1. Creating Youth-Supportive Communities: Outcomes from the Connect-to-Protect® (C2P) Structural Change Approach to Youth HIV Prevention
- Author
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Miller, Robin Lin, Janulis, Patrick F, Reed, Sarah J, Harper, Gary W, Ellen, Jonathan, and Boyer, Cherrie B
- Subjects
Psychology ,Clinical and Health Psychology ,Social and Personality Psychology ,Applied and Developmental Psychology ,Behavioral and Social Science ,Adolescent Sexual Activity ,Prevention ,Clinical Research ,Pediatric AIDS ,HIV/AIDS ,Pediatric ,Good Health and Well Being ,Adolescent ,Black or African American ,Community Networks ,Community-Based Participatory Research ,Cross-Sectional Studies ,Female ,HIV Infections ,Hispanic or Latino ,Homosexuality ,Male ,Humans ,Male ,Sexual Behavior ,Social Stigma ,Young Adult ,HIV prevention ,Structural change ,Coalitions ,High-risk youth ,Young MSM ,Adolescent Medicine Trials Network for HIV/AIDS Interventions ,Specialist Studies in Education ,Developmental & Child Psychology ,Applied and developmental psychology ,Clinical and health psychology ,Social and personality psychology - Abstract
Reducing HIV incidence among adolescents represents an urgent global priority. Structural change approaches to HIV prevention may reduce youth risk by addressing the economic, social, cultural, and political factors that elevate it. We assessed whether achievement of structural changes made by eight Connect-to-Protect (C2P) coalitions were associated with improvements in youth's views of their community over the first 4 years of coalitions' mobilization. We recruited annual cross-sectional samples of targeted youth from each C2P community. We sampled youth in neighborhood venues. We interviewed a total of 2461 youth over 4 years. Males (66 %) and youth of color comprised the majority (52 % Hispanic/Latinos; 41 % African Americans) of those interviewed. By year 4, youth reported greater satisfaction with their community as a youth-supportive setting. They reported their needs were better met by available community resources compared with year 1. However, these findings were moderated by risk population such that those from communities where C2P focused on young men who have sex with men (YMSM) reported no changes over time whereas those from communities focused on other at-risk youth reported significant improvements over time in satisfaction and resource needs being met. Internalized HIV stigma increased over time among those from communities serving other at-risk youth and was unchanged among those from YMSM communities. The very different results we observe over time between communities focused on YMSM versus other at-risk youth may suggest it is unreasonable to assume identical chains of structural causality across youth populations who have such different historical relationships to HIV and who encounter very different kinds of entrenched discrimination within their communities.
- Published
- 2016