A preventive intervention emphasizing both AIDS information related behavioral competencies will be conducted targeting pregnant inner-city women. Pregnant inner-city women were chosen because they are on of the highest risk heterosexual groups and because HIV infection endangers them and their fetus/infant. The interventions were designed based on health models that indicate the importance of personal action plans nd self-competency and based on stress models that suggest the need for social support in adopting new coping behaviors. The inventions were also designed to address in general problem of reinforcing new behaviors outside of the training environment. Women in the two AIDS groups will receive either 1) four sessions of AIDS competency training that focus on than general health during pregnancy and AIDS specific concerns or 2) the same AIDS competency training reinforced by four AIDS newsletters designed with interests and reading level of the target population in mind. Two yoked control groups will receive either 1) general health competency training (that does not target AIDS) or 2) the same general health competency training reinforced by four health newsletters. These control groups allow for examination of the possibility that general health competencies may be sufficient in producing AIDS behavior change, given that AIDS information is increasingly available through the media. Half of the women in each of the four intervention groups will also receive four home visits by peer interventionists aimed at further reinforcing learned competencies. A third control group will receive only the questionnaires and no intervention in order to control for the effects of history and the questionnaires themselves. Questionnaires will be administered before, following, and 6 months after intervention. It is predicted that:1) AIDS competency training will be more effective in influencing adoption of safer sex behaviors that general health competency training or no training; 2) that groups that receive further reinforcement of training (e.g., newsletters, social support) will be more likely to adopt safer sex practices than those who do not receive such reinforcement; 3) that those with greater resources (e.g., greater mastery, natural social support, age, income, and education) will benefit more from intervention that those with lower resources; and 4) that those with low resources will only benefit form the more intensive social intervention. An ecological perspective guides the general intervention strategy.
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