The broad, long-term objective of the proposed research is to identify theory-based interventions to reduce risk of sexually transmitted infection, including HIV infection, among college women. The proposed research will develop and test the efficacy of an intervention designed to increase awareness of the effects of alcohol on safer sex practices, and to help college women develop negotiation skills to exert greater control of their sexual experiences, specifically in the context of alcohol use. The research will be conducted at a midwestern college campus where alcohol use is an acknowledged and recurrent problem. In Phase I, elicitation surveys and focus groups will be conducted with 40 college students (25 women and 15 men) regarding binge drinking, sexual intercourse, condom use, and alcohol use in conjunction with sex. In Phase II, information from Phase I will be used to develop a questionnaire to assess alcohol use, condom use, and alcohol use in conjunction with sex and potential mediators of such behavior. The questionnaire will be administered to 120 college women to identify modifiable variables that predict alcohol use, condom use, and alcohol use in conjunction with sex in this population. Phase III, the theory of planned behavior and social cognitive theory and information gathered from Phases I and II will be used to develop the intervention. A randomized controlled trial will then be conducted with 200 college women to pilot test the intervention. The control condition will involve a diet and exercise intervention, which will include information and activities designed to inform participants about behaviorally affected health risks such as heart disease, cancer, hypertension, and that offers methods to reduce such risk. Participants will complete confidential questionnaires administered by researchers blind to intervention condition, preintervention, immediately postintervention, and at 3-month follow-up. Outcome variables include self-reported sexual intercourse, condom use, alcohol use, and alcohol use in conjunction with sex. Other measures include intentions, beliefs, and self-efficacy theoretically relevant variables hypothesized to mediate intervention effects. The data will be analyzed with analysis of covariance, multiple regression, and logistic regression. This project will contribute to scientific knowledge about ways of reducing unprotected sexual intercourse among college women. The next step will be to modify the intervention and evaluate it in a full-scale randomized controlled trial with longer term follow- up.
