Multitheoretical Approach to Prevent HIV Among Women

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DESCRIPTION (provided by applicant): HIV/AIDS is a growing threat to women in central Illinois. Women marginalized by poverty, drug use, and/or sex trading are at high risk for contracting HIV from sharing needles, having unprotected sex with romantic partners who are HIV positive, or trading sex with partners who are HIV positive. This pilot study is designed to test the effectiveness of an intervention to help women correctly and consistently use male or female condoms. Specific objectives include: 1) Test the effectiveness of the intervention to increase condom use; 2) Evaluate the acceptability of the intervention; and 3) Explain variability on outcome measures of condom use. Findings will be used to develop a comprehensive HIV prevention program for women at high risk. To guide the study an eclectic model will combine theories of self efficacy, gender, and power with awakening, a theory about natural opportunities for changing behavior. The target population is heterosexual women exiting county detention facilities or drug treatment centers, 18 years or older, not planning a pregnancy, English speaking, HIV negative, able to give informed consent, and living in McLean or Champaign County. The design will combine a randomized clinical trial and grounded theory methodology. Main hypotheses are: 1) Women in the treatment group will engage in fewer unprotected episodes of vaginal intercourse than women in the comparison group; and 2) Women in the treatment group will use male or female condoms correctly more often than women in the comparison group. Women (N=80) will be randomly assigned to treatment and comparison groups (40 each) with pre and post intervention data collection and follow-up at three and six months. Multivariate techniques will be used to analyze quantitative data including repeated measures ANOVA, hierarchical regression, and path analysis. Following the final data collection point women (N=20) will be selected to participate in single in-depth interviews for the purpose of theoretical triangulation using grounded theory. Interview data will be used to shed light on hypothesis testing, variance on outcome measures, and the nature of relationships between self-efficacy, gender, and power and awakening to women's sexual communication and negotiation skills, and condom use. Qualitative data will be analyzed using constant comparison.