The development and evaluation of innovative strategies designed to enhance the maintenance of HIV-preventive behaviors following exposure to a risk-reduction intervention, over an extended time period, remains a public health priority. The proposed study, STARS: Students Talking About Real Solutions, utilizes a randomized controlled trial design to evaluate the efficacy and cost-effectiveness of two relapse prevention strategies. The proposed study will recruit 650 African American women between the ages of 18-24 currently enrolled in the Job Corps training program in Atlanta, Georgia. All students will complete an ACASI baseline assessment. Students will then be randomized to one of two conditions either a telephone relapse prevention condition or a group relapse prevention condition. Students randomized to the telephone relapse prevention condition receive the SISTA HIV risk-reduction program, a 4-session, culturally-appropriate and gender tailored program for young adult African-American women that has been cited by the Centers for Disease Control and Prevention in their """"""""Compendium of HIV Prevention Interventions with Evidence of Effectiveness"""""""" and one 25-minute telephone relapse prevention session per month over the 24 month follow-up period (providing a total of 600 minutes of telephone relapse prevention education). The one-on-one telephone calls are personalized to address the individuals' skills and barriers (i.e. attitudinal, relational, skills, environmental) that serve as impediments to practicing safer sex. Students randomized to the group relapse prevention condition receive the same SISTA HIV risk-reduction program and five 120 minute group sessions following their scheduled follow-up assessments at 4-,8-, 12-, 16-, and 20-months post-intervention (providing a total of 600 minutes of group relapse prevention education). The group sessions are designed to reinforce group norms supportive of HIV prevention and address skill, attitudinal, relational, and environmental barriers to practicing safer sex. Thus, students in each condition receive the SISTA HIV intervention and are exposed to an equivalent amount of relapse prevention education designed to reinforce adherence to HIV-preventive behaviors. All students return at 4-,8-, 12-, 16-,20 and 24-month follow-up to complete an ACASI interview that is similar to the baseline assessment. An intent-to-treat analysis, controlling for baseline assessments, will determine the efficacy of the innovative telephone relapse prevention condition relative to the group relapse prevention condition to prevent relapse to HIV-associated sexual behaviors and enhance psychosocial mediators of HIV-preventive behaviors over 24 month follow-up. The proposed study will examine the cost-effectiveness of the telephone relapse prevention condition relative to the group relapse prevention condition.
