The primary objective of this 5-year study is to describe the HIV risk and prevention behaviors of Puerto Rican an Mexican severely mentally ill women, ages 18 to 45, in Cuyahoga and San Diego Counties and the context in which such behaviors occur (severely mentally ill, SMI: schizophrenia, bipolar disorder, and major depression). Secondary objective include the (1) acquisition of additional insights that can be incorporated into the informed consent process and the content and delivery of a future HIV intervention, (2) examination of the feasibility and acceptability of various modes o delivery of an HIV prevention for this population, and (3) field testing of an HIV peer education model for SMI). The several components of the study are variously premised on social cognitive theory, the theory of gender and power, and leadership-focused model. Phase 1 (months 1-4) focus groups with Latina SMIs, family members of Latina SMIs, and key informants will focus on the refinement of strategies to optimize the informed consent process, recruitment, and retention of Latina SMIs during Phase 2. Phase 2 (months 5-48) consists of 300 ethnographic interviews (1 per year for 2 years with each of 75 women at each site) accompanied by the administration of standardized instruments, 100 hours o participant observation per participant, participant journals, and 600 key informant interviews. The third phase (month 49-60) will examine through focus groups and interviews the acceptability and feasibility of various potential prevention interventions for this population and will field-test for feasibility an HIV peer education model for SMI. This research is critical to inform the later development of an HIV prevention intervention trial to test the efficacy of an intervention that is culture- and gender-sensitive to this high risk population: Latina SMI.
