The face of HIV/AIDS is becoming increasingly female, African American, and young; adolescent girls, are at increasing risk for HIV infection primarily due to sexual behavior. Sexually abstinent girls represent a significant subgroup of the adolescent population, with recent data indicating that more than 50% of females ages 14-19 have never had vaginal intercourse. It is crucial to address prevention of HIV/AIDS prior to when adolescent girls become sexually active; interventions should help (a) to delay sexual initiation and (b) to prepare girls for risk reduction when they do become sexually active. Of the small number of small-group sexual risk reduction interventions developed for adolescent girls in the community, none has focused solely on sexually abstinent girls. The research proposed in this application aims to address this gap in HIV prevention science. Specifically, we will evaluate the feasibility of an intervention designed to maintain abstinence and to reduce future sexual risk behavior in sexually abstinent girls. The purposes of this proposal are to identify and clarify the specific needs of abstinent girls through formative research and then to pilot test a gender specific """"""""abstinence-plus (AbsPlus)"""""""" intervention designed to maintain abstinence and reduce future risk behaviors. Specifically, we will conduct focus groups with 18 sexually abstinent girls ages 14-19 to gain insight into the context of sexual abstinence and identify potential determinants of self- protective behavior in this population; we will also determine how to tailor a group-based intervention (developed previously for use with sexually active girls) to maintain abstinence, delay onset of sexual activity, and promote self-protection at the first and subsequent sexual contact. We will then assess the feasibility of the AbsPlus intervention with sexually abstinent girls using a randomized, two-group (controlled) experimental design. This design will allow us to estimate the effect sizes for both the theoretical antecedents of risk behavior and actual behavioral outcomes. We will recruit 60 adolescent females aged 14 to 19 years from youth development programs and randomly assign groups to one of two conditions: (a) a sexual risk reduction intervention based on the Information-Motivation-Behavioral Skills model (Fisher & Fisher, 1992) or (b) a structurally equivalent health promotion control group (CTL). Groups will be facilitated by trained adult female leaders using a motivational enhancement style. At immediate and short-term (3- month) follow up assessments, we expect that girls enrolled in the AbsPlus intervention will increase their HIV-related knowledge, motivation, and behavioral skills; we also expect that girls who receive the intervention will be more likely to maintain abstinence and to decrease the frequency of related-risk behaviors relative to CTL participants. The long-term goal of this study is to develop an effective intervention to prolong abstinence and decrease future HIV risk in girls ages 14-19. ? ? ?
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