Women in the United States are facing a rapidly growing AIDS epidemic. AIDS incidence among women has risen at alarming rates since 1985 (a 20-fold increase to 11,561 cases in 2003). Heterosexual contact now is the greatest risk for women. African Americans and Latinas account for more than three-quarters of all female cases. The female condom is a promising HIV prevention option for women. However, this device has not been promoted actively by the private or public sectors of the U.S. Not surprisingly, female condom uptake has been slow despite its availability in the U.S. market for more than a decade, since 1994. Our preliminary research suggests that social networks are important predictors of female condom use. Network based interventions have been successful in modifying various health risk behaviors including HIV-related sexual risk and injection drug use. Nonetheless, few network interventions are designed to promote the female condom among women. Thus, little is known about the most acceptable and feasible approaches in delivering a female condom promotion network intervention to women. We propose a three-phase study (R34) to develop a network intervention aimed at increasing female condom use among ethnically diverse women. The proposed intervention applies social influence network theory, diffusion of innovations theory, and social learning theory. It also incorporates our extensive previous research on female condom acceptability and efficacy of female condom skills training. In Phase 1, we will identify the most acceptable approaches in delivering a female condom promotion network intervention to women by conducting seven focus groups with 60 women (15 for each of the four major ethnic groups in the U.S.: African American, Asian American, Latino, and White; Phase 1). In Phase 2, we will design a female condom promotion network intervention most acceptable to women based on Phase 1 focus group data. In Phase 3, we will test the feasibility of implementing and assessing this most acceptable network intervention by conducting baseline and 3-month surveys with social network members of Phase 1 participants. The proposed study will expand the field of HIV prevention by developing a much-needed new intervention for women. In addition, the study has the potential to create a prevention program that could reach a larger number of women at risk for HIV and, in turn, greatly reduce the number of heterosexually transmitted HIV infections. ? ? ?
