolescents.