The broad objective of this proposal is to identify effective culturally sensitive behavioral interventions by nurses to reduce the risk of sexually transmitted HIV infection and AIDS among inner-city Black women. AIDS is the leading cause of death among Black women of childbearing age in New Jersey. A related problem is pediatric AIDS cases. More than one-half of the reported cases of pediatric AIDS in New Jersey have occurred among Black children. To reduce the spread of HIV infection among women of childbearing age and the associated perinatally acquired infections f children, efficient and cost-effective theoretically based behavioral interventions are needed. Nurses are key health professionals in the effort to combat AIDS, and interventions by nurses in the health-care setting may maximize resources. There are no published studies that tested AIDS risk-reduction interventions on women of childbearing age. The subjects in the proposed experiment will be 720 Black women of childbearing age attending the Family Planning Clinic of a Women's Health Center serving a low-income community in Newark, New Jersey. The approach draws on Bandura's social cognitive theory, Fishbein and Ajzen's theory of reasoned action, and the applicant's previous AIDS risk-reduction research with inner-city Black populations. The subjects in the proposed research will be randomly assigned to a social cognitive intervention designed to increase perceived self- efficacy and favorable outcome expectancies regarding condom use or to one of two control conditions: an informational intervention designed to increase AIDS knowledge or the standard clinic treatment of brief one- to-one AIDS prevention counseling. All interventions will be implemented by nurses. Repeated measures ANOVA, planned contrasts, and multiple regression will be used to test experimental effects immediately postintervention and at 3, 6, and 12 month follow-ups. The outcome variables include self-reported sexual behavior, condom-coupon redemption, and clinically documented sexually transmitted infections. Other measures include theoretically relevant variables hypothesized to mediate intervention effects, including AIDS knowledge, self-efficacy, outcome expectancies, and intentions. Analyses on these variables will address the important theoretical question of why the interventions have effects on outcome measures. Analyses will also examine intervention effects are systematically different depending on participant characteristics, including age, relationship status, and self-esteem. The results of this project will contribute to the development of efficient and effective risk reduction programs for inner-city Black women of childbearing age.
| Jemmott, Loretta Sweet; Jemmott, John B; Hutchinson, M Katherine et al. (2008) Sexually transmitted infection/HIV risk reduction interventions in clinical practice settings. J Obstet Gynecol Neonatal Nurs 37:137-45 |
| O'Leary, Ann; Jemmott, Loretta Sweet; Jemmott, John B (2008) Mediation analysis of an effective sexual risk-reduction intervention for women: the importance of self-efficacy. Health Psychol 27:S180-4 |
| Jemmott, Loretta Sweet; Jemmott 3rd, John B; O'Leary, Ann (2007) Effects on sexual risk behavior and STD rate of brief HIV/STD prevention interventions for African American women in primary care settings. Am J Public Health 97:1034-40 |
