Latinas have been disproportionately affected by HIV/AIDS since the beginning of the epidemic. Nearly 19% of women living with HIV/AIDS are Latina, even though Latinas constitute only 16% of US women, and HIV/AIDS is the fourth leading cause of death in Latinas aged 35-44. In 2006, Latinas represented one-quarter of new HIV infections in women, a rate of HIV infection four times higher than that of white women. While some behavioral prevention interventions tailored for Latinas have shown efficacy in reducing sexual risk, their successful replication has been hampered by cost, implementation challenges, and participation retention. At the same time, a new wave of computer-delivered interventions has emerged in the past few years, but none of these programs are tailored for adult Latinas or available in Spanish language versions. This project will address these gaps by continuing development of and conducting a randomized controlled efficacy trial on culturally tailored, English and Spanish language, computer-delivered versions of Project SAFE, an existing efficacious HIV prevention program for minority women. The resulting product will (1) make an efficacious HIV prevention intervention widely available to service agencies at low cost;(2) facilitate faithful program implementation (i.e., by means of a computer) with minimal staff involvement;(3) promote target population participation by permitting sensitive topics to be addressed privately (i.e., one-on-one with the computer) and according to a flexible schedule;and, (4) reduce sexual risk-taking behavior and HIV infection rates among Latinas, who are disproportionately affected by the HIV/AIDS epidemic.
The proposed research will develop and conduct an efficacy trial on computer-based versions of Project SAFE, an effective HIV prevention program for Latinas. The new applications, C-SAFE (English format) and CSEGURO (Spanish format) will be the first computer-delivered HIV prevention interventions specifically tailored for adult Latinas, as well as the first evidence-based, Spanish language computer-delivered intervention. The product will be available on multiple platforms - a USB flash drive, online, and installed as computer software - increasing the potential accessibility, cost-effectiveness, and program implementation fidelity in a variety of health service and education settings. The design and format of the applications are intended to promote community members'participation in HIV prevention activities by permitting sensitive topics to be addressed privately (i.e., one-on-one with the computer) and according to a flexible schedule. Ultimately, the interventions have the potential to reduce sexual risk-taking behavior and HIV infection rates among Latinas, who are disproportionately affected by the HIV/AIDS epidemic.