BARRIER ACCEPTABILITY IN CULTURALLY DIVERSE HIV+ WOMEN

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DESCRIPTION (Adapted from the applicant's description): The principal objectives of the proposed study are to 1) assess the acceptability of female- controlled sexual barrier methods in ethnically diverse populations in the developed and developing world, 2) develop and test the efficacy of culturally sensitive interventions using cognitive/behavioral strategies and experiential training techniques to facilitate negotiation skills and coping strategies to increase and maintain sexual barrier use and 3) identify factors that influence the initiation and maintenance of microbicide use to reduce the transmission of HIV/STDs in the target populations. Low income women of color living with HIV/AIDS are among the most neglected and understudied populations affected by the AIDS epidemic. The sites selected for the proposed research grant reflects two major epicenters of HIV incidence in women in the developed and developing worlds: in the United States, Miami, Florida, and in Africa, Lusaka, Zambia. Florida ranks third in the United States for newly reported AIDS cases; Miami-Dade County has the highest incidence of HIV/AIDS in Florida. Among minority women living with HIV in Florida, 59% are African American, 25% are Hispanic, and 16% are Haitian. Approximately 25% of Lusaka's 2 million inhabitants are HIV seropositive; this figure is projected to double by 2005. To accomplish the above objectives, the proposed two-site clinical trial will randomize a total of 900 ethnically diverse (African American, Hispanic, Haitian, Caucasian, Zambian) women living with HIV/AIDS (Miami: n = 450; Lusaka: n = 450) into 1) a group cognitive/behavioral safer sex skills training experimental condition, 2) an individual "enhanced usual care" comparison condition or 3) a "usual care" control condition. Both experimental group and comparison individual conditions will receive a manualized three session program devoted to safer sex and female controlled barrier methods based upon the New York Hierarchy of safer sexual practices. In addition to baseline assessment and session evaluations, long term follow-up assessments will be carried out at 6 and 12 months.