Maintenance Strategies for Homeless Youth’s Reductions in HIV Risk

Street Smart (SS) is an effective HIV preventive intervention for homeless youth selected by the CDC as part of Replicating Effective Programs. However, substantial relapse diminishes the program’s effects over two years. This study examines a computerized strategy for maintaining the efficacy of the SS intervention for 400 homeless youth in Los Angles, CA. A two-stage sampling strategy (agency level and then youth within agency) was conducted in a randomized controlled trial examining the efficacy and cost-effectiveness of SS for reducing risk for HIV among homeless youth aged 12-20 years in three conditions:

• SS, but no maintenance strategy
• SS and a 2. computerized internet-based strategy for behavioral maintenance (Computerized SS; n=100)
• A one-session AIDS video Control Condition (CC; n=100)

Based on a social learning theory, the maintenance strategy provides skill training, social support, informational updates, and access to an expert for consultation, referrals, and coping with emerging crises. Youth are assessed at recruitment, and at three-, six-, 12-, 18-, & 24 month intervals in three domains:

• Youth’s substance use and sexual behaviors.
• Youth’s and staff members perceptions of the program’s acceptability and quality and program. utilization over time.
• Generalization of the program’s effects on youth’s problem behaviors (sex work, delinquent acts,. conduct problems, school truancy/unemployment, emotional distress, and chronic homelessness).