Brazilian HIV/Sexually Transmitted Infection (STI) Prevention for Adolescents With Mental Health Disorder
Condition: HIV; Sexually Transmitted Infection; Pregnancy
MeSH terms: Infections; Communicable Diseases; Sexually Transmitted Diseases
Study type: Interventional
Phase: Phase 1

Summary: 
      Adolescents with mental health (MH) disorders (MHD) have higher rates of HIV/STI sexual risk
      behaviors than those in the general population. In Brazil, among youth seeking HIV testing,
      those testing positive had more MH problems than HIV-negative youth; HIV/STI sexual risk
      reduction is not regularly implemented within MH care for adolescents. Our NIMH-funded RCT in
      Rio de Janeiro (Rio; R01MH065163; PI: Wainberg) promises to provide such intervention for
      adults with MHD. A comparable evidence-based HIV/STI prevention intervention for adolescents
      is not available in Brazil; this application targets this need.

      Using quantitative and qualitative methods we will explore the contextual influences on
      sexual risk behavior of Brazilian youth ages 13-24 with MHD to inform intervention
      adaptation. The investigators will then pilot-test the family-based (parent-adolescent dyad)
      intervention HIV, STI and pregnancy prevention intervention with a sample of male and female
      youth age 13-24 years (n=144) with MHD who are in MH treatment in four community-based sites
      in preparation for the RCT.
    

Detailed description: 
      Adolescents with mental health (MH) disorders (MHD) have higher rates of HIV/STI sexual risk
      behaviors than those in the general population. In Brazil, among youth seeking HIV testing,
      those testing positive had more MH problems than HIV-negative youth; HIV/STI sexual risk
      reduction is not regularly implemented within MH care for adolescents. Our NIMH-funded RCT in
      Rio de Janeiro (Rio; R01MH065163; PI: Wainberg) promises to provide such intervention for
      adults with MHD. A comparable evidence-based HIV/STI prevention intervention for adolescents
      is not available in Brazil; this application targets this need. To address this public health
      need and opportunity, we propose to a) adapt a U.S. efficacious family-based HIV prevention
      intervention for youth with MHD (STYLE; R01MH63008; PI: Brown) within the three types of
      settings providing most of the care to adolescents with MHD in Brazil; and b) pilot test the
      intervention to examine the acceptability, feasibility, and implementation parameters of the
      resulting Brazil intervention (STYLE-B) within these settings, and to determine key research
      parameters in preparation for an implementation randomized clinical trial (RCT). Using
      quantitative and qualitative methods we will explore the contextual influences on sexual risk
      behavior of Brazilian youth ages 13-24 with MHD to inform intervention adaptation. The
      investigators will then pilot-test STYLE-B with a sample of male and female youth age 13-24
      years (n=144) with MHD who are in MH treatment in four community-based sites. Youth/caregiver
      dyads will receive a full-day group session, return in two weeks for an adolescent/caregiver
      dyad session, and participate in a half-day group session three months later. Acceptability
      and feasibility will be assessed using process measures after each session. The investigators
      will assess change in sexual risk behavior outcomes from baseline to 3-months
      post-intervention. The investigators will elucidate factors influencing intervention adoption
      (e.g., recruitment, referrals; resources; climate, readiness and capacity for intervention)
      within the three service systems for youth with MHD in Brazil. The investigators will develop
      digital web-based interactive technology to train intervention facilitators in preparation
      for the RCT.
    

Intervention name(s): STYLE Brazil; Health Promotion
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Multifamily group HIV/STI Prevention Intervention; Health promotion intervention
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: unsafe sex; safer sex; HIV; STI; Pregnancy