Rates of HIV infection continue to rise in U.S. inner-cities, particularly among young ethnic minority men and women. Research has consistently demonstrated that prevention programs derived from social learning theory and based on cognitive behavioral skills training principles can produce HIV-risk reduction behavior changes. Unfortunately, cognitive behavioral interventions tested to date have relied on professional interventionists for implementation in face-to-face formats, making them difficult to transfer to community-based organizations. This application requests four years of support to develop, implement, and evaluate a behavioral skills training HIV prevention intervention to be delivered by videotape and community group facilitators to inner-city African-American men. The proposed research will begin with a 6-month period of formative study to expand our preliminary studies of situations and circumstances related to HIV-risk among young African-American men and to identify culture and gender themes for use in developing videotape contexts. The second half of the first year will be used to develop and produce two sets of videotapes: a five-session HIV prevention intervention using behavioral skills training techniques presented on videotape with subsequent group practice sessions facilitated by community group leaders; and a five-session videotape-based control condition focusing on social issues unrelated to AIDS and of relevance to inner-city men. Group sessions will be led by community-based organization staff who will be randomly assigned to intervention conditions and provided with group facilitation training. The intervention trial will be conducted at an inner-city neighborhood center, where 300 African-American men at recent risk for HIV infection will be randomly assigned to conditions. Assessments collected at baseline, post- intervention, 3-, 6-, 9-, and 12-month follow-ups will be used to determine relative intervention effects on AIDS-related knowledge, risk- related attitudes, intentions and self-efficacy to change behavior, and sexual risk behavior, as well as differences in communication skills and redemption of coupons to receive condoms. It is hypothesized that the HIV prevention intervention will result in increased behavioral skills relevant to HIV-risk reduction, decreases in unprotected sexual intercourse, and increases in condom use relative to the control condition. This research is intended to test the effects of a behavioral skills training intervention delivered by videotape that, if effective, could be readily disseminatable to community-based organizations.
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