Factors Associated with Teens' Non-Responsiveness to HIV Intervention

描述（由申请人提供）：我致力于艾滋病/性病预防研究。为了成为一名完全独立的研究者，我正在申请NIMH指导研究科学家发展奖（K01），以加强我在弱势青少年艾滋病/性病预防研究方面的培训和研究。为了实现这一目标，我将参加课程、讲习班、研讨会和指导会议，以提高我现有的知识和研究技能，并获得针对青少年艾滋病毒/性病预防项目的设计、实施、适应和评估的新知识和研究技能。在我的导师（主要导师：R. DiClemente，共同导师：G. Wingood和S. Kalichman）的指导下，我提出的研究计划将在乔治亚州亚特兰大的埃默里大学和富尔顿县卫生与保健部进行，可以以实质性和实际的方式为青少年艾滋病毒预防科学领域做出重大贡献。研究1是一项混合方法研究，是根据我的共同导师（Kalichman博士）的研究进行的，旨在：1)确定暴露于艾滋病毒干预下不改变安全套使用的非裔美国女性青少年的比例，以及2)描述与艾滋病毒干预后“未能改变”安全套使用相关的个人，行为和社会心理因素。研究1的数据直接用于研究2。在研究2中，我将对我的导师（DiClemente博士和Wingood博士）开发的现有有效的性别和文化量身定制的青少年艾滋病毒干预措施进行调整，以提高其在参与艾滋病毒干预后未改变安全套使用方式的非裔美国女性青少年中推广安全套使用的功效。适应过程将由一个顺序和系统的适应模型指导。温伍德和迪克莱门特，以促进适应过程。研究2也是一项针对无反应青少年亚组的适应性SiHLE干预有效性的试点试验。这两项研究的结果将为我们理解青少年性风险行为和制定有效的艾滋病干预措施做出重要贡献，这些干预措施可以改变难以改变的青少年感染艾滋病的风险轨迹。

DESCRIPTION (provided by applicant): I am committed to a career in HIV/STD prevention research. To become a fully independent investigator, I am applying for the NIMH Mentored Research Scientist Development Award (K01) to augment my training and research in HIV/STD prevention research for vulnerable adolescents. Towards this goal, I will participate in courses, workshops, seminars, and mentoring meetings to enhance my existing knowledge and research skills, and acquire new knowledge and research skills specific to the design, implementation, adaptation and evaluation of HIV/STD prevention programs for adolescents. My proposed research plan, to be conducted at Emory University and the Fulton County Department of Health and Wellness, in Atlanta, Georgia, with the guidance of my Mentors (Primary Mentor: R. DiClemente, Co-Mentors: G. Wingood and S. Kalichman), can contribute significantly to the field of adolescent HIV prevention science in substantive and practical ways. Study 1 is a mixed-method study patterned after research conducted by my Co-Mentor (Dr. Kalichman), designed to: 1) identify the proportion of African-American female adolescents exposed to an HIV intervention that do not change their condom use, and 2) describe the personal, behavioral and psychosocial factors associated with "failure to change" condom use following an HIV intervention. Data from Study 1 directly informs Study 2. In Study 2, I will adapt an existing effective gender and culturally tailored adolescent HIV intervention developed by my Mentors (Dr. DiClemente, & Dr. Wingood), to enhance its efficacy for promoting condom use among African-American female adolescents who did not change their condom use after participating in an HIV intervention. The adaptation process will be guided by a sequential and systematic adaptation model, developed by Drs. Wingood and DiClemente, to facilitate the adaptation process. Study 2 is also a pilot test of the effectiveness of the adapted SiHLE intervention for this subgroup of non-responsive adolescents. The findings from the two studies in this application will make significant contributions to our understanding of adolescent sexual risk behavior and the development of effective HIV interventions which could modify the risk trajectory for HIV acquisition in hard-to-change adolescents. PUBLIC HEALTH RELEVANCE: HIV prevention interventions tailored for African-American adolescent females who are non-responsive to sexual behavior risk-reduction interventions are urgently needed as these individuals are at especially high- risk for contracting HIV/STDs. The adoption of the adapted SiHLE intervention by other health departments and community-based AIDS service organizations has the potential to reach a broad audience and a population substantially impacted by the HIV epidemic.