Marvel Francoise, Rowe Cynthia L, Colon-Perez Lissette, DiClemente Ralph J, Liddle Howard A
Department of Epidemiology and Public Health, Center for Treatment Research on Adolescent Drug Abuse, University of Miami Miller School of Medicine, 1120 NW 14th Street Stc. 1019, Miami, FL 33136, USA.
Fam Process. 2009 Mar;48(1):69-84. doi: 10.1111/j.1545-5300.2009.01268.x.
Drug and juvenile justice involved youths show remarkably high rates of human immunodeficiency virus (HIV)/sexually transmitted disease (STD) risk behaviors. However, existing interventions aimed at reducing adolescent HIV risk behavior have rarely targeted these vulnerable young adolescents, and many approaches focus on individual-level change without attention to family or contextual influences. We describe a new, family-based HIV/ STD prevention model that embeds HIV/STD focused multifamily groups within an adolescent drug abuse and delinquency evidence-based treatment, Multidimensional Family Therapy (MDFT). The approach has been evaluated in a multisite randomized clinical trial with juvenile justice involved youths in the National Institute on Drug Abuse Criminal Justice Drug Abuse Treatment Studies (www.cjdats.org). Preliminary baseline to 6-month outcomes are promising. We describe research on family risk and protective factors for adolescent problem behaviors, and offer a rationale for family-based approaches to reduce HIV/STD risk in this population. We describe the development and implementation of the Multidimensional Family Therapy HIV/STD risk-reduction intervention (MDFT-HIV/ STD) in terms of using multifamily groups and their integration in standard MDFT and also offers a clinical vignette. The potential significance of this empirically based intervention development work is high; MDFT-HIV/STD is the first model to address largely unmet HIV/STD prevention and sexual health needs of substance abusing juvenile offenders within the context of a family-oriented evidence-based intervention.
涉毒及涉青少年司法的青少年感染人类免疫缺陷病毒（HIV）/性传播疾病（STD）的风险行为发生率极高。然而，现有的旨在降低青少年HIV风险行为的干预措施很少针对这些易受伤害的青少年，而且许多方法侧重于个体层面的改变，而没有关注家庭或环境影响。我们描述了一种新的、基于家庭的HIV/STD预防模式，该模式将以HIV/STD为重点的多家庭小组纳入针对青少年药物滥用和犯罪行为的循证治疗——多维家庭治疗（MDFT）之中。该方法已在美国国立药物滥用研究所刑事司法药物滥用治疗研究（www.cjdats.org）中针对涉青少年司法的青少年进行了多地点随机临床试验评估。从基线到6个月的初步结果很有前景。我们阐述了关于青少年问题行为的家庭风险和保护因素的研究，并为基于家庭的方法提供了理论依据，以降低该人群的HIV/STD风险。我们从使用多家庭小组及其融入标准MDFT的角度描述了多维家庭治疗HIV/STD风险降低干预措施（MDFT-HIV/STD）的开发与实施，还提供了一个临床案例。这项基于实证的干预开发工作具有重大潜在意义；MDFT-HIV/STD是首个在以家庭为导向的循证干预背景下，解决药物滥用青少年罪犯在很大程度上未得到满足的HIV/STD预防和性健康需求的模式。
