Inner-city Latino adolescents are at high risk of sexually transmitted HIV infection. Although evidence from controlled trials demonstrates that theory-based culture-sensitive interventions can reduce adolescents' HIV risk-associated sexual behavior, there are important gaps in the literature: no randomized controlled trials have tested interventions to reduce risk- associated sexual behavior among Latino adolescents, including monolingual Spanish speakers. The broad objective of this research is to develop effective behavioral interventions that will reduce HIV risk behavior among Latino adolescents, 13-18 years of age, recruited from community and school settings will be randomly assigned to a theory- based HIV promotion intervention tailored for inner-city Latino adolescents or a control condition, a general health promotion intervention focusing not on HIV, but on behavior-linked diseases, including cancer, heart disease, and diabetes. About one-half the participants will be monolingual Spanish speakers and will receive the interventions in Spanish; the others will receive the interventions in English. This research draws upon social cognitive theory, the theory of reasoned action/planned behavior, existing research concerned with the influence of Latino cultural values on health behavior, and the investigative team's prior research with Latino and African American adolescents. Data will be collected pre- intervention, immediately post-intervention, and a 3,6, and 12 month follow ups. Outcomes will be collected pre-intervention, immediately post- intervention, and at 3,6, and 12 month follow-ups. Outcome measures includes self-reported HIV risk-associated, sexual behavior and hypothesized mediators of intervention effects, including attitudes, beliefs, subjective norms, self efficacy and behavioral intentions. Mixed model analysis of variance, planned contrasts, multiple regression, and logistic regression analysis will be performed to address 3 Specific Aims: First, does the HIV risk-reduction intervention reduce self-reported HIV risk- associated sexual behavior compare with the control condition? Second, are the intervention's effects moderated by key variables, including pre- intervention sexual experience, gender age, and such culturally relevant factors as familialism, gender-role expectations, religiosity, primary language (i.e., Spanish as opposed to English), acculturation, and generation? Third, do theory-based mediators explain the intervention's effects on self-reported behavior? This research addresses the urgent need for HIV behavioral intervention specifically designed for inner-city Latino adolescents, a population at disproportionately high risk of sexually transmitted HIV infection.
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