The long-term objective of this research is to implement interventions that eliminate health disparities among women with HIV disease. The study aims to extend the investigators' ongoing research of the effectiveness of a face-to- face peer counseling intervention for rural women with HIV disease (Moneyham 1999-2002, NIH Grant # 3R01 NR04956-01A1) by testing the effectiveness of a potentially more feasible and cost-effective telephone approach to delivery of the peer counseling intervention. The peer counseling intervention was developed in response to the changing face of the HIV/AIDS epidemic and the increasing disparity in the rate of cases among female, minority, and rural populations, especially in the southeastern United States. The primary aim of the study is to compare the effects of two formats (face-to-face and telephone) for delivery of a peer counseling intervention designed for rural women with HIV disease on three adaptational outcomes: depressive symptoms, disease management, and quality of life. The sample will consist of n=480 HIV-infected women, age 18 and older, who live in rural areas of South Carolina, and report levels of depressive symptoms that meet the study criterion level. Women will be recruited from 6 local HIV care consortiums serving rural counties of the state. The 5-year longitudinal study uses a quasi-experimental design with women randomly assigned to one of three groups, the control group (n=240) and two intervention groups, a face-to-face peer counseling group (n = 120) and a telephone peer-counseling group (n = 120). Women assigned to the intervention groups will receive 12 peer-counseling sessions over a six-month period. The peer counseling interventions focus on providing social support, cognitive reappraisal, and problem-focused coping strategies to manage the problematic aspects of HIV disease. The research questions will be analyzed with repeated measures analysis of variance, general linear model procedures and logistic regression. The findings of the study will provide empirical data that will support the development of culturally and contextually relevant practice based strategies to support rural women with HIV disease.
