This Scientist Development Award application describes a comprehensive program of training and research in the field of AIDS prevention. The goal of these efforts is (a) to facilitate the PI's transition to AIDS prevention research; and (b) to develop and evaluate an AIDS prevention model for community-based health programs which serve urban women. The proposed training would enhance the PI's knowledge about: (a) HIV/AIDS (i.e., its prevalence, transmission, course, treatment); (b)AIDS prevention research, including theoretical, methodological, and practical aspects; and (c) the social and health needs of economically disadvantaged urban women. This training will be supervised by Jeffrey A. Kelly, Ph.D., and will take place at the Community Health Behavior Program (Medical College of Wisconsin), HIV Center for Clinical and Behavioral Studies (Columbia University), and Center for Health and Behavior (Syracuse University). The proposed research will examine two questions: (a) Will urban women who participate in an AIDS prevention program increase their knowledge, motivation, and assertion skills and decrease high risk sexual practices compared to women who participate in a health promotion (i.e., attention-control) intervention unrelated to AIDS? (b)Does the effectiveness of the AlDS-prevention program differ depending upon whether it is administered by mental health professionals or paraprofessional group leaders? Initial formative research will elicit information on AIDS relevant knowledge, attitudes, behavior, and social norms to inform the subsequent assessment and intervention protocol. Next, 150 women at high risk for HIV infection will be recruited from a health care program for low income, primarily minority, single mothers. A baseline assessment comprising a structured interview, self-report questionnaires, and behavioral role-plays will yield information on HIV risk knowledge, attitudes, social norms, and high risk behavior. Subjects will then be randomly assigned to one of three conditions: (a) HIV prevention led by professionals; (b)HIV prevention led by paraprofessionals; or (c) health promotion led by paraprofessionals. Subjects will be re-assessed 3 and 6 months after the intervention. Meetings will occur at an inner-city community center to enhance the generalizability of the findings. It is hypothesized that participants in both HIV programs will increase their risk knowledge, motivation, and assertion skills and decrease high risk sexual practices compared to those receiving the control intervention. It is also expected that participants in the professionally-led HIV prevention program will benefit more than will those in the paraprofessionaIly-led group.
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