IMARA, Adapting SiHLE for Detained African American Adolescent Females

African American adolescent females in youth detention centers are at high risk for HIV
infection. There are, however, no evidence-based interventions (EBI) for this vulnerable
population. The aim of this project is to develop and test a culturally and
gender-appropriate sexual health education program designed to promote HIV preventive sexual
behaviors among African American adolescent females in youth detention centers. The study
will be conducted in four stages: (1) adaptation of SiHLE intervention; (2) pilot adapted
intervention; (3) revisions to adapted intervention, measures, and implementation; and (4)
implementation and evaluation.

We will work closely with the Metro Regional Youth Detention Center (RYDC), in Atlanta,
Georgia for all four stages of the project. The first stage, adaptation of SiHLE
intervention, will be implemented using data collected from a prior study and with use of
Community and Teen Advisory Boards (CAB and TAB). The pilot intervention will be completed
with 20 participants from Metro RYDC and will test recruitment and retention strategies, the
adapted intervention, and all measures. Revisions will be made based on findings from the
pilot. For stage four, implementation and evaluation, we propose to recruit 350 unmarried
African American adolescent females, 13-17 years of age, from Metro RYDC. While at the Metro
RYDC, adolescents will be invited to participate in the proposed study. All adolescents
will be required to have verbal informed parental/guardian consent and complete signed
assent forms. Adolescents who are eligible and willing to participate in the project will
complete an initial survey conducted on a computer(ACASI). The survey is designed to assess
adolescents' sexual risk and preventive behaviors. After they complete the survey,
adolescents will then be assigned, by chance alone, to receive either the adapted SiHLE
intervention or a time-equivalent health promotion condition. All adolescents will complete
2 group sessions implemented by an African American health educator and co-facilitated by a
trained African American peer educator.

As we anticipate the participants will be released prior to the follow-up assessment,
adolescents will come to a central community site to complete follow-up interviews at 3 and
6-months after completing their initial survey. We will also obtain a self-collected vaginal
swab specimen to test for chlamydia and gonorrhea. In addition, both groups will attend an
individual booster session at the 3 month follow-up designed to reinforce concepts presented
in the initial group sessions. We will compare the new adapted SiHLE intervention, IMARA, to
the general health education program in its ability to maintain or enhance adolescents' use
of HIV prevention behaviors. If successful, the findings could have important implications
for HIV prevention in this vulnerable population.