African Americans (AAs) in the rural Deep South continue to experience a disproportionate increase in new HIV/AIDS infection despite the availability of HIV prevention interventions with demonstrated effectiveness. In comparison to other areas of the nation, the South has the highest number of adults and adolescents living with and dying from AIDS and the highest percentage of new AIDS cases among people living in rural areas. The number of new cases of HIV/AIDS and other STIs among adolescents is rapidly increasing in the rural Deep South and Alabama. It is important for prevention interventions to target young adolescents prior to their becoming sexually active. However, few interventions are directed toward young adolescents. The search for new intervention strategies appropriate for young adolescents has recently led to the use of electronic games. Electronic gaming interventions hold promise of being developmentally appropriate for young adolescents. However, research involving the use of such strategies in HIV prevention is quite limited. The purpose of the proposed research is to develop a proof of concept prototype for an individually tailored, electronic HIV prevention adventure game for young African American rural adolescents (AARAs), age 12-14 years. We will conduct focus groups with AARAs (n = 80) to better understand the sociocontextual influences on the sexual risk. The gaming intervention will be designed to help AARAs improve decision-making and learn behavioral strategies that assist them with avoiding sexual risk behaviors. Focus groups will be conducted to better understand the sociocontextual influences on HIV/AIDS risk behaviors. Based on these findings, a draft of intervention components will be developed and programmed into a gaming prototype with the assistance of programming experts;the acceptability and relevance of the prototype will then be assessed with members of the target population (n=40). Verbatim transcripts of audiotapes of focus group discussions will be the primary data for analysis. Content analysis will be used in analysis and interpretation of the data. The qualitative research software, QSR N-Vivo(R), will be used in coding and sorting data. Descriptive statistical analyses of demographic data will be conducted using SPSS. The study is the first steps in a user-centric approach which involves identifying user needs and using a rapid iterative prototyping process. Findings from this research will serve as the basis for future application for NIH funding (e.g. R34 or R21) to furthe develop and test the electronic gaming intervention. The proposed career development plan is designed to provide additional training in qualitative data analyses, mixed methods research, HIV prevention intervention development, and electronic gaming development. In addition, this award will provide further hands-on research experience under the guidance of an interdisciplinary mentorship panel to meet training goals and enhance the applicant's development as a funded independent investigator and a recognized leader in the field of prevention of HIV and other STDs.
Although many HIV prevention interventions have been developed for AA adolescents, few interventions focus on young AA adolescents. The continuing increasing rates of HIV and STIs in AAs in the Deep South warrants renewed efforts to reduce the disparity in HIV/AIDS by focusing on adolescents before they become engaged in risky sexual behavior. The proposed research will contribute to increasing the understanding of the sociocontextual factors that influence HIV/AIDs risk from the young African American Rural adolescents'perspective, and on using this information to develop a culturally relevant and developmentally appropriate innovative intervention.