A Multilevel HIV-Prevention Strategy for High-Risk Youth

描述（由申请人提供）：这个多地点项目提供了一个独特的测试的多层次艾滋病毒/性病预防战略的高危青年。 将通过4个城市的社区组织招募1600名12-16岁的非洲裔美国青少年，其中两个在东北部（普罗维登斯和锡拉丘兹），两个在东南部（哥伦比亚和梅肯），参加这项艾滋病毒/性病预防试验。 青少年将完成ACASI管理的基线调查，以评估他们的态度，信仰和性行为，并提供尿液样本检测三种流行的性病。 基线评估后，所有青少年将被随机分配接受关注儿童艾滋病毒预防干预或一般健康促进控制。随后，将对青少年进行纵向随访，并在6个月、12个月和18个月随访时完成类似评估。 第二个层次的干预措施是通过当地大众媒体提供有针对性的艾滋病毒/性传播疾病预防信息。 每个区域城市对中的一个城市将被随机指定接受艾滋病毒预防媒体宣传活动，另一个城市将作为对照城市（不开展媒体宣传活动）。 因此，媒体信息将只针对每个地理区域两个城市中的一个城市的非裔美国青年。媒体方案将提供对文化敏感和适合年龄的艾滋病毒预防信息;这些方案将促进禁欲和减少风险的做法。 在接受媒体宣传的两个城市和两个媒体控制城市，将在30个月内对1 200名非洲裔美国青年进行横断面调查，使用随机数字拨号电话访谈，以确定艾滋病毒媒体宣传对整个社区的影响。 这一设计将能够在18个月的后续行动中对参与小组干预的青年进行两种干预的联合和单独效果的测试。 此外，媒体宣传活动预计独立地提高青少年的艾滋病毒预防的态度，信念和行为的基础上，在整个社区的青年相比，在非媒体控制的城市。 因果关系建模方法将被用来评估两个层次的干预的效果，并确定通过媒体和同龄人，预计将保持安全的性行为，作为青少年成熟的支持信息的作用。

DESCRIPTION (provided by applicant): This multisite project provides a unique test of a multilevel HIV/STD prevention strategy for high-risk youth. A total of 1600 African American adolescents, ages 12-16, will be recruited through CBOs in 4 cities, two in the Northeast (Providence and Syracuse) and two in the Southeast (Columbia and Macon), to participate in this HIV/STD prevention trial. Adolescents will complete a baseline ACASI administered survey to assess their attitudes, beliefs and sexual behaviors, and provide a urine specimen for detection of three prevalent STDs. Following baseline assessment, all adolescents will be randomly assigned to receive either the Focus on Kids HIV-prevention intervention or a General Health Promotion control. Subsequently, adolescents will be followed longitudinally and complete similar assessments at 6-, 12- and 18-months follow-up. The second level of intervention involves tailored HIV/STD prevention messages through local mass media. One city in each regional city-pair will be randomly assigned to receive the HIV prevention media campaign while the other city will serve as a control city (no media campaign). Thus, the media messages will be directed to African American youth in only one of the two cities in each geographic region. The media program will deliver HIV-prevention messages that are culturally sensitive and age appropriate; these programs will promote both abstinence and risk reduction practices. Cross-sectional surveys of 1200 African American youth using random-digit-dialing telephone interviews in the two cities that receive the media campaign and the two media control cities will be conducted over a 30-month period to determine the community-wide effects of the HIV media campaign. This design will enable a test of the joint and separate effects of the two interventions over an 18-month follow-up for the youth participating in the small-group interventions. In addition, the media campaign is predicted to independently enhance adolescents' adoption of HIV-preventive attitudes, beliefs and behaviors on a community-wide basis compared to youth in the non-media control cities. Causal modeling methodology will be employed to assess the effects of the two levels of intervention and to identify the role of supportive messages received through the media and from peers that are predicted to maintain safer sexual behavior as adolescents mature.