PHAT Life: Preventing HIV/AIDS Among Teens in Juvenile Justice

High rates of mental illness, HIV/AIDS/STI, and incarceration among African Americans (AA)
reflect significant health disparities, particularly among youth. Teens in juvenile justice
are disproportionately AA, and compared to the general population, juvenile offenders (JO)
report more risky sexual behavior, drug and alcohol use, and psychiatric disorders, and are
more likely to test positive for STIs. Still, few empirically-supported, theoretically-driven
programs exist to address their negative health outcomes. This proposal addresses these
health disparities by testing an innovative and uniquely tailored HIV/AIDS/STI, mental
health, and substance use program designed for and pilot tested with recently arrested 13 -
17 year-old urban males and females (85% African American, 14% Latino/a) released on
probation. PHAT Life was derived from a carefully staged process that included an active,
diverse, multi-disciplinary advisory board, a youth advisory board, focus groups, two pilot
tests, extensive feedback, and a series of curriculum revisions over three years. The R34
established feasibility and acceptability, revealed positive youth and stakeholder feedback,
and yielded good preliminary outcomes at 3-month follow-up (e.g., increased condom use) to
justify an efficacy trial. This application proposes a 2-arm randomized controlled trial to
test PHAT Life versus a health promotion program with recently arrested 13-17 year-old male
and female, mostly ethnic minority JO (as representative of Cook County) on probation in
Chicago. The investigators will use the procedures and methods established in the
developmental study to recruit, enroll, assess, track, and intervene with teens.
Investigators will randomly assign youth to PHAT Life (N=150) or a health promotion control
group (N=150). The interventions will be delivered in single sex groups of 5 - 7 teens at
Evening Reporting Centers. Assessments will occur at baseline, 6-, and 12-months
post-treatment, and participants will be screened for three common STIs (Chlamydia,
Gonorrhea, Trichamonas) at baseline and 12-month follow-up. All youth who test positive for
an STI will receive single dose antibiotic treatment free of charge. An intent-to-treat
analysis will be used to test and compare PHAT Life to the health promotion control group on
adolescent risky sexual behavior, substance use, and theoretical mediators. This study
answers a compelling need for innovative prevention programs that address the intersecting
health disparities of mental illness and HIV/AIDS/STIs among youth in juvenile justice.
Without intervention, these teens continue to engage in risk behaviors post-release,
amplifying their own and their partner's risk for HIV/AIDS/STIs. The lasting effects on
community well-being, individual employment prospects, and neighborhood health are profound,
but effective programs can alter the negative developmental trajectories of this very
high-risk population and begin to redress existing health disparities.

Inclusion Criteria:

- male or female gender

- placed on probation following arrest

- remanded to a probation program

- 13-17 years old

- both adolescent and parent are fluent English speakers

- not a ward of the state (DCFS Ward).

Exclusion Criteria:

- are unable to understand the consent/assent process

- do not speak English, because instruments are normed for English speakers

- do not assent; d) legal guardians do not consent to teens' participation

- are not 13 -17 years old

- are not on probation or remanded to a probation program

- are Wards of the state (DCFS Ward)