EXCEED THE SPACE PROVIDED. We propose a randomized, controlled clinical trials study with 3-arms of a mixed primary/secondary prevention intervention. We will compare General AIDS Competency (GAC) training to a cognitive behavioral intervention aimed at reducing conflict fears and raising conflict resolution competency, called Accelerating Capacity for Conflict Exposure Negotiation Training (ACCENT). AIDS prevention with inner-city women has addressed general AIDS competencies with modest to moderate success. However, because of the high percentage (estimated as high as 60%) of women from this population with a lifetime history of sexual and physical abuse, greater emphasis onconfronting fears, of conflict and learning conflict resolution may prove more efficacious. Moreover, even if women have not been sexually abused, learning conflict resolution skills will serve a preventive function to reduce future risk. We target 1128 single, inner-city women who have heightened risk for STD infection. Women will be randomly assigned to 1 of 2 intervention conditions or a didactic-intervention control. In the GAC condition women will receive a 6-session skill- based intervention that focuses on AIDS knowledge and safer-sex skills. In the ACCENT condition women will receive 6-session training that imparts AIDS knowledge, but with a central, concentrated emphasis on conflict resolution. A third group will receive a 2-session didactic intervention about AIDS and STDs. Questionnaires will be administered before, immediately following, and 6 and 12months following intervention. STD chart review, laboratory testing for STDs, behavioral observation ratings, and pharmacy reports of use of condom 'credit cards' will provide additional objective indications of program success. It is predicted that 1) ACCENT will be more effective in promoting safer-sex than GAC training, 2) GAC training will be more effective than didactic-intervention, 3) women who have a history of sexual and physical abuse will benefit most from the ACCENT intervention, and 4) that ACCENT will have a preventive impact both on sexual risk and violence-victimization risk. It is further hypothesized that 5) history of sexual andphysical abuse will be related to low personal (e.g., self-esteem, self-efficacy) and social resources (e.g., communal-mastery, social support), which, in turn, are related to PTSD - related symptoms and high risk sexual behavior. PERFORMANCE SITE ========================================Section End===========================================
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