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Evaluating an Integrative Theoretical Framework for HIV Sexual Risk among Juvenile Justice involved Adolescents.

ABSTRACT: Juvenile justice involved youth are at great risk for negative outcomes of risky sexual behavior including HIV/AIDS. Given the strong connection between alcohol use and risky sex in this population, it is important to consider alcohol use in interventions designed to decrease risky sexual behavior. This paper provides support for an integrative translational model that incorporates psychosocial, neurobiological, and genetic factors to better predict alcohol-related sexual risk behavior. Specifically, we present the design, methods, and baseline data from a complex randomized control trial, Project SHARP (Sexual Health and Adolescent Risk Prevention) in order to illustrate how this broad array of factors can best predict alcohol-related sexual risk behavior. Participants were justice-involved adolescents (n=284) who completed an fMRI and self-report assessments prior to randomization to either a sexual risk plus alcohol risk reduction group intervention or to an information-only contact control group intervention. Structural equation modeling was utilized and findings supported the hypothesized relationships in the translational model. Preliminary data suggest that interventions among justice-involved adolescents targeting alcohol-related sexual risk behavior may be more effective if a biopsychosocial approach is considered.

SUBMITTER: Magnan RE

PROVIDER: S-EPMC4128495 | biostudies-literature | 2013 Jun

REPOSITORIES: biostudies-literature

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Evaluating an Integrative Theoretical Framework for HIV Sexual Risk among Juvenile Justice involved Adolescents.

Magnan Renee E RE Callahan Tiffany J TJ Ladd Benjamin O BO Claus Eric D ED Hutchison Kent E KE Bryan Angela D AD

Journal of AIDS & clinical research 20130601 6

Juvenile justice involved youth are at great risk for negative outcomes of risky sexual behavior including HIV/AIDS. Given the strong connection between alcohol use and risky sex in this population, it is important to consider alcohol use in interventions designed to decrease risky sexual behavior. This paper provides support for an integrative translational model that incorporates psychosocial, neurobiological, and genetic factors to better predict alcohol-related sexual risk behavior. Specific ...[more]

PMID: 25126447

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Project description:IntroductionJustice-involved adolescents are at high risk for sexually transmitted infections; one primary reason is co-occurring substance use. This study investigates the additive benefit of including alcohol and cannabis use content in a theory-based sexual risk reduction intervention, delivered using group-based motivational enhancement therapy.Study designThis study had a cluster randomized design, with randomization of single-sex clusters to 1 of 3 interventions.Setting/participantsParticipants were male and female justice-involved adolescents (N=460) residing in youth detention facilities. Data were collected from 2010 to 2014; analyses were completed in 2018-2019.InterventionAdolescents were randomized to 1 of 3 motivational enhancement therapy interventions: sexual risk reduction intervention, sexual risk reduction intervention with alcohol content, or sexual risk reduction intervention with alcohol and cannabis content.Main outcome measuresThe primary outcome was risky sexual behavior (aggregation of condom use and frequency of intercourse), measured every 3 months for 1 year. Secondary outcomes were theoretical mechanisms on which the intervention was based (condom use attitudes, self-efficacy, peer norms, and behavioral intentions), collected at baseline and post-test.ResultsRisky sexual behavior significantly decreased from baseline to 3-month follow-up (t=10.59, p<0.001) and this decrease was maintained 1 year later (t=9.04, p<0.001). Intervention was associated with improved values on all theoretical mechanisms. Although all outcomes improved over time, changes did not differ by intervention condition (p>0.29 for all). Comparisons to a historical, information-only, sexual risk reduction control arm conducted with a similar juvenile justice sample confirm the effectiveness of all 3 motivational enhancement therapy-based interventions.ConclusionsAll 3 interventions were associated with decreased sexual risk up to 1 year later, suggesting that the intervention modality (motivational enhancement therapy) may resonate with this population beyond the specific substance use content. This single-session manualized intervention can be readily disseminated to juvenile justice settings.Trial registrationThis study is registered at www.clinicaltrials.gov NCT01170260.

