This proposed study targeting high risk Hispanic Migrant Workers (HMWs) is a 3-year randomized trial of a Cognitive Behavioral HIV Prevention Intervention (A-SEMI) compared with a Health Promotion (HPC) condition. This application takes the innovative approach of expanding on current """"""""effective"""""""" behavioral interventions to include contextual components that are likely to produce long term maintenance of HIV risk reduction effects. A pre-and post-test experimental design is proposed. A sample of 80 female and male Hispanic migrant workers who engage in HIV high risk behaviors?a group disproportionately affected by HIV and other health disparities?will be enrolled and randomized to one experimental intervention (A-SEMI) and one comparison group (HPC) and followed at 3 and 9 months to evaluate the effectiveness of the A-SEMI intervention to reduce HIV related high risk behaviors. We propose an efficient design which permits us to simultaneously implement and evaluate the effectiveness of the A-SEMI intervention as well as the effectiveness of its different components. We hypothesize that: 1) The A-SEMI will produce a greater beneficial effect than the HPC on reducing HIV sexual risk behaviors (ratio of protected to unprotected sex following intervention, ratio of faithful to transient sex, and frequency of unsafe sex). 2) The A-SEMI will produce more beneficial effects than the HPC in the mediator variables (social influence, stages of change, alcohol and other drug use, and attitude-motivation-skills). 3) The A-SEMI will be more effective for participants who are women, acculturated, have high levels of cognitive functioning and no history of traumatic abuse. This project addresses the problem of health disparities in HIV risks and the potential to adapt """"""""effective"""""""" interventions to reach this vulnerable population. The proposed project further responds to the CDC priority on rapidly translating and disseminating new knowledge, which emphasizes bringing intervention strategies developed during efficacy trials in a rigorous academic setting, into community settings in a manner adaptable to """"""""real world"""""""" conditions. If successful, this research will delineate important HIV intervention strategies that can be practically implemented to improve maintenance of HIV risk reduction behaviors among high risk HMWs.
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