HIV Prevention for Youth With Severe Mental Illness

This 4-year competing continuation will extend the follow-up for 750 subjects enrolled in a
randomized interventions trial, Project STYLE: "HIV Prevention for Youth with Severe Mental
Illness" (R01, MH 63008). Extending the follow-up from one year to 36 months will 1) discern
the long-term impact of the Project STYLE interventions and 2) permit complex modeling of
the predictors and trajectories of sexual health (delay of sex) and risk (incident STIs).
Adolescents, particularly those in mental health treatment, are at risk for HIV because of
sexual and substance behaviors. Parent-child communication about sexual topics and parental
supervision are associated with delays in the onset of sexual activity and more responsible
sexual behavior; thus, the parent project, Project STYLE, is a randomized trial that is
evaluating the comparative efficacy of three interventions: a) family-based HIV prevention
intervention, b) adolescent-only HIV prevention intervention, and c) general health
promotion intervention. This multi-site project (Rhode Island Hospital, Emory University,
and the University of Illinois at Chicago) is enrolling an
ethnically/racially/geographically diverse group of 750 adolescents in outpatient mental
health treatment and their parents. Subjects receive a full day group intervention on the
day of randomization, return in two weeks for an individual session, participate in a half
day booster session three months later, and are assessed six and 12 months after the
intervention. This application offers a unique opportunity to assess this already
ascertained sample at three additional points (24,30, and 36 months). This is important
because few studies have examined the longer-term predictors of the delay of sex and
incident STIs over 36 months using a comprehensive array of family functioning, family
monitoring/communication, and trauma history. Additionally, this continuation will provide
important data concerning the long-term impact of Project STYLE's theoretically based HIV
prevention programs which are designed to maintain safe sexual behaviors. The Family-Based
program has increased parent/adolescent sexual communication and reduced adolescent
unprotected sex after six months and extended assessment will determine whether these
benefits are maintained over time.