HIV increasingly affects young and impoverished minority communities. Community-level HIV primary prevention interventions are urgently needed and must be focused on populations vulnerable to the disease. Research has shown that intensive cognitive-behavioral small group HIV prevention workshop interventions can promote short-term changes in sexual risk practices. However, interventions which attempt to change only the behavior of the individual may be much less affective than those which also change the social and peer reference group environment so as to provide sustained reinforcement, modeling, and normative support for enacting and maintaining risk avoidance behavior change. Following a successful randomized community- level HIV prevention intervention field trial undertaken with at-risk women who live in public housing developments, our collaborative and multi-institutional research team requests renewal support to extend our research to populations of adolescents in urban housing developments. Formative studies will be undertaken to delineate HIV risk issues facing inner-city adolescents. We will then initiate a community-level intervention trial in 15 low-income public housing developments. All adolescents ages 12 to 17 in all 15 developments will be administered assessment surveys to establish baseline levels of population risk. The 15 housing development populations will then be randomized within matched triads of developments to one of three study conditions: (1) population member followup risk survey assessments only; (2) cognitive- behavioral HIV risk reduction workshops offered to all adolescent population members followed by a sustained community-level 'opinion leader' intervention that creates HIV risk avoidance models, norms, and reinforcement supports; or (3) risk reduction workshop followed by an attention control community intervention in an area unrelated to AIDS. Population members will be reassessed at 6-and 12-month followup points, with data also collected from health clinic records on STD treatment. We hypothesize that the lowest levels of population HIV risk behavior, risk characteristics, and STD treatment rates will be found at followup among adolescents who participated in risk reduction workshops and were then also exposed to a sustained community intervention to provide models, associate reinforcement, and produce peer norms favoring HIV risk avoidance.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH042908-11
Application #
2890371
Study Section
Psychobiological, Biological, and Neurosciences Subcommittee (MHAI)
Program Officer
Weise, Richard E
Project Start
1990-09-01
Project End
2000-09-30
Budget Start
1999-07-01
Budget End
2000-09-30
Support Year
11
Fiscal Year
1999
Total Cost
Indirect Cost
Name
Medical College of Wisconsin
Department
Psychiatry
Type
Schools of Medicine
DUNS #
073134603
City
Milwaukee
State
WI
Country
United States
Zip Code
53226
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Sikkema, K J; Kelly, J A; Winett, R A et al. (2000) Outcomes of a randomized community-level HIV prevention intervention for women living in 18 low-income housing developments. Am J Public Health 90:57-63
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Kelly, J A; Murphy, D A; Sikkema, K J et al. (1997) Randomised, controlled, community-level HIV-prevention intervention for sexual-risk behaviour among homosexual men in US cities. Community HIV Prevention Research Collaborative. Lancet 350:1500-5
Norman, A D; Perry, M J; Stevenson, L Y et al. (1996) Lesbian and bisexual women in small cities--at risk for HIV? HIV Prevention Community Collaborative. Public Health Rep 111:347-52
Heckman, T G; Sikkema, K J; Kelly, J A et al. (1996) Predictors of condom use and human immunodeficiency virus test seeking among women living in inner-city public housing developments. Sex Transm Dis 23:357-65
Roffman, R A; Kalichman, S C; Kelly, J A et al. (1995) HIV antibody testing of gay men in smaller US cities. AIDS Care 7:405-13
Heckman, T G; Kelly, J A; Roffman, R A et al. (1995) Psychosocial differences between recently HIV tested and non-tested gay men who reside in smaller US cities. Int J STD AIDS 6:436-40

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