Project description:BackgroundAdolescents involved in the juvenile justice system who use cannabis are at an increased risk of future substance use disorders and rearrest. Many court-involved, nonincarcerated (CINI) youth are referred for services in the community and often encounter multiple barriers to care, highlighting the need for minimally burdensome services that can be delivered in justice settings. Digital health interventions are accessible, easy to implement, and can provide ongoing support but have not been developed to address the unique needs of CINI youth who use cannabis.ObjectiveThis multiphase study will aim to develop, implement, and pilot test a novel smartphone app, Teen Empowerment through Computerized Health (TECH), to reduce cannabis and other substance use among CINI youth. TECH is conceptualized as a digital adjunct to a brief computerized intervention delivered by our family court partner.MethodsFollowing the principles of user-centered design, phase I interviews with CINI youth aged 14-18 years (n=14-18), their caregivers (n=6-8), and behavioral health app developers (n=6-8) will guide the TECH design decisions. Next, in phase II, CINI youth (n=10) will beta test the TECH app prototype for 1 month; their feedback regarding feasibility and acceptability will directly inform the app refinement process. Finally, in phase III, CINI youth (n=60) will participate in a pilot randomized controlled trial for 6 months, comparing the preliminary effectiveness of the adjunctive TECH app on cannabis use outcomes.ResultsPhase I data collection began in September 2020 and was completed in December 2021; 14 CINI youth, 8 caregivers, and 11 behavioral health app developers participated in the study. Phases II and III will occur in 2022 and 2023 and 2023 and 2025, respectively.ConclusionsThis body of work will provide insight into the feasibility and acceptability of a smartphone-based adjunctive intervention designed for CINI youth. Phase III results will offer a preliminary indication of the effectiveness of the TECH app in reducing cannabis use among CINI youth.International registered report identifier (irrid)DERR1-10.2196/35402.

Project description:FiguresCory cat panel figureDrawing of bite force measuring equipment and indentation rig Pygocentrus nattereri jaw muscle morphology and skull anatomyBox plot grid of number of Pygocentrus nattereri bites before puncture along different body regions of Corydoras trilineatus during feeding trials resultsDrawing of color-coded Corydoras trilineatus with attack frequencies and average bites until puncture by Pygocentrus nattereriBox plot of average voluntary juvenile Pygocentrus nattereri bite forces to standard lengthPanel of linear ordinary least-squares regressions of Pygocentrus nattereri bite force to adductor mandibulae mass, standard length, and body massOrdinary least-squares regressions of voluntary bites to restrained bites of Pygocentrus nattereriPanel of indentation tests for intact and removed Corydoras trilineatus scutesPanel of indentation tests for Corydoras trilineatus body region.SynopsisThere is an evolutionary arms race between predators and prey. In aquatic environments, predatory fishes often use sharp teeth, powerful bites, and/or streamlined bodies to help capture their prey quickly and efficiently. Conversely, prey are often equipped with antipredator adaptations including: scaly armor, sharp spines, and/or toxic secretions. This study focused on the predator-prey interactions between the armored threestripe cory catfish (Corydoras trilineatus) and juvenile red-bellied piranha (Pygocentrus nattereri). Specifically, we investigated how resistant cory catfish armor is to a range of natural and theoretical piranha bite forces and how often this protection translated to survival from predator attacks by Corydoras. We measured the bite force and jaw functional morphology of P. nattereri, the puncture resistance of defensive scutes in C. trilineatus, and the in situ predatory interactions between the two. The adductor mandibulae muscle in juvenile P. nattereri is robust and delivers an average bite force of 1.03 N and maximum bite force of 9.71 N, yet its prey, C. trilineatus, survived 37% of confirmed bites without any damage. The C. trilineatus armor withstood an average of nine bites before puncture by P. nattereri. Predation was successful only when piranhas bit unarmored areas of the body, at the opercular opening and at the caudal peduncle. This study used an integrative approach to understand the outcomes of predator-prey interactions by evaluating the link between morphology and feeding behavior. We found that juvenile P. nattereri rarely used a maximal bite force and displayed a net predation success rate on par with other adult vertebrates. Conversely, C. trilineatus successfully avoided predation by orienting predator attacks toward their resilient, axial armor and behavioral strategies that reduced the predator's ability to bite in less armored regions of the body.

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Evaluating an Integrative Theoretical Framework for HIV Sexual Risk among Juvenile Justice involved Adolescents.

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Evaluating an Integrative Theoretical Framework for HIV Sexual Risk among Juvenile Justice involved Adolescents.

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