The incidence of AIDS is increasing at an alarming rate among African- Americans. Of particular concern is the risk of HIV infection among African-American male adolescents who live with their mothers in single- parent households in low-income urban areas. Although their mothers can play a key role in reducing the adolescents' risk of HIV, effective strategies for such mothers are not well established. Moreover, HIV serosurveillance data indicate that the mothers themselves are at heightened risk of sexually transmitted HIV infection. Accordingly, the broad objective of this project is to identify effective, theory-based, culturally sensitive behavioral interventions to help single mothers reduce their own risk of sexually transmitted HIV infection and that of their sons. In a field experiment, 630 African-American mothers who reside in 42 low-income housing developments in Philadelphia, PA with adolescent sons 11-15 years of age will be assigned randomly to: (a) a HIV risk-reduction condition in which they will receive an intervention to enhance their ability to reduce their own and their son's risk of HIV infection or (b) a control condition in which they receive a general health promotion intervention to enhance their ability to reduce their own and their son's risk of behavior-linked diseases, including cancer, heart disease, hypertension. The interventions will be structurally similar: 16 1-hour modules that include films, exercises, and small group discussions led by specially trained African-American facilitators from the mothers' housing development implemented in four sessions. The approach draws on Bandura's social cognitive theory, Fishbein and Ajzen's theory of reasoned action/theory of planned behavior, and the applicant's risk-reduction research with inner-city African-American adolescents and their mothers. Data from the mothers and their sons will be collected preintervention, immediately postintervention, and at 3-, 6-, 12-, 18-, and 24-month follow-ups. At the 3- and 6-month follow-ups, mothers will receive additional """"""""booster"""""""" intervention sessions that contain three 1-hour modules. The data will be analyzed with ANCOVA, mixed model ANOVA, planned contrasts, and multiple regression. Outcomes include mothers' influence attempts and mothers' and sons' self-reported HIV risk- associated sexual behavior. Other measures include mothers' and sons' intentions, beliefs, and self-efficacy--the theoretical mechanisms hypothesized to mediate intervention effects. Analyses on these variables address the important theoretical question of why the interventions affect outcomes. Analyses will also examine whether intervention effects differ systematically depending on mothers' age, involvement with her son, and sexual anxiety and sons' age and sexual experience. The findings will contribute to the development of efficient and effective HIV risk- reduction programs for low-income inner-city African-American mothers and their adolescent sons.
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