The purpose of this application is to develop and evaluate the feasibility of an interactive, web-based HIV prevention curriculum for youth with intellectual disabilities (ID) (I.Q. approximately 55 through 70). A recent longitudinal study of male and female youth with disabilities reports that, by the time they were 18 or older (i.e., 18-21), 73% reported they had had sexual intercourse.1 Many youth with disabilities do not receive instruction on sexual health.2 This Phase I will focus on healthy relationship development and basic HIV knowledge. The Phase I program, "HIV Prevention for Youth with ID" will be tailored by age (11-14), gender, and sexual preference. Four content segments will be developed in Phase I prototype: 1) motivational segment for adolescents that normalizes sexuality and sexual health, a) healthy relationship development b) practices associated with abstinence, and c) transmission of HIV through high-risk body fluids. This project is consistent with the mission of the National Institute of Mental Health Division of AIDS Research (DAR), which supports proposals designed to prevent HIV transmission among at-risk populations. The predictive risk factors for HIV infection among people with intellectual disabilities (ID) are: a) high rates of sexual abuse3, 4 and sexual assault,5 b) information processing difficulties,6 and c) low literacy rates. 7 In Phase I, formative procedures with teachers and service providers (i.e., telephone interviews) will be used to identify youth knowledge of healthy relationships, abstinence, and HIV risk issues unique to youth with ID (e.g., lack of knowledge, socially-appropriate responding, unstable relationships) to inform program content, scriptwriting, and framing. A total of ten teachers and service providers will complete the telephone interviews. Focus groups with youth with ID (n= 8 females and n=8 males) will be conducted to identify knowledge and skill deficits associated with healthy relationship development, abstinence practices, and HIV transmission. The program will be pilot-tested with 10 youth with ID. To demonstrate the feasibility of our approach, the Phase I program will be evaluated with youth with ID (n=20 girls and n=20 boys). In addition, teachers, and service providers (n=15) will review the program to provide feedback on six areas of consumer satisfaction: ease of use, usefulness, interest, comprehensibility, acceptability, and persuasiveness. At Phase II, the program will be expanded to address taking responsibility for condom usage (i.e., what a condom is, where to purchase them, keeping them handy, how to put a condom on a penis), relationship-based HIV avoidance strategies and getting tested for HIV. In addition, a teaching guide will be developed to accompany the final Phase II product. The Phase II product will be a downloadable web-based program for use on personal computers, iPad(R), and other tablet based technologies, suitable for use by adolescents with ID.
In 2010, 26% of new HIV infections occurred in youth between the ages of 13 to 24;8 and there is evidence that suggests the prevalence of HIV in people with intellectual disabilities (ID) is similar to, if not greater than, that of the non-ID population.7 In the health disparity literature, the sexual health needs of people with ID are overlooked in public health campaigns.2,9