This five-year collaborative IRPG project is a resubmission in response to Program Announcement 94-054, """"""""Strategies to Reduce HIV Sexual Risk Practices in Drug Users."""""""" The research program at the rural South Florida site will focus on developing and implementing sexual risk-reduction interventions targeting rural and migrant crack smokers and their sex partners not currently in drug treatment who are at increased risk of HIV infection/transmission as a consequence of their drug/sexual practices. The research study will be conducted in two phases. The first phase will consist of two sub-phases, 1A and 1B, which together will assess the individual, social, and environmental context of sexual risk behavior and sexual risk reduction, and inform the development of interventions to reduce sexual risk in selected drug-user populations. Phase 1A will elicit in-depth qualitative information about behavioral and normative beliefs, barriers and facilitator, and social influence and network factors related to sexual risk reduction. In Phase 1B, a comprehensive interview instrument about specific risk-reducing sexual behaviors and their antecedents will be developed and administered, guided by data collected in Phase 1A. Additionally, a formalized behavioral context study of sexual risk-reducing behaviors will be conducted with rural and migrant crack smokers and their sexual partners. Based on information gained in Phase 1, theory-driven, empirically informed interventions will be developed and evaluated in a randomized field experimental design for use during Phase 2. The Collier County, FL intervention is a sequenced and additive model in which three types of interventions will be compared: 1) an individual counseling intervention, 2) a Couples counseling intervention, and 3) a Stage-of-change intervention. Intervention strategies will be guided by empirically derived frameworks of behavior change readiness and social influence theories. Randomization will provide the opportunity to measure the additive effects of dyad to individual counseling, individual and couples to group counseling. The three types of interventions will be sequenced in order to measure the separate effects of each intervention type. Although the stated research objectives will be substantially realized by the study design set forth in this proposal for rural South Florida, the value of the proposed initiative will be greatly enhanced by an expected collaboration with two other sites (Houston, Texas and New Orleans, Louisiana) that propose to conduct independent complementary studies for development of sexual risk-reduction interventions within the same theoretical and analytical framework. Each collaborating site will develop unique interventions targeting local populations that will be compared with a standardized control intervention that is uniform across sites. Monitoring of sites (site visits by the executive committee and training by collaborating research associate) will help ensure quality control for intervention integrity, and for data management and analyses.
| Shehadeh, Nancy; Virginia McCoy, H; Rubens, Muni et al. (2012) The impact of ethnic identity on changes in high risk HIV behaviors in sexually active migrant workers. J Immigr Minor Health 14:100-6 |
| Metsch, Lisa R; McCoy, Clyde B; Miles, Christine C et al. (2004) Prevention myths and HIV risk reduction by active drug users. AIDS Educ Prev 16:150-9 |
| McCoy, H V; Wasserman, A (2001) Gender differences in condom usage among rural crack-using men and women. Women Health 33:143-62 |
| Bowen, A M; Williams, M; McCoy, H V et al. (2001) Crack smokers' intention to use condoms with loved partners: intervention development using the theory of reasoned action, condom beliefs, and processes of change. AIDS Care 13:579-94 |
| McCoy, H V; McCoy, C B; Lai, S et al. (1999) Behavior changes among crack-using rural and urban women. Subst Use Misuse 34:667-84 |
