The proposed study, to be jointly conducted by the Department of Epidemiology and Public Health of the University of Miami School of Medicine and the Department of Community Medicine of the University of Zambia School of Medicine, will compare two HIV-related risk reduction approaches targeting adolescent females in Lusaka, Zambia to determine the more effective method for promoting safer sex practices among them, and to assess the long-term sustainability of the effects of the interventions. The study is designed to determine which beliefs and values are important in effectively structuring HIV-related risk reduction campaigns among adolescent females in urban Zambia and to compare peer-led risk reduction groups, individual risk reduction counseling sessions, and a control group to identify the more successful approach to use in promoting safer sex practices or maintaining abstinence among mostly sexually active Zambian adolescent females, aged 14-18. An intensive period of ethnographic fieldwork (utilizing open-ended interviewing, participant observation, observation, conversations, focus groups, and maintaining diary and field notes) will be conducted. Two hundred ten adolescent female students from two secondary schools in Lusaka will be randomized into one of 3 groups. At the end of the intervention program, subjects from the 3 groups will be re-interviewed concerning their sexual behavior to determine changes that have occurred during the eight week interval (post -intervention assessment). Longterm behavior changes will be re-assessed during four follow-up interviews at four month intervals. The study should serve as a model for future HIV-related risk reduction interventions aimed at this risk population. it is anticipated that the results of this study can be utilized to substantially slow the spread of HIV among adolescent females in Zambia.
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