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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