Prevention of HIV/AIDS and STDs in Women over Fifty

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DESCRIPTION (provided by applicant): HIV infection is on the rise among older women in the U.S. There is an urgent need for culturally- sensitive, gender-specific, and age-appropriate HIV prevention interventions for older women, particularly minority older women who are most at-risk - a need that is disturbingly unmet. The need to overcome stigma and privacy barriers to HIV/AIDs and STD education in this group, combined with the explosive growth in the number of wired seniors, including minority seniors, makes an e-intervention an ideal delivery method for addressing this problem, and for addressing ethnic disparities in HIV infection rates among older women. Our overall goal is to develop a comprehensive (educational and behavioral), tailored, accessible, and innovative HIV/AIDs and STD prevention e-intervention for culturally-diverse older women age 50 and over. Specific Phase 1 Aims are to: 1) Develop a prototype website for a risk reduction e-intervention for culturally- diverse older women, incorporating a "peer chatroom" and "ask the expert" segment; 2) Collect pilot data to develop an individually tailored online coaching component to be incorporated into the Phase 2 site; 3) Evaluate the feasibility, acceptability, and immediate effectiveness of the Phase 1 site for increasing knowledge and perceived risks; and, 4) Prepare for the Phase 2 application with respect to functional expansion, evaluation, and commercialization of the website, to be developed in Phase I. Specific Aims for the Phase 2 application are to 1) Expand the "peer chatroom" to a fully-functional, interactive component of the website for users to meet peers, and share stories and experiences; 2) Expand the "ask the expert" segment to a fully-functional, interactive component in which user questions will be answered and posted on the website on an ongoing basis; 3) Incorporate scheduled, individually tailored, online behavioral coaching sessions with a health expert (nurse, gynecologist, or social worker); 4) Implement and evaluate the effectiveness of the enhanced risk reduction intervention in a randomized controlled trial, focusing on both proximal (e.g., increasing self-efficacy for safe sex practices, sexual negotiation skills, and physician communication skills), and distal outcomes (e.g., increase in consistent safe sex practices, successful sexual negotiation, and successful physician communication, including appropriate HIV/AID/STD testing); 5) Market the website through collaboration with national and local aging organizations, including CyberSeniors and the New England Association of HIV Over 50; and, 6) Commercialize the product(s) through individual subscription, advertising, and partnerships with other companies and nonprofits to ensure financial and administrative sustainability of the website. Environment and Health Inc. is well poised to successfully accomplish the proposed aims, given our highly qualified team, technical expertise, and infrastructure. PUBLIC HEALTH RELEVANCE: HIV infection rates are rising among older women, particularly African American women, creating public health and distributive justice imperatives for culturally-sensitive and gender-specific HIV and STD prevention interventions for older women. To date, no such interventions exist. We propose developing the first comprehensive (educational and behavioral), tailored, accessible, and innovative STD and HIV prevention e- intervention for culturally-diverse older women. The intervention will help prevent STD and HIV infection among older women, and reduce ethnic disparities in HIV/AIDS.