An HIV Risk Reduction Intervention for African-American Female Teens by yurtgc548


									  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
                                                                         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?

                                                                                                     SCRIPT G                        Aggressive                        Supportive
                                                                                                                                     SCRIPT M                          SCRIPT N

                                                                                                     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

 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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