This research proposal is in response to the Request for Applications """"""""Alcohol Abuse and HIV/AIDS in Resource-Poor Societies"""""""" (RFA-03-009) and requests 3 years of support to conduct developmental research to design and field test a theory-based behavioral risk reduction intervention for men and women who use alcohol and are at-risk for HIV infection in the Western Cape of South Africa. As many as one in five South Africans is HIV positive and there are an estimated 1,500 new HIV infections in South Africa each day. Guided by the Information-Motivation-Behavioral Skills model of health promoting behaviors we will conduct 3 phases of intervention development research: (1) Initial interviews, focus groups, and quantitative surveys with men and women who use alcohol and are at risk for HIV transmission in a Black township in Cape Town South Africa. Based on information gained from rapid formative studies, this first phase of research will develop a theory-based alcohol related risk reduction intervention tailored for use in HIV voluntary testing and counseling contexts in South Africa; (2) Test the feasibility of the newly developed alcohol related HIV risk reduction intervention with a small sample of men and women who use alcohol and engage in risky behavior; and (3) Conduct a randomized field test to determine the potential efficacy of the alcohol risk reduction intervention for South African men and women. Participants in the field test will be randomly assigned to either receive the newly developed intervention or assigned to a time matched attention comparison condition. Following a 6-month follow-up period, we will test for differences between groups on behavioral outcomes. We will also test the mediating effects of information, motivation, and behavioral skills constructs on intervention outcomes. Results of the proposed research will provide critical information about the role of alcohol in HIV transmission risks and will offer urgently needed strategies for improving HIV prevention interventions in South Africa.
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