The primary aim of this proposed Phase 2 research study is to: 1) refine and pilot test the feasibility and acceptability of a family-based intervention for pre- and early adolescent perinatally HIV-infected youth and their adult caregivers in three urban pediatric AIDS clinics; 2) identify barriers and facilitators to implementation of the proposed intervention; 3) estimate intervention parameters (e.g., effect size, study population variance, attrition rates, and response rates) and; 4) examine the preliminary impact of the intervention on youth's risk taking behaviors, as well as on family processes that promote youth's physical and mental health immediately post intervention and at 4-month follow-up. These preliminary data will ultimately be used to inform a larger scale effectiveness study. The need for this study is reflected in increasing numbers of perinatally HIV-infected children reaching adolescence as a result of successful antiretroviral therapies (ART). Perinatally infected adolescents are a fast emerging risk group for substantive mental health and behavioral difficulties. Further complicating the life circumstances of perinatally infected youth is the fact that even brief episodes of non-adherence to ART can permanently undermine treatment and lead to reduced efficacy of ART and increased resistance to medications. Thus, perinatally infected adolescents may be living with a multidrug resistant virus. This grim reality becomes a serious public health issue as youth approach adolescence, a time of increased experimentation with sexual behavior and drug use. The proposed family-based intervention, CHAMP+, draws upon an evidence-based HIV prevention program developed for inner-city pre and early adolescents and their families, the CHAMP (Collaborative HIV prevention and Adolescent Mental Health Program) Family Program (McKay et al., 2000; Madison, McKay et al., 2000). Originally, CHAMP was created to promote resilience in uninfected inner-city youth and their families by bolstering key family and youth processes related to youth risk taking behaviors. After a process of adaptation with input from researchers, adult caregivers of HIV-positive youth, youth and health care providers, the CHAMP+ curriculum was developed. CHAMP+ consists of 13 weekly family group meetings that focus on: 1) the impact of HIV on the family; 2) loss and stigma associated with HIV disease; 3) HIV knowledge and understanding of health and medication protocols; 4) family communication about puberty, sexuality and HIV; 5) social support and decision making related to disclosure; and 6) parental supervision and monitoring related to sexual and drug use possibility situations and to helping youth manage their health and medication. A sample of 60 pre- and early adolescent youth (10 to 14 years) and their adult caregivers receiving care in three pediatric HIV programs in New York City will be randomly assigned to one of two study conditions: 1) CHAMP+ or; 2) standard of care (HIV health-related education is provided as part of standard health care at all sites) and assessed at pre-test, post-test and 4-month follow-up. The proposed study is being conducted by a multi-disciplinary team of investigators that have substantial experience conducting research studies related to HIV, health, and mental health.
| McKernan McKay, Mary; Alicea, Stacey; Elwyn, Laura et al. (2014) The development and implementation of theory-driven programs capable of addressing poverty-impacted children's health, mental health, and prevention needs: CHAMP and CHAMP+, evidence-informed, family-based interventions to address HIV risk and care. J Clin Child Adolesc Psychol 43:428-41 |
| Small, Latoya; Mercado, Micaela; Gopalan, Priya et al. (2014) Enhancing the Emotional Wellbeing of Perinatally HIV Infected Youth across Global Contexts. Glob Soc Welf 1:25-35 |
