Initiation of drug use and participation in HIV-risk behaviors such as multiple sexual partners, unprotected sexual intercourse, and intercourse with IV drug users, are all too common among giris with maltreatment histories. Studies consistently find that giris in the Child Welfare System (CWS) have disproportionately high rates of these problems that, in addition to increasing risk for negative long-term outcomes, have other costly sequelae such as drug addiction, eariy pregnancy, delinquency, and eariy mortality. In a prior prevention trial, we prevented eariy onset sexual intercourse and tobacco and marijuana initiation in pre-teen giris in the CWS. Although this intervention demonstrated efficacy with giris who were 11-years old (and who had not yet entered middle school), we know very little about how to prevent the more serious and costly HIV-risk and illicit drug use behaviors in CWS-involved giris during the high school years (age 14-17), a significantly riskier period in development for engagement in such behaviors. Moreover, our CWS partners have identified drug use, HIV-risk behaviors, and intergenerational involvement in the CWS as serious problems in need of solutions. Research Component 2 will extend our prior intervention work with CWS-involved giris to develop and test new intervention components specific to HIV-risk behaviors and drug use with high school aged giris with CWS involvement. Using a sample of 120 giris with CWS involvement, we will randomly assign half to a parent and giri skill-building and awareness intervention, and half to services-as-usual. The intervention will be comprised of weekly foster parent groups and weekly skills coaching sessions for giris and their families (16 sessions in total). Six ofthe sessions will be newly developed to focus specifically on education and refusal skills regarding drug use and HIV-risk behaviors. To expand and refine the intervention before initiating the RCT, we will conduct focus groups with a subsample of 16 late adolescent giris who experienced both childhood maltreatment and sexual intercourse prior to high school. Assessments measuring drug use, HIV-risk behaviors, and delinquency will be conducted at baseline, intervention termination (4-months), and 8- and 12-month follow-ups.
Children in the CWS are among the most disadvantaged individuals in America, with elevated drug use, delinquency, and HIV-risk behaviors. Evidence-based interventions for CWS-involved families are rarely implemented into routine CWS practice. The proposed Center would provide a national resource in drug abuse prevention research, with the ultimate goal of reducing drug use and related outcomes for CWS youth.
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