A Parent and Adolescent HIV/STD Risk Reduction Program

DESCRIPTION (provided by applicant): Minority group inner-city adolescents are at high risk for HIV/STDs. Several theory-based preventive interventions for adolescents have been tested, but the magnitude of their effects is small. While researchers have noted the importance of using a socio-ecological framework and emphasized the links between family context/characteristics and adolescent sexual risk behavior, few family-based HIV/STD interventions for teens have been evaluated. This proposal is for a 3-year exploratory/ developmental study involving a partnership between our Preventive Intervention Research Center and Planned Parenthood of New York City (PPNYC). Its goal is to apply an iterative approach that will support the early phases of development and evaluation of a family-based HIV/STD prevention program for 14-17 year old sexually experienced adolescents. This work is preparation for submitting an R01 in which we will conduct a full scale two-group intent-to-treat randomized controlled trial. The proposed family-based intervention has 2 components:1) "Let's Talk," an adaptation of a successful HIV/STD prevention program for inner-city adolescents, is a 13-session paid prevention program in which teens learn about safer sex behavior. Goals include helping teens to understand how gender and relationships norms influence sexual risk, and include sessions on talking to parents. In a 6-week internship, teens then develop and present a workshop of their own to educate their parents about teen sexual relationships and how youth want parents to talk to them about sex;and 2) a series of 4 skill-based peer educational workshops that help parents communicate more comfortably and effectively about sexuality with adolescents. They are conducted by PPNYC's Adult Role Models (ARMs), who are community parents trained as peer educators. We will involve the target community in this endeavor by first conducting focus groups with 20 adolescents and their parents to obtain input on the proposed program content and on possible strategies to recruit and retain families in the research and intervention. We then will conduct a pilot "run-through" of each of the two parts of the intervention with these families to evaluate the feasibility and acceptability of the intervention to participants. Last, we will recruit and randomize 66 families into a small-scale RCT of the revised program that will compare risk reduction effects of Let's Talk combined with the added parent workshops to those obtained when the adolescent intervention is given alone. This will allow us to: 1) test proposed recruitment procedures, 2) pre-test study measures, and 3) obtain the preliminary data needed as a pre-requisite to estimating effect sizes for a full-scale study. Public Health Relevance Adolescents are at high risk for HIV/AIDS and that risk is increasing in minority teens. Some previous risk reduction programs have been shown to be moderately effective, but the magnitude and longevity of effects has been disappointing. The study will provide information on risk and protective factors associated with adolescent sexual behavior and ways of intervening with adolescents and parents to prevent or reduce risk.