This K01 research and training award advances the long-term goal of reducing ethnic/racial health disparities in HIV/AIDS infection. The proposed training and research plans will enable the PI to develop the skills needed for an independent research career in this area of research. The objective of this application is to develop skills in HIV prevention research and the use of Community-Based Participatory Research and qualitative data collection methods to inform the development of an intervention which targets specific risk and protective factors associated with Hispanic adolescents'drinking and sexual risk taking behaviors. Data demonstrate that both sexual risk behaviors and alcohol use are prominent among Hispanic adolescents, and that the co- occurrence of these behaviors are directly associated with HIV/AIDS infection. Despite literature demonstrating the influence that intrapersonal factors, contextual factors, and culturally specific factors play in Hispanic adolescents'drinking and sexual risk taking behaviors, to date, no interventions addressing all three of these factors exists. This application addresses this gap by developing and evaluating a culturally specific HIV prevention intervention addressing risk and protective factors within these three domains to reduce Hispanic adolescents'risk of HIV infection. Specifically, the culturally specific intervention will include: 1) an adolescent Individual Motivational Interview (IMI) to address alcohol- and sex-related expectancies and attitudes, and alcohol refusal and safe sex behavioral intentions and self-efficacy;2) a parent Motivational Interview to address parental monitoring and supervision and alcohol- and sex-related family communication;and, 3) an additional module designed to address acculturation conflicts between parents and adolescents, to restore the protective factors of familismo and respeto, and increase adolescents'ethnic identity and pride. A three-phase top-down research approach to adapt, refine, and pilot test the preventative intervention will be conducted. Phase I will include focus groups with Hispanic adolescents and parents and initial manual development. Phase II will include therapist training, an open pilot trial, qualitative exit interviews, and further manual revisions. Phase III will inclde a small-randomized clinical trial with 75 families recruited and randomly assigned to a culturally specific HIV prevention intervention, a standard HIV prevention intervention, or an assessment only condition. Feasibility, acceptability, and preliminary indication of a reduction in HIV risk behavior and alcohol use will be examined at 3- and 6-month follow-ups. To enable the PI to pursue this long- term research agenda, she will work with experienced mentors to build four areas of expertise: (1) expertise in HIV prevention research;(2) expertise in the use of Community-Based Participatory Research methods;(3) skills for conducting qualitative research;and (4) skills in developing integrated alcohol and sexual risk interventions. This K01 addresses a key priority in HIV prevention science, and it will fully prepare the PI for an independent research career in the field.
The long-term objectives of this application include 1) reducing and eliminating health disparities in HIV infection and alcohol use disorders among ethnic/racial groups, and 2) increasing access to care among ethnic/racial groups through the development of community-based and culturally appropriate interventions. This application also addresses Healthy People 2020's objectives to increase the proportion of adolescents who are connected to a parent, to reduce the proportion of students engaging in binge drinking, and to reduce new HIV infections among adolescents.