HIV infection through needle-sharing, the dominant transmission route in China, is growing rapidly in rural areas. In spite of the widely acknowledged magnitude of this problem, there is still a critical gap in the implementation of successful theory-driven intervention programs targeting drug-related risk behaviors. We, therefore, propose a pilot study in which a drug-related HIV intervention program driven by Protection Motivation Theory (PMT) will be developed in a rural area in China, where sharing needles is the dominant HIV transmission route. Our long-range goal is to develop a sustainable HIV prevention program targeting the reduction of drug-related HIV risks among students and their parents in rural China. The objective of this proposal, which is the first step toward attaining our long-range goal, is to develop a school-based, parental- involvement drug-prevention intervention program among 7th and 8th grade students in an HIV endemic rural area. We expect to achieve the objective of this application by pursuing a specific aim: to develop a culturally appropriate and PMT-based program targeting initiation of drug use among rural early adolescents. The development of the curriculum will be performed by (1) combining qualitative and quantitative studies among students, parents, teachers, and village doctors; (2) adapting of an existing HIV prevention curriculum used by our research team, and (3) further modifying the curriculum by input from local Chinese experts, school teachers and village doctors. Five rural middle schools with a high level of prevalence of injection drug users in their catchment areas will be selected. Focus groups will be performed among 16 students and 10 teachers in 2 schools, and among 5 village doctors. In-depth interviews will be conducted among the 16 students' parents. Two cross-sectional studies will be conducted among 420 7th and 8th grade students in another 3 schools and among randomly-selected 210 parents. The newly-developed curriculum will be further assessed by 3 local Chinese experts, 5 school teachers and 3 village doctors. This study addresses significant public health issues related to drug use and HIV infection among youths in rural China.
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