This is an amended continuation application requesting 5 years of support to test interventions to reduce the risk of HIV infection among 800 inner-city women who are pregnant or who seek evaluation for an STD. These two groups of women were chosen because of their increasing risk for exposure to HIV. The interventions were based on health models that indicate the importance of personal action and communal action (an Afrocentric viewpoint) and on models of coping with threat that stress the development of personal and social resources to successfully address threat. The interventions also emphasize the importance of reinforcing behaviors in women's home ecology. Women will be randomly assigned to conditions. Women in the two AIDS prevention groups will receive four 90-minute curriculum-based, health training sessions focusing on AIDS-specific prevention knowledge and skills. Those in Group-1 are assigned to receive the intervention without the participation of a significant other. Those in Group-2 are assigned to receive the intervention with their chosen significant other (i.e., partner, friend, or family member). One-half of the women in each of these two groups will receive either: a) two additional individualized training sessions (with or without significant other) or b) two additional group discussion sessions (with or without significant other). Comparison women will receive general health training, not specific to AIDS prevention. Control-1 will include groups of target women only, and Control-2 will include groups of target women and their significant others. Control-1 and Control-2 participants will also receive either 1) two additional individualized sessions or 2) two additional group discussion sessions. A fifth group (Control-3) will receive no intervention. Questionnaires will be administered before, immediately following, and 6 months following intervention. STD testing and condom """"""""credit cards"""""""" will provide additional indications of program success. It is predicted that 1) AIDS competency training will be more effective than general health or no training, 2) individualized attention will enhance intervention effectiveness, 3) personal and social resources are necessary for behavioral change, 4) groups with significant others will be more effective than will groups with target women only, and 5) evaluation of personal risk will increase following """"""""marker"""""""" AIDS events in society.
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