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针对使用毒品的青少年罪犯的家庭式艾滋病毒预防干预措施的效果。

Outcomes of a family-based HIV prevention intervention for substance using juvenile offenders.

作者信息

Tolou-Shams Marina, Dauria Emily, Conrad Selby M, Kemp Kathleen, Johnson Sarah, Brown Larry K

机构信息

University of California, San Francisco, Department of Psychiatry, Weill Institute for Neurosciences, United States; Zuckerberg San Francisco General Hospital, Division of Infant Child and Adolescent Psychiatry, United States.

University of California, San Francisco, Department of Psychiatry, Weill Institute for Neurosciences, United States; Zuckerberg San Francisco General Hospital, Division of Infant Child and Adolescent Psychiatry, United States.

出版信息

J Subst Abuse Treat. 2017 Jun;77:115-125. doi: 10.1016/j.jsat.2017.03.013. Epub 2017 Apr 5.

Abstract

Approximately 80% of all arrested youth are diverted from detention and supervised in the community through probation, specialty courts and other community-based diversion efforts. Justice-involved youth have greater psychiatric impairment, substance use and sexual risk behaviors than their non-justice-involved peers. Family-based interventions to address mental health, substance use and recidivism have been successful in improving these youth outcomes; but the lack of integration of HIV/STI prevention is notable given the co-occurrence of substance use, delinquency and sexual risk-taking behaviors among justice-involved youth. Moreover, emotion dysregulation may be an important and understudied underlying construct of these co-occurring risk behaviors for justice-involved youth. Study participants were 47 caregiver-youth dyads enrolled in a juvenile drug court program. As part of a pilot efficacy trial, dyads were randomized to a 5-session family-based integrated substance use and HIV/STI prevention intervention that relied on affect management strategies for risk reduction or an adolescent-only psychoeducation condition matched for time and attention. Data collected at baseline and 3months post-intervention suggest that a family-based integrated affect management substance use and HIV prevention pilot intervention may lead to justice-involved youths' enhanced motivation to change their marijuana use, decreased marijuana use and decreased risky sexual behavior over time. Future research is required to replicate these pilot trial findings and should also examine family-level mediators and moderators of treatment response, particularly with respect to HIV prevention efforts for these youth.

摘要

所有被捕青少年中约80%被从拘留中分流出来,通过缓刑、专门法庭及其他基于社区的分流措施在社区接受监管。涉司法系统的青少年比未涉司法系统的同龄人有更严重的精神障碍、物质使用问题及性风险行为。基于家庭的干预措施在解决心理健康、物质使用和再犯问题方面已成功改善了这些青少年的状况;但鉴于涉司法系统的青少年中物质使用、犯罪和性冒险行为同时存在,缺乏将艾滋病毒/性传播感染预防纳入其中的情况值得关注。此外,情绪调节障碍可能是这些涉司法系统青少年同时出现的风险行为的一个重要但研究不足的潜在因素。研究参与者为47对参与青少年毒品法庭项目的照顾者-青少年二元组。作为一项试点疗效试验的一部分,二元组被随机分配到一个为期5节的基于家庭的综合物质使用和艾滋病毒/性传播感染预防干预组,该干预组依靠情感管理策略来降低风险,或者分配到一个仅针对青少年的心理教育组,该组在时间和关注度上与之匹配。在基线和干预后3个月收集的数据表明,基于家庭的综合情感管理物质使用和艾滋病毒预防试点干预可能会随着时间的推移,使涉司法系统的青少年增强改变大麻使用的动机,减少大麻使用,并减少危险性行为。未来需要开展研究来重复这些试点试验的结果,还应研究治疗反应的家庭层面的调节因素和中介因素,特别是针对这些青少年的艾滋病毒预防工作。

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