Proposed is a comparison of four interventions to reduce sexual behavior related to risk of HIV transmission in a group of inner city males, primarily black, who have been diagnosed with a condom-preventable sexually transmitted disease in Essex County, New Jersey. A Vulnerability intervention will enhance perceived personal vulnerability to HIV infection, and increase awareness of -- while creating salient mental representations for -- the impact of end-stage HIV infection. A Skill intervention will increase skills required for regulating sexual impulses and negotiating condom use with sexual partners, using goal-setting, role- playing, and other skills-training techniques. A Combined intervention will contain all of these components. These intervention, which will involve six weekly group meetings, will utilize a peer education model. Finally, a Counseling Control group who will receive the standard clinic counseling will be included. The interventions will be evaluated by contrasting behavior change achieved by members of the groups. Through survey/interview assessment, we will measure factors potentially correlated with behavior, behavior change, and maintenance of behavior change. These factors include vulnerability, AIDS outcome expectancies, experience with HIV/AIDS, self-efficacy, perceived barriers to condom use. Follow-up behavioral data will be obtained for 18 months through telephone interview. We hypothesize that the two reduced-focus interventions (Vulnerability and Skills) will be effective only in those subjects who have, through other means, acquired the component that their intervention lacked, as reflected in pre-intervention scores on the vulnerability and related scales of the questionnaire measure (outcome expectancies, experience with HIV/AIDS) and skills-related scales (self-efficacy, perceived barriers to condom use). The largest treatment effect is predicted in the Combined intervention, which both provides enhanced motivation for behavior change and increases levels of the skills required to perform the safer behaviors.
