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黄金项目:一项针对性活跃的黑人青年的新型预防艾滋病病毒/性传播感染心理教育干预措施的试点随机对照试验。

Project GOLD: A pilot randomized controlled trial of a novel psychoeducational HIV/STI prevention intervention for heterosexually-active black youth.

作者信息

Brawner Bridgette M, Jemmott Loretta Sweet, Wingood Gina, Lozano Alicia J, Hanlon Alexandra L

机构信息

Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.

Department of Nursing, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania.

出版信息

Res Nurs Health. 2019 Feb;42(1):8-28. doi: 10.1002/nur.21930.

Abstract

Black youth account for the largest number of new HIV infections among heterosexual youth. Mental illness and difficulties in emotion regulation contribute to increased reports of HIV/sexually transmitted infection (STI) risk-related sexual behaviors in this group. Yet limited interventions exist to address this affective component of the sexual decision-making process. The purpose of this paper was to describe the trial design, research challenges, and baseline characteristics from a study designed to fill this gap. Project GOLD was a pilot randomized controlled trial of a psychoeducational HIV/STI prevention intervention designed to address the role of mental illness and emotion regulation in HIV/STI risk among heterosexually-active Black youth aged 14 to 17 (N = 108). Challenges encountered in the research process warrant further attention in future research (e.g., disagreement among the regulatory bodies on parental permission requirements). The most common mental health diagnoses were Recurrent Major Depressive Disorder (15.7%) and current substance abuse (7.4%). Participants reported higher levels of emotional suppression, and adaptive methods of emotion management, than culturally inappropriate expressions of anger or sadness. They also reported a mean age of 13.6 at first vaginal sex, used condoms 66% of the time for vaginal sex, and had an average of three sexual partners in the past 6 months. More than one-quarter (26.9%) had sex with more than one person in the same day. These findings indicate intervention is crucial for this population. The forthcoming trial evaluation will indicate the promise of such interventions in reducing HIV/STI infections in this key population.

摘要

黑人青少年在异性恋青少年中新感染艾滋病毒的人数最多。精神疾病和情绪调节困难导致该群体中与艾滋病毒/性传播感染(STI)风险相关的性行为报告增加。然而,针对性决策过程中这一情感因素的干预措施有限。本文的目的是描述一项旨在填补这一空白的研究的试验设计、研究挑战和基线特征。GOLD项目是一项针对14至17岁有异性性行为的黑人青少年(N = 108)的心理教育艾滋病毒/性传播感染预防干预的试点随机对照试验,该干预旨在解决精神疾病和情绪调节在艾滋病毒/性传播感染风险中的作用。研究过程中遇到的挑战值得未来研究进一步关注(例如,监管机构在父母许可要求上存在分歧)。最常见的心理健康诊断是复发性重度抑郁症(15.7%)和当前药物滥用(7.4%)。与在文化上不适当的愤怒或悲伤表达相比,参与者报告的情绪抑制水平和适应性情绪管理方法更高。他们还报告首次阴道性交的平均年龄为13.6岁,66%的阴道性交使用了避孕套,并且在过去6个月中平均有三个性伴侣。超过四分之一(26.9%)的人在同一天与不止一人发生性关系。这些发现表明干预对这一人群至关重要。即将进行的试验评估将表明此类干预措施在减少这一关键人群中艾滋病毒/性传播感染方面的前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd2a/6913528/c2de3965acf7/nihms-1059226-f0001.jpg

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