Contextual factors related to HIV/STIs among heterosexually-active black adolescents with mental illnesses

Background: Black adolescents are disproportionately affected by HIV and other sexually transmitted infections (STIs). Current intervention models primarily focus on cognitive-behavioral strategies to reduce risk among adolescents; however, factors unique to Black adolescents with mental illnesses are absent from these models. Community-based participatory research methods can be used to explore contextual factors relating to HIV/STI risk, and develop effective intervention programs. Methods: A youth community advisory board was developed to have members of the target population partner with the research team in the study design, implementation and evaluation. Four mixed gender focus groups were conducted with Black adolescent males (n = 15) and females (n = 15) aged 14-17 receiving outpatient mental health treatment. The intervention baseline questionnaire was piloted (N = 20) to examine the psychometric properties of the assessment. Results: Preliminary findings indicate that the adolescents' emotional state influenced their intended behaviors, including condom use and concurrent/sequential partnerships. Emotion regulation strategies are therefore needed in addition to tradition HIV/STI psycho-education to mitigate psychopathology (e.g., loneliness and impulsivity) that contributes to HIV/STI risk. The majority of participants were enthusiastic about and in support of the proposed intervention model. Conclusions: Additional resources are needed to increase HIV/STI knowledge and prevention skills in a contextually appropriate manner. This elicitation work provides a starting point to better understand factors that influence HIV/STI risk among Black adolescents with mental illnesses. Results from the larger randomized controlled trial will determine the effectiveness of this model.