Reducing HIV/STD Risk in African American Women with At-Risk Male Partners

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Racial/ethnic disparities in sexually transmitted infections (STl), especially HIV/AIDS, are most apparent among Black women, who account for two-thirds of female US AIDS cases, while comprising just 13% of the population. The majority of these infections have been attributed to sex with men. The risk of transmission from behaviorally bisexual men is particularly relevant in California, where men who have sex with men (MSM) comprise 65% of all people living with HIV/AIDS. Sociocultural factors unique to African American communities and to heterosexual partnerships call for HIV interventions specifically designed for African American women with at-risk male partners (e.g., behaviorally bisexual or drug-using men). We propose to test the efficacy of two small-group interventions: Females of African American Legacy Empowering Self (FemAALES) ~ an innovative and culturally congruent intervention guided by the Theory of Reasoned Action and Planned Behavior, the Critical Thinking and Cultural Affirmation (CTCA) Model, and the Empowerment Theory, that incorporates new media in order to enhance information acquisition and access to services and social support, and the Healthy Alternatives to Risk Reduction for HIV Project (HARRP) ~ a "homegrown" intervention based on the Transtheoretical Model of Behavior Change. FemAALES is a gender- and ethnic-specific intervention consisting of six two-hour core and three two-hour technology and project-focused group sessions. HARRP is a non-ethnic specific, informational and skillbuilding intervention consisting of four one-hour sessions, developed and routinely offered by our community partner. Both are conducted over four weeks. We propose to evaluate 540 African American women with at-risk male partners using a 3-arm evenly randomized controlled trial: FemAALES versus HARRP versus Control/Standard Care. Baseline and 3- and 9-month post-intervention assessments, each accompanied by STl (gonorrhea and Chlamydia) testing, will be conducted and compared. Specific aims are to: 1) test the efficacy ofthe FemAALES and HARRP interventions to reduce HIV risk factors including a) number of sex partners, b) unprotected anal/vaginal sex, and c) incidence of bacterial STls and 2) To test the efficacy ofthe FemAALES and HARRP interventions to improve psychosocial outcomes, including selfefficacy for safer sex negotiation and discussions with partners regarding HIV/STI testing and risk, the impact ofthe FemAALES intervention on the use of new media for social support and networking, obtaining health information, and identifying resources and services.