Improving HIV Prevention and Substance Use Post-Sexual Assault Services for Adolescents and Young Adults

University Of Texas Hlth Sci Ctr Houston, Houston TX

Investigators

Abstract

One in four women and one in nine men experience sexual violence in their lifetime. Sexual violence is a public health concern for youth, with 80% of first assaults occurring before age 25. Despite high rates of sexual assault, few adolescents and young adults (AYA) who experience sexual violence seek care afterward, posing a critical missed opportunity for HIV prevention. For those who do seek care, that care rarely addresses the substance use issues that often intersect with sexual violence. Addressing HIV risks and substance misuse among AYA sexual violence and trafficking survivors can prevent life-long health issues, however, to our knowledge no developmentally tailored interventions exist. When AYAs do seek medical care, it is typically from sexual assault nurse examiners trained to address sexual violence (e.g. SANEs). SANE services typically lack access to same-day HIV prophylaxis and substance misuse interventions that might mitigate long-term health issues and prevent repeated assaults. Our goal is to increase HIV and substance misuse prevention and treatment among AYA sexual violence survivors through increased access to enhanced SANE services. The specific aims for this R34 exploratory research (RFA-DA-25-018) are to: 1.Tailor existing SANE services with same-day HIV prophylaxis and substance use prevention using semi-structured AYA survivor (n=20), key informant (n=20) interviews, and iterative co-design/pilot strategies with the YWG (n=10). 2. Optimize study mechanisms and outcome measures using cognitive interviews, analysis of community partner data, and recruitment and retention strategies with the YWG and CAB. 3. Conduct a pilot RCT with 40 AYA to test feasibility, acceptability, and initial efficacy compared to usual care. 3a. Evaluate recruitment, randomization, and follow-up strategies; adherence to intervention dose; retention benchmarks; and acceptability. 3b. Evaluate preliminary efficacy of outcome measures (uptake of post-assault HIV prevention and substance use treatment) at baseline and 1-month follow-up.