Family impact on drug use and HIV risk behavior in Hispanic sexual minority youth

University Of Miami School Of Medicine, Coral Gables FL

Investigators

Linked publications & trials

Abstract

? DESCRIPTION (provided by applicant): Adolescence is a period in which many risk behaviors tend to peak leading to adverse health outcomes, such as HIV infection. Hispanic adolescents have been shown to be at particularly high risk. Hispanic HIV incidence rates in 2010 were three times higher than non-Hispanic rates with 79% of male cases attributed to same-sex sexual contact. From 2007 to 2010, the greatest increase in Hispanic HIV rates was seen among those aged 13-24. Furthermore, drug use and unprotected sex are disproportionately high in Hispanic sexual minority youth (HSMY) (e.g., men who have sex with men, lesbian, bisexual) compared to white heterosexual youths. Limited understanding of the mechanisms driving these disparities has resulted in a lack of evidence-based interventions targeting these risk behaviors in HSMY. Family relationships have consistently shown to significantly impact these behaviors in both sexual minorities and Hispanic adolescents alike. [For example, parental awareness and support of youth's sexual identity is associated with drug use and unprotected sex.] Accordingly, the Institute of Medicine has recommended further research examine the role of family life in HSMY risk behaviors. This [mixed methods] study will use participants of [6] randomized control trials examining the relative efficacy of the Familias Unidas family-based intervention. By improving family functioning processes such as parent-child communication and parental involvement, the intervention has been efficacious in preventing and reducing drug use and unprotected sex in Hispanic adolescents. Participants reporting any sexual contact with a person of the same sex (i.e., HSMY) will be examined. [Quantitative data from five studies will be combined and analyzed using integrative data analysis (IDA) methods to account] for cohort and study-level differences across trials to minimize bias. [Participants for the qualitative study will be recruited from a currently ongoing trial.] Using past 90-day illicit drug use and past 90- day unprotected sex as primary outcomes, [quantitative analyses] will: a) test the simultaneous effects of complex social, family and individual-level factors on the primary outcomes among HSMY participants; b) assess intervention efficacy by comparing the change in primary outcomes among intervention and control groups. The qualitative study will explore HSMY experiences regarding disclosure of their sexual identities and] experiences in the intervention. [Using a mixed methods study design, results from quantitative and qualitative data will produce meta-inferences that will shed light on the role of family in HSMY sexual and drug risk behaviors to guide] the future development or adaption of preventive interventions for HSMY. The applicant will be guided by an experienced sponsorship team and engage in meaningful training activities to: increase content area HSMY health knowledge; expand skills (IDA, qualitative methods, intervention development); and promote professional growth through conference presentations and collaborative projects. The [combined research and training will ensure] the applicant a successful future as an independent researcher.