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This study will develop a computerized intervention to train youth to regulate their emotions. This strategy is based on our previous successful experiences developing computerized interventions. We will develop a computerized intervention to reduce HIV risk behaviors grounded in a framework that augments Social Cognitive strategies by increasing the adolescents’ skills to manage affect and self-regulate. The CARE (Controlling and Regulating Emotions) intervention will target situations in which sexual risk behaviors occur and develop skills that allow adolescents to recognize intense affect, build strategies for tolerating intense affect and interrupt cycles of maladaptive expressions of affect in those situations.

Studying Youth in Northern California (SYNC) is a public health research study assessing narcotic and stimulant use among 14-25 year-olds in five Northern California counties with an emphasis on how such factors and forces place this population at risk for HIV and related health problems. The SYNC Study is a multidisciplinary collaboration of researchers and public health experts from SFSU, UCSF, & the counties of Alameda, Contra Costa, San Francisco, San Joaquin and San Mateo funded by the California Department of Health Services/Office of AIDS (CDHS/OA). SYNC hopes to provide information to complement previously collected data from the Young Women’s Survey (YWS) and HEYMAN studies, which were also collaborative efforts of the CDHS/OA and CAPS. This study will help to inform future public health interventions and policy targeting youth. The SYNC Study will be conducted in two phases: A formative qualitative information gathering phase regarding drug use in youth and risk of HIV 1. An epidemiological study of the prevalence of narcotics and stimulant use in 2. youth and young adults in the 5 counties. All the information we get will be used to assist county public health agencies and organizations to improve services for the treatment and care of youth at risk, and to develop better methods of helping young people prevent drug use and disease and promote good health.

Among the numerous health disparities disproportionately burdening people of color, HIV/AIDS is among the highest. In the African American community the HIV/AIDS epidemic is one of the most urgent public health issues. In order to address the health disparity in HIV/AIDS, detection of HIV in the African American community is crucial. The benefits for early detection of HIV include potentially prolonged duration and quality of life for those living with the virus. HIV testing has also been proposed as a HIV preventive strategy. Detection of HIV has a number of potential preventive benefits, including reduced transmission risk behaviors by those infected9 and reduced viral load by those taking antiretroviral medications, whereby potentially reducing transmission. The proposed study makes a significant public health impact by developing and pilot testing an innovative strategy to increase the number of high-risk adolescents receiving HIV screening. In response to PA-09-146 (Pilot and Feasibility Studies in Preparation for Drug Abuse Prevention Trials [r34]), we propose a pilot study to examine the acceptability and feasibility of a peer-driven, HIV-testing campaign. Peer education and outreach strategies have been successful at reducing sexual risk behavior and increasing the use of health resources in adolescents and other at-risk groups, including adults residing in census tracts where STI rates are high. A potential vehicle for outreach to adolescents is socially interactive technologies (e.g., text messages). The proposed study makes a scientific impact in examining the effectiveness of messaging diffused through the social network of adolescents. A total of 100 current patients at an urban adolescent health clinic serving predominately African Americans will be recruited to disseminate at least 5 text messages to friends they believe are sexually active. Youth will be provided with a brief guide to help them develop their messages. The youth generated text messages will encourage their friends to visit the clinic and get tested. The specific aims of this project are to: Aim 1: Develop protocols and a theory-informed message guide for a peer-driven text message intervention for adolescents recruited from an adolescent health clinic. Aim 2: Examine the acceptability and feasibility of sending text messages related to obtaining HIV/STI testing. We will obtain participant feedback and examine the recruitment rate, number of youth failing to meet inclusion criteria, number of youth verified to have sent text messages, and number of text messages sent. We will also obtain feedback from the clinic providers regarding impact on patient and services flow, provider reactions, and impact on clinical visit. Aim 3: Preliminarily examine the efficacy of a youth generated messaging intervention to increase the: 1) number of high-risk youth seeking services and 2) clinic volume as measured by: a) number of new patients at clinic, b) increase in rate of new patient appointments, and c) number of STI tests conducted. If successful, the proposed study will significantly contribute to the field of HI prevention by examining the acceptability, feasibility and potential impact of an innovative strategy for delivering messages to high-risk youth, which encourage connection with the healthcare system and screening for HIV. This trial will fill a critical need to improve the sexual health outcomes of high-risk African American youth and lay the groundwork for a subsequent R01 proposal with a larger sample and that would include control sites. PUBLIC HEALTH RELEVANCE: Adolescents exhibit high rates of STI/HIV, which have implications for a myriad of other sexual health issues, including reproductive health. Further, African American youth are disproportionately impacted by HIV. The proposed study will significantly contribute to the field of HIV/STI prevention by examining the impact of an innovative strategy for delivering telehealth messages to high-risk youth that encourage connection with the healthcare system and screening for HIV. This trial will fill a critical need t improve the sexual health outcomes of high-risk youth.

Problem: During  the  summer  of  2009,  the  State  of  California  experienced  an  unprecedented  budget  crisis,  resulting  in  cuts  to  social  services  across  the  state.  Approximately  $85  million  was  eliminated  from the budget of the State Office of AIDS  (OA)  for  FY  2009‐2010,  about  half  of  the  allocation of $167 million in FY 2008‐2009. Following  the  cuts,  reports  in  the  local  media  and  press  releases  indicated  that  several  community‐based  organizations  (CBOs)  and  AIDS  service  organizations  (ASOs) had to close their doors or drastically  reduce  the  level  of  HIV‐related  services,  including  activities  such  as  HIV  testing  and  counseling.  The  UCSF  AIDS  Policy  Center  Rapid Response Team conducted this study  to  gather  more  details  on  the  impact  of  these budget reductions.

The Until There's A Cure Foundation has provided financial support for the UCSF AIDS Policy Research Center since 1998. One of the primary goals of this funding is to research and publish a monograph analyzing an area of current HIV/AIDS public policy.  Previous monographs have focused on the development an AIDS vaccine and the validity of abstinence-only education.  This year’s project, funded by Until There's A Cure Foundation, explores what role, if any, criminal law should have in addressing HIV transmission and what the scope of that role should be.  This monograph reviews the criminal law approach to HIV transmission, including the history and policy background to criminalization of intentional HIV exposure and the reasons that states may use such laws.  It then analyzes in detail the statutes that states have adopted to criminalize intentional HIV exposure, focusing on the specific statutory and its implications to highlight how criminal HIV exposure laws can support or undermine public health prevention efforts.