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Intervention for Young People Living with HIV. Mary Jane Rotheram-Borus, Ph.D. Youth Living with HIV (YLH), 2001. 500,000. 470,000. 280,000. 500,000. 210,000. 3,050,000. 220,000. 700,000. 14,200,000. 7,500. Total: 20 Million YLH. Source: UNAIDS. YLH – U.S.
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Intervention for Young People Living with HIV Mary Jane Rotheram-Borus, Ph.D.
Youth Living with HIV (YLH), 2001 500,000 470,000 280,000 500,000 210,000 3,050,000 220,000 700,000 14,200,000 7,500 Total: 20 Million YLH Source: UNAIDS
YLH – U.S. 900,000 People w/ HIV110,000-250,000 YLH1 in 4 new infections Sources: www.niaid.nih.gov/factsheets/aidsstat.htm; Office of National AIDS Policy/Youth & HIV/AIDS; A Report to the President, 1996.
Motivations for Youth Living with HIV • Enhance health acts – Self-preservation • Reduce transmission – Altruism • Enhance quality of life – Self actualization
Module 1: Staying Healthy (10 Sessions) Disclosure/Stigma Drugs/Sex Medical Care
Module 2: Act Safe(8 Sessions) Drugs Sex
Module 3: Being Together (7 Sessions) Mental Health Quality of Life Relapse
Youth Living with HIV New York City n = 101 Los Angeles n = 136 Miami n = 48 San Francisco n = 65 n = 350
Developmentally Weighted Index of Substance Use HIV+ Youths Male Percentage Abstainer Marijuana/ Stimulants Halluci- Cocaine/ Heroin Injecting Alcohol nogens Crack
Module 1: Stay Healthy Intervention Control Relative (n = 181) (n = 76) Effect Size # positive lifestyle changes 5.6 4.1 36% (female) Coping Positive action (female) 3.4 2.9 19% Positive styles (female) 3.2 2.7 18% Social support 2.5 2.3 7% (male & female) *Baseline, Race, and City controls
Youth in Intervention:Changes in Risk Acts • 78% Unprotected sex acts • 42% Sexual partners • 47% HIV-negative sexual partners • 31% Substance use
Cost Effectiveness HIV-Partners Pre Post M – F 35 4 M – M 72 56 Cost $511 Range $7,426-$31,729
Reduce Sessions # of Sessions Stay Healthy 6 Act Safe 6 Be Together 6
CLEAR(n = 175) • LA, SF, NYC • 22% female • 26% African American • 42% Latino • 76% Gay/Lesbian/Bisexual • 50% HAART
Summary • Prevention Y PLH • Small group, in-person, & telephone • Sexual risk • Substance use treatment necessary • Target risky
Thank You George Ayala Henry Anaya Ron Brooks Coleen Cantwell Suzi Cantwell Scott Comulada Betty Crenshaw Fred Dechow Naihua Duan Amy Elkavich Mark Etzel Rise Goldstein Patricia Jones Ella Kelly Jae Lee Martha Lee Marguerita Lightfoot Kathy Mattes Norweeta Milburn Peter Newman Fen Rhodes Michael Bullock Dallas Swendeman Selina Tam Juwon Song Rob Weiss Andrea Witkin And all those involved with the project