BEHAVIORAL AIDS RISK REDUCTION WITH MINORITY ADOLESCENTS

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This application requests funding to evaluate the impact of community-based behavioral AIDS risk reduction training to assist minority adolescents in reducing activities which confer HIV infection risk. As co-investigator over the past 5 years, the investigator has collaborated on a group intervention model that established the behavior change impact of risk education, self-management training, sexual assertiveness, problem-solving, and health beliefs training for gay men at high AIDS risk. The intervention produced substantial and well maintained reductions in risk behavior. The proposed investigation will adapt and evaluate this model with minority adolescents. Minority adolescents in urban areas characterized by poverty, drug use, high teen pregnancy rates, and high STD prevalence represent a population at high HIV infection risk, yet there are few controlled evaluations of AIDS risk reduction interventions for this population. The proposed study will recruit 240 adolescents from a primary health care clinic serving low income residents in Jackson, Mississippi. 120 teenagers will be randomly assigned to participate in an 8-session group intervention based on behavioral principles and 120 adolescents will be randomly assigned to an education control condition. Before intervention, after training, and at 12-month followup, all subjects will complete assessment measures of AIDS risk knowledge, perceptions of peer social norms, sexual values, self values, self-reported and self-monitored sexual and substance use behavior, and behavioral skill in role play simulations of coercive risk situations. As corroborative measures, STD and pregnancy information will be collected from medical records before and 12 months after the intervention. Condom-taking will be monitored as an unobtrusive measure of behavioral intentions to use condoms during sexual activity. Multivariate data analysis will compare the experimental and control groups to evaluate the intervention. It is hypothesized that experimental group subjects will be higher in knowledge, lower in risk behavior as assessed by self-report and self-monitoring records, more behaviorally skilled in role play enactments, perceive greater peer support for safety, endorse personal values consistent with precautionary behavior, and evidence lower STD and pregnancy rates after intervention than control group subjects. If successful, the intervention model will be disseminated to settings serving minority adolescents. This research will also yield data relevant to teen pregnancy prevention.