This study is a longitudinal analysis of STD/HIV exposure among adolescent female offenders in Mississippi, a population that is disproportionately African American, and at higher risk than adolescents in general due to their propensity to engage in a variety of risk-taking behaviors, earlier onset of sexual behaviors, and the greater prevalence of mental disorders, substance abuse disorders, maltreatment, and family dysfunction. Based on social cognitive theory and Fisher and Fisher's (1992) IMB (Information, Motivation, and Behavioral skills) model, we request funding to evaluate a drug abuse related HIV risk reduction intervention and to compare outcomes against a STD/HIV information and health education control condition. Approximately 400 females committed to the state reformatory/training school for girls will be recruited for participation. The research design will consist of alternating cohort/waves of about 36 subjects each. One treatment condition will be administered at a time with a washout period between cohort/waves. Over a three-year period, one half of subjects will get 18 hours of HIV prevention and one half will get 18 hours of Health Education. Before and after the intervention, subjects' social competency skills and health knowledge will be measured. Before intervention and at 6-month and 12-month follow-up, self-report measures of alcohol and drug use, sexual risk behaviors, and impulsivity will be collected. Measures of condom attitudes, self-efficacy, sexual decision-making, and attitudes towards HIV prevention will be collected four times. Urine tests for the detection of 2 STDs (chlamydia and gonorrhea) will also be performed before intervention and at 6-month and 12- month follow-up. Multivariate data analyses will compare the experimental program against the Health Education control condition to evaluate the impact of the prevention program on lowering sexual risk behavior. It is hypothesized that the HIV prevention intervention will produce more favorable attitudes towards condoms and HIV prevention, more consistent use of condoms, and lower risk behavior post intervention and through the one-year follow-up period than the Health Education control condition. It is also hypothesized that the incidence of chlamydia and gonorrhea infection during the follow-up period will be lower for participants of HIV prevention than participants in the control group. The results will be useful to juvenile justice administrators and others that work with this high-risk population.
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