Women have been identified as the """"""""third wave"""""""" of the HIV/AIDS epidemic. With the early anti-viral treatments, introduction of treatments, and living with their condition as a chronic illness for increasing periods of time. To date little is known about how infected women, most of them minority women, manage the many adaptive tasks associated with their HIV antibody positive serostatus; there are few assessments of the quality of life these women are able to attain. Therefore we propose a two-stage quasi-longitudinal study of adaptation to living with HIV infection as a chronic condition, with a focus on identifying white-black-Puerto Rican womens differences. Stage 1 will consist of a combined qualitative/quantitative study employing in-depth focused interviews with a sample of 45 white, 45 black, and 45 Puerto Rican women (total N=135) and standard psychological tests. Women from each group will be equally divided among those who are asymptomatic infected, those who are symptomatic infected (but not qualifying for a diagnosis of AIDS), and those diagnosed with AIDS. The findings of the Stage 1 study will be used, not only to make recommendations for interventions to improve adaptive success, but also to design and conduct a large Stage 2 survey study. Currently, we are seeking support only for Stage 1. Research objectives will be to: 1) identify adaptive tasks that HIV- infected women must accomplish to make a successful psychosocial adjustment to their condition and describe how these may or may not vary by disease stage and ethnicity; 2) describe the strategies used by HIV- infected women to address the adaptive tasks posed by their condition and how these may or may not vary by disease stage and ethnicity; 3) examine how the health beliefs, perceptions and values of white, black and Puerto Rican women are associated with the strategies they adopt to address adaptive tasks; 4) begin to develop, prioritize and test relational propositions describing the nature of the associations among adaptive tasks, strategies used to meet these tasks, psychosocial adjustment to HIV infection, stage of disease and ethnicity; 5) gather information that will inform the design of the Stage 2 survey; and 6) with data from an existing grant on HIV-infected white, black and Puerto Rican men who have sex with men, make preliminary cross-study comparisons between men and women to illuminate similarities and differences in adaptive challenges, treatment- related behaviors, and coping styles.
