In this study the researchers will develop and evaluate an HIV-prevention plus educational planning program for abused and neglected youths in foster care, which will be implemented through the Independent Living Program (ILP), a skills-building program that provides life skills to youths before they are discharged from state custody. Previous research indicates that educational parameters such as relationships with teachers, skipping school, grades, and educational aspirations are predictive of HIV-risk knowledge, attitudes, behavioral intentions, and behaviors. Although brief cognitive-behavioral interventions appear to be promising in the short term, long-term follow-up indicates that outcomes achieved do not last in this high risk adolescent population. An integral part of HIV-prevention with abused and neglected youth should involve providing youths with opportunities, skills, and hope for their futures. This can be achieved by implementing a life skills program that integrates HIV-prevention with a life-options building intervention that emphasizes educational aspirations and planning. An experimental design will be used and 430 youths will be assigned randomly either to an HIV-Prevention Plus Life Options condition or to the usual care condition. Both conditions will be delivered over an 8-month intervention phase. Evaluation of the program will be performed using data assessed during pre-, post-, and 9-month follow-up interviews. The primary outcome will be HIV-risk behaviors. Secondary outcomes include: knowledge and attitudes about HIV prevention, self-efficacy, intentions to engage in HIV-risk behaviors, future aspirations and beliefs about savings, and educational plans. A major strength of this study is that the program will be delivered through the ILP, a well-established, state-administered program in the community. ILP will provide: (1) access to high-risk abused and neglected youths; (2) the involvement of committed staff delivering a program whose philosophy is consistent with that of the study; and (3) the potential to disseminate the curriculum developed for the proposed study to ILP programs both statewide (in the seven regions of Missouri's Department of Social Services) and nationwide.
