Reducing teen HIV is GWB project goal

As if troubled teen-agers in foster care didn't have enough problems already, research shows that family instability, home disruptions and mental health problems often place these adolescents at an especially high risk of HIV infection.

Changing teen behavior can be an incredible challenge, but students and faculty of the George Warren Brown School of Social Work will try to do just that this summer as they team with the Independent Living Program of the Missouri Division of Family Services to test a novel HIV prevention program among 430 teens in St. Louis County foster care programs.

Funded by a $2.2 million grant from the National Institute of Child Health and Human Development (NICHD), the pilot study will rely on a two-pronged approach that couples an intensive HIV education program with an incentive system that rewards teens by helping them save for their futures using Individual Educational Savings Accounts.

The use of savings incentives is an outgrowth of work by Michael Sherraden, Ph.D., the school's Benjamin E. Youngdahl Professor of Social Development and director of the Center for Social Development. Sherraden's work on asset building and Individual Development Accounts is being tested across the country as a vehicle for helping low-income people save their way out of poverty.

"Research indicates that youths with mental health or behavioral problems are less likely to engage in the risky behaviors that lead to HIV infection if they have future educational plans and the resources to pursue an education," said Wendy Auslander, Ph.D., associate professor of social work and principal investigator for the study.

"Our program will provide these teens with plenty of information about HIV and risk behaviors, but we're also trying to give them some motivation to change their ways by offering them opportunities, skills and hope for their futures."

Known as the HIV Prevention and Life Options for Youth in Foster Care Program, the four-year study draws on the unique expertise of researchers in the school's Center for Mental Health Services Research and the Center for Social Development.

Curtis McMillen, Ph.D, assistant professor of social work and co-investigator on the project, brings a wealth of experience in foster care services. Arlene Stiffman, Ph.D., professor of social work and associate director of the mental health center, contributes extensive knowledge of children's mental health services. Diane Elze, a social work doctoral student with a background in delivering services to at-risk teens, also has been involved. Hope Krebill, a registered nurse who soon will be a social work student here, is project manager.

Teen-agers in the life options program will receive an Individual Educational Savings Account (ESA), to which cash deposits will be made upon completion of various program phases, including educational planning sessions and an expanded Independent Living Program with an added focus on HIV prevention.

During the program, teens will receive monthly statements showing the accumulation of savings and assets in their accounts. Program coordinators hope the teenagers' outlook for their futures will rise as their savings mount, because an improved orientation toward the future is associated with a decrease in HIV risk behaviors, they said.

The life options program, which includes multiple interventions over an eight-month period, will be delivered in conjunction with Missouri's Independent Living Program, a state-operated life skills training program that prepares youths for independent living after leaving state custody or foster care. The state program is directed by Lynn Mathis of the Division of Family Services through Missouri's Department of Social Services.

"The study has the potential to make major changes in future HIV prevention programs to at-risk teens," Auslander said.

Project researchers are hiring 10 social work students to assist in the study by performing interviews with participating teens. The study will be conducted on adolescents ages 15-18 under the supervision of the child welfare system.