In this proposed 5-year study the researchers will compare the effects of an Enhanced Cognitive-Behavioral (E-CB) Intervention to a Standard Care Information (SC-INFO) Condition in reducing the risk of HIV transmission (e.g., proportion of protected sexual acts, number of sex partners, use of alcohol or other drugs [ADD] proximal to sex activity) among a culturally diverse, inner city, ADD- abusing population of 440 HIV-negative adolescent offenders and 50 HIV- positive adolescent offenders. Their specific aims are to evaluate: (1) if E-CB reduces HIV risk behaviors to a greater extent than SC-INFO; (2) if E-CB reduces AOD use to a greater extent than SC-INFO; (3) if AOD abuse may mediate the relationship between our interventions and HIV risk behaviors outcomes, (4) if key variables mediate the relationships between these interventions and HIV risk behaviors and AOD-abuse interventions and the HIV-risk behavior and AOD-abuse outcome. The exploratory aim is to evaluate effects of HIV serostatus on outcome variables. The study is significant because it addresses the urgent need to develop an effective intervention to reduce HIV risk and AOD use in a growing population of adolescent offenders court ordered into treatment. The needs of these offenders have not been addressed adequately by traditional AOD-abuse treatment programs as indicated by an extremely high rate of relapse to unsafe sex and alcohol/drug abuse. Specific features of this project that increase the probability that it will produce definitive and innovative information include: (a) the use of a standardized, psychosocial E-CB intervention which has been specifically tailored for the target population; (b) the employment of a randomized experimental design that compares subjects assigned to E-CB with those assigned to a standard care condition; (c) the timing of the intervention to occur prior to the stressful transition from inpatient to outpatient status; and (d) the inclusion of HIV-positive youths in the study and validation of an intervention that attempts to reduce risky sex and AOD-using behaviors in mixed serostatus groups.

R01AA011752

1998-09-24

2005-08-31