Homeless youth exhibit high rates of alcohol and other drug (AOD) use and sexual risk behaviors that increase their likelihood of getting HIV/AIDS. Few risk reduction programs have been developed for homeless youth that are both effective and can be easily incorporated into settings serving this population. Some existing programs are integrated AOD and sexual risk reduction programs that require substantial time and resources to deliver. However, programs requiring substantial resources are simply not feasible in the current service delivery climate of increasing demand for services combined with decreasing budgets and staffing. At the other extreme, some existing programs are brief motivational interventions or outreach efforts that provide limited treatment exposure and do not typically address multiple risk behaviors. These types of programs have not demonstrated sustained treatment effects over even a relatively short period of time. Thus, HIV prevention programs for homeless youth need to strike a balance between being intensive enough to address the multiple and interrelated risk behaviors that most youth exhibit, yet feasible to integrate into settings that routinely serve this population. The proposed R34 study will address an important gap in HIV prevention services for homeless youth by conducting a pilot test of an innovative 5-session group-based MI-delivered risk reduction intervention for this population that is feasible to deliver in settings where these youth seek services. An integral part of the program is the provision of written personalized feedback that is discussed across different sessions and focuses on the youth?s individual (AOD and sexual behavior) and contextual (social network) risk profiles to help them understand their current behavior and how their social networks may contribute to their risk behavior. To our knowledge, this is the first evaluation of a group-based MI-delivered risk reduction intervention for homeless youth, as well as the first to incorporate personalized feedback into a group-based intervention setting for this population. The proposed study will: (1) Investigate whether homeless youth who participate in the program (N = 108) show reductions in HIV-related risk factors (e.g., AOD use intentions, behavior and consequences, as well as sexual activity intentions and risk behavior), over a 3-month period compared to a control sample of youth who do not receive the program (N = 108);and (2) Gain a better understanding of intervention effects by exploring whether improvements in self-efficacy, readiness to change, outcome expectancies, and exposure to peer substance use and offers serve as explanatory mechanisms for reductions in these HIV-related risk factors among youth who participate in the program.
The proposed R34 study will address an important gap in HIV prevention services for homeless youth by conducting a pilot test of an innovative 5-session integrated substance use and sexual risk reduction program for this population that is feasible to deliver in settings where these youth seek services. An integral part of the program is the provision of written personalized feedback that is discussed across different sessions and focuses on the youth?s individual (AOD and sexual behavior) and contextual (social network) risk profiles to help them understand their current behavior and how their social networks may contribute to their risk behavior. To our knowledge, this is the first evaluation of a group-based MI-delivered intervention for homeless youth targeting HIV-related risk behaviors, as well as the first to incorporate personalized feedback into a group-based intervention setting for this population.
| Garvey, Rick; Pedersen, Eric R; D'Amico, Elizabeth J et al. (2018) Recruitment and Retention of Homeless Youth in a Substance Use and HIV-risk Reduction Program. Field methods 30:22-36 |
| Pedersen, Eric R; Ewing, Brett A; D'Amico, Elizabeth J et al. (2018) Predictors of Retention in an Alcohol and Risky Sex Prevention Program for Homeless Young Adults. Prev Sci 19:459-467 |
| Tucker, Joan S; D'Amico, Elizabeth J; Ewing, Brett A et al. (2017) A group-based motivational interviewing brief intervention to reduce substance use and sexual risk behavior among homeless young adults. J Subst Abuse Treat 76:20-27 |
| D'Amico, Elizabeth J; Houck, Jon M; Tucker, Joan S et al. (2017) Group motivational interviewing for homeless young adults: Associations of change talk with substance use and sexual risk behavior. Psychol Addict Behav 31:688-698 |
