Traslating Effective Health Behavior Strategies Into Practice for HIV+ Women

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DESCRIPTION: This multisite application for a controlled "translational" trial proposes to test a dissemination strategy for an evidence-based behavioral intervention designed to reach poor women of color living with HIV. Over the past ten years, this multidisciplinary research team (University of Miami and Clinical Directors Network, New York) has conducted two behavioral clinical trials with poor women of color living with HIV/AIDS (the SMART/EST Women's Program) SWP. These trials demonstrated significant improvements in antiretroviral medication adherence, nutrition, self-efficacy, coping skills, and quality of life, accompanied by significant reductions in viral load, depression, anxiety, sexual risk and substance use. The applicants propose to test whether Community Health Center staff can be trained to implement the SMART/EST Women's Program in CHCs in New York, New Jersey and south Florida, three locales with the highest HIV rates for women in the U.S. Beginning with a six month "pilot phase" to refine the dissemination strategy, the study will provide intensive training and follow-up support for CHC health care staff to deliver the entire 16 session manualized intervention in English, Spanish and Creole, as appropriate. Organizational and clinical variables will be assessed to determine the effectiveness of this strategy for the adoption, implementation and maintenance of this program by the participating CHCs.