Inner-city African American adolescents are at high risk of sexually transmitted disease (STD), including HIV. Practicing sexual abstinence by postponing or ceasing sexual involvement can eliminate the risk of STD. Parents can play a key role in reducing the adolescents' sexual risk behavior. Increased attention is focusing on natural social networks and the social context in designing HIV risk reduction programs. The Black church historically has served as a social resource and network important to the well-being of the black community. However, few studies have documented the effects among adolescents of HIV sexual risk reduction interventions that involve their parents, and none have tested such interventions in church settings. The broad objective of this randomized controlled trial is to identify effective, theory-driven interventions that involve parents and that can be implemented in church settings to reduce inner-city African American adolescents' risk of STDs, including HIV. The participants will be 720 African American parents and one of their 6th and 7th grade children recruited through 10 black Baptist churches in low-income communities in Philadelphia, PA. We will randomly assign parent-child dyads to 1 of 2 conditions: (a) a STD/HIV risk-reduction condition in which they will receive an intervention emphasizing the importance of delaying or curtailing sexual intercourse until later in life or (b) a control group that receives a general health promotion intervention concerning health issues unrelated to sexual behavior. Both interventions will be structurally similar: 12 1- hour modules that include films, exercises, and group discussions implemented by specially trained adult facilitators on 3 consecutive Saturdays. Three-hour """"""""booster"""""""" intervention sessions will be implemented with parents and children 3 and 6 months later. The approach draws on social cognitive theory, the theory of reasoned action/planned behavior, family theory, and the applicant's risk-reduction research with inner-city African American adolescents and their parents. Data will be collected before, immediately after, and 3, 6, 12, 18, and 24 months after the initial interventions. Primary outcome measures are children's' HIV sexual risk behavior. Secondary outcomes include parents' influence attempts and parents' and children's' intentions, beliefs, and self-efficacy-the theoretical mechanisms hypothesized to mediate intervention effects. The data will be analyzed with ANCOVA, mixed-model ANOVA, planned contrasts, multiple regression, and logistic regression.
Specific Aims i nclude (a) testing the effects of the interventions on adolescents' sexual behavior, (b) examining theoretical mediators of intervention effects, and (c) testing potential moderators of intervention effects. The findings will contribute to the development of efficient and effective HIV risk-reduction programs for inner-city African American adolescents.
