An HIV Risk Reduction Intervention for African-American Female Teens

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An HIV Risk Reduction Intervention for African-American Female Teens Powered By Docstoc
					  A Gender- and Culturally-Appropriate
 HIV Prevention Maintenance Intervention
for African American Adolescent Females:
      A Randomized Controlled Trial


    Ralph DiClemente PhD, Gina Wingood ScD, MPH
                and Eve Rose, MSPH

 Rollins School of Public Health at Emory University
           Emory Center for AIDS Research
                     _________
                      Theory of Gender and Power
Structure of Labor     Primary HIV Intervention
                        - Age
                    - Education
               - Employment status
                 - Insurance status
                      - Income                  Structure of Power
            - Number of dependents
             - Living arrangements
               - Economic hardship                                                  Primary Outcome
            - Neighborhood income                        - Sexual abuse
                 - Social cohesion                      - Physical abuse
              - Partner pay inequity                  - Sexual harassment
                                                    - Traumatic life events        -Consistent Condom
Structure of Cathexis                     - Exposure to sexually degrading media           Use
                                                   - Racial discrimination
                                                  - Partner communication
                 - Pregnancy desire
                                             - Partner resistance to condom use
                   - Gender norms
                                                - Partner’s drug/alcohol use
                     - Spirituality
                                                - Women’s drug/alcohol use
               - Partner availability
                     - Partner age
               - Relationship length
               - Relationship status
           - Relationship commitment
            - Relationship satisfaction
                     - HIV stigma
               - Sexual dysfunction
HIV Prevention Maintenance Intervention
                                          Behavioral Decision Model
                                                                                 OPENING
                                                                         So Are You Seeing Anyone?


           Has No Boyfriend                                                                    Has a Boyfriend
              SCRIPT A
      Do you need more condoms?


  NO                           YES                 Using Condoms                       Wanted to Use Condoms                    Practicing Abstinence
SCRIPT D                     SCRIPT C                SCRIPT B                                 SCRIPT D                               SCRIPT K
                                             Do you need more condoms?               Why did you not use condoms?              Were you able to discuss
                                                                                                                                with your boyfriend?


                                          NO                         YES                              Attitude            NO                             YES
                                        SCRIPT D                   SCRIPT C                          SCRIPT F           SCRIPT L                    How did your
                                                                                                                                                  boyfriend respond?

                                                                                                       Skills
                                                                                                     SCRIPT G                        Aggressive                        Supportive
                                                                                                                                     SCRIPT M                          SCRIPT N


                                                                                                     Accessibility
                                                                                                     SCRIPT H



                                                                                              Relationship Barriers
                                                                                                    SCRIPT I



                                                                                              Engaged, Married or
                                                                                                Living Together
                                                                                              SCRIPTS J-1; J-2; J-3


                                                                                           Do you need more condoms?




                                                                                              NO               YES
                                                                                            SCRIPT D         SCRIPT C
                         Primary Aims
To evaluate the efficacy of the HIV Prevention Maintenance Intervention among
   African-American female teens over a 18-month follow-up period to
   enhance:

 Safer sex behaviors
       Consistent condom use (Primary Outcome)
       Condom use at most recent sexual intercourse
       Proportion of condom-protected sexual episodes
       Number of unprotected vaginal sex episodes

 Psychosocial mediators of safer sex behavior (Secondary Outcomes)
       Communication frequency
       Condom attitudes
       Condom use self-efficacy
       HIV knowledge
       Ethnic pride
       Condom use skills
Areas for Collaboration:
1. Integrating biological markers to complement self-reported
   behavioral outcomes.

2. Assessing the reliability and validity of psychosocial mediators
   across a spectrum of risk-behaviors. (e.g. substance use, exercise)

3. Potential sub studies examining different modes of data collection
   (e.g. ACASI, CAPI, SAS, interviews) for targeted behavioral
   outcomes across a spectrum of risk-behaviors.

4. Developing explanatory and predictive models of differential
   reporting of target risk behaviors.

5. And many, many more!!!

				
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posted:4/12/2013
language:English
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