The rapid increase in the number of AIDS cases in the United States mandates the development, implementation, evaluation, and if effective, replication of behavior modification strategies in those communities at greatest risk of new infections. Although a number of studies have documented an increased number of myths, as well as a gap between knowledge and behaviors in adolescents, few have demonstrated the long- term effectiveness of neighborhood based interventions, particularly among African-American adolescents. Our current project, Project SAMM, is a community based African-American founded and run AIDS education organization which is based in a high-risk neighborhood in the inner city. This new application requests support to test the effectiveness of this intervention in four targeted neighborhood centers. The study will be undertaken in two phases. Phase I (eight months) will consist of formative studies including focus groups, and key informant and elicitation interviews with inner city neighborhood teens at high-risk for HIV infection. Phase I will also include a self-administered survey and face- to-face interviews of 200 at-risk adolescents from these neighborhood centers. Phase II of the study (two years) will be the full-scale field trial testing the effectiveness of the Project SAMM intervention in two neighborhood centers in high-risk populations.. The intervention tested -- peer AIDS education -- will identify, recruit, and engage adolescents who are identified as popular and/or leaders to serve as peer educators. In this intervention, the peer educators will be intensively educated about HIV/AIDS, as well as sexually transmitted diseases, Afrocentric culture and values, and behavior skills for enacting HIV/AIDS risk reduction behaviors. After completion of the peer education training, these peers will be contracted to co-lead similar AIDS risk reduction modules with adolescents recruited from the neighborhood center. Effects of the intervention on neighborhood adolescent behavior will be determined through baseline, post-intervention, and follow-up self-administered questionnaires and risk assessment interviews of all teen participants in these sessions. In addition, corroborative indices of adolescent behavior change including condom redemption, self-report STD occurrences, HIV testing requests, and visits to local health clinics/reproductive clinics will be compared with the comparison group. The overall objective of this -project is to test the effectiveness of the Project SAMM model, which can and has reached a large number of adolescents in an HIV-vulnerable community. This model, if effective, can be easily replicated and widely disseminated.
