Preventive Intervention Research Center, Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue VE6B25, Bronx, NY, 10461, USA.
Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.
Prev Sci. 2021 Nov;22(8):1023-1035. doi: 10.1007/s11121-021-01203-0. Epub 2021 Feb 19.
Despite calls for evidence-based HIV/STI prevention programs for youth aged 12 to 14 transitioning to adolescence, few effective programs exist. In a two-group intent-to-treat randomized trial in the Bronx, NY, 397 participants were randomly assigned to Project Prepared or an attention control, TEEN. Participants completed surveys at baseline, 6 months, and 12 months. Prepared had two components, an 11-session program and a 3-week internship. Content covered sexual risk behavior, social cognitions, gender norms, relationships, and resilience. TEEN built communication skills and had the same intensity and structure as Prepared but no sexual content. In both, boys and girls were trained together in mixed groups of ~ 11 teens. Primary outcomes were HIV knowledge, self-efficacy, condom outcome expectancy, and behavioral intentions. Secondary outcomes were relationship expectations and endorsement of risky gender norms. Generalized estimating equation analyses showed youth randomized to Prepared had significant improvements compared to TEEN at T2 in HIV knowledge, sexual self-efficacy, and outcome expectancy for condom use. At T3, there were significant differences favoring Prepared in outcome expectancy for condom use, sexual self-efficacy, and intention for partner communication about HIV/AIDS or STIs. Analyses by gender showed program effects in both boys (intention to talk to a partner about condom use, abstinence self-efficacy, sexual self-efficacy, and condom outcome expectancy) and girls (gender norms, and abstinence outcome expectancy). Prepared effectively reduced risk in young adolescents. ClinicalTrials.gov ID: NCT01880450, Protocol ID: 2008-551.
尽管呼吁为即将进入青春期的 12 至 14 岁青少年提供基于证据的艾滋病毒/性传播感染预防方案，但目前有效的方案很少。在纽约布朗克斯的一项 2 组意向治疗随机试验中，397 名参与者被随机分配到项目准备或注意对照 TEEN。参与者在基线、6 个月和 12 个月时完成了调查。准备有两个部分，一个 11 节的方案和一个为期 3 周的实习。内容涵盖性行为风险、社会认知、性别规范、人际关系和适应力。TEEN 培养了沟通技巧，与准备一样具有相同的强度和结构，但没有性内容。在这两种方案中，男孩和女孩都在混合组（约 11 名青少年）中一起接受培训。主要结果是艾滋病毒知识、自我效能感、避孕套结果预期和行为意向。次要结果是关系期望和对风险性别规范的认可。广义估计方程分析显示，与 TEEN 相比，随机分配到准备组的青少年在 T2 时在艾滋病毒知识、性自我效能感和避孕套使用结果预期方面有显著改善。在 T3，在避孕套使用结果预期、性自我效能感和与伴侣就艾滋病毒/性传播感染进行沟通的意图方面，准备组有显著差异。按性别分析显示，该方案对男孩（与伴侣谈论避孕套使用、禁欲自我效能感、性自我效能感和避孕套结果预期的意图）和女孩（性别规范和禁欲结果预期）都有效果。准备方案有效地降低了青少年的风险。临床试验.gov ID：NCT01880450，方案 ID：2008-551。
