AIDS Intervention Programs that are derived from social cognitive theory and based on cognitive-behavioral principles have demonstrated the greatest promise in changing HIV high-risk behaviors. Unfortunately, cognitive behavioral interventions have not been transferable to community-based organizations for cost effective implementation due to their dependence on professional interventionists with expertise in cognitive behavioral skills techniques. In contrast, interventions that rely on videotapes to facilitate skills building provide an affordable and easily implemented mechanism for guiding the delivery of HIV prevention interventions. To date, videotape-based skills building approach to risk reductions has only been tested with men and has not been independently replicated. This application requests four years of support of research to adapt, implement, and evaluate the efficacy of an HIV-risk reduction skills training intervention conducted with videotapes among low income African American men and women in an effort to increase the generalizability of video-based skills training. Four hundred African American men (N=200) and women (N=200) who meet high-risk behavior criteria will be randomly assigned to one of two experimental conditions: (1) A comprehensive HIV-risk reduction intervention based on cognitive behavioral principles delivered by videotape and facilitated by community organization staff with minimal training in counseling and facilitator skills techniques; or (2) A time- and contact- matched standard HIV education only control condition. The study will therefore use 2 (intervention) conditions X 2 gender factor designs to test the following hypotheses: (1) The HIV prevention intervention is expected to result in increased HIV-related knowledge, sensitization to HIV-risk, and intentions to change risk behaviors relative to the control group; (2) The HIV prevention interventionism expected to result in increased self-efficacy for reducing behaviors and increased effectiveness in communicating ways to reduce risk with sexual partners; (3) Participants in the HIV prevention intervention are expected to experience significantly greater reductions and longer-lasting maintenance of behavior change in unprotected sexual intercourse, decreased numbers of sexual partners, and increased use of condoms relative to the control group. If the delivery of skills instruction via videotape and community facilitators proves successful, we will have established the generalizability of videotape-based HIV prevention intervention as a feasible and cost effective method of HIV prevention among African American men and women.
