StaySafe: Reducing Risk Among Adolescents

DESCRIPTION (provided by applicant): Minority group inner-city adolescents are at particular risk for acquiring HIV/STDs. Interventions based on Social Cognitive theory have been successful in reducing risk, but the magnitude of effects has been small. We propose a new intervention, StaySafe, to inner-city teens aged 13-16 who are virgins. StaySafe will provide a basic HIV/STD harm reduction intervention in 8 sessions based on Social Cognitive Theory. However, we will augment this content with sessions on gender, gender roles, gender beliefs, and HIV risk. We will then engage them as paid collaborators with us in a Participatory Action Research project on gender and HIV/STD risk. They will help develop the study, conduct media analysis, do participant observation on gender behavior in their communities, and participate in data analysis and interpretation. Our hypothesis is that learning how gender contributes to risk for HIV by being a participant in action research will give them ownership of the complex ideas underpinning gender norms and provide the tools they need to recognize and resist gendered messages that increase HIV/STD risk. StaySafe will have two parts: (1) a paid 8-session HIV /STD prevention program that provides skills and knowledge about sexual risk reduction and includes gender role content, and (2) a paid position on the "Gender and HIV" research study for 6 weeks working 4 hours per week. We propose a three-group intent-to-treat randomized controlled trial involving 600 minority group inner-city adolescents recruited from Montefiore Medical Center (200 per group). The two control groups are: (1) Staycool, an 8-session HIV/STD harm reduction program that uses the same HIV curriculum as StaySafe but without the gender content or the research experience; and (2) So4Real, an 8-session HIV/STD harm reduction program that uses the same HIV curriculum as Staysafe, including the gender content, but without the research experience. Contrasting StayCool with So4Real will assess the effectiveness of adding gender content to HIV/STD interventions; comparing So4Real to Staysafe will assess the effect of the gender content combined with the research internship. Adolescents will be interviewed five times: baseline; T2 (2 months after baseline when curriculum training is completed, to assess effects of the training itself); T3 (4 months later, 6 months post-baseline, when the StaySafe internship experience is completed to assess the effects of the gender internship); T4 (one year after baseline) and T5 (1 8 months post baseline) to assess longer-term effects.