Reducing HIV Risk in Adult Women with Intellectual Disabilities

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DESCRIPTION (provided by applicant): The purpose of this application is to expand upon our Phase I work and further develop a fully-interactive multimedia (IMM) computer-based HIV/AIDS prevention curricula for adult women with mild intellectual disabilities (ID) (I.Q. approximately 55 through 75). In this Phase II application, we will expand the work completed in Phase I of the "Reducing HIV Risk in Women with Intellectual Disabilities" program. Phase II development will result in a suite of three 30-minute IMM programs. The three programs will focus on 1) Sex and Sexuality education program based on input from Phase I professional interviews that addresses sex and sexuality, birth control, pregnancy, menopause, and HIV/AIDS, 2) using content developed in Phase I, we will revise our prototype using high-definition (HD) video and create a program focused on HIV/AIDS Facts, Knowledge, Testing and Condom Use, and 3) we will develop a program on Relationship Negotiations around sexual behavior. Program 1 on sex and sexuality, and program 3 on relationship negotiations will include messages tailored for women who are both pre- and postmenopausal as they seldom use condoms due to lack of pregnancy risk. End users of the three Phase II programs will be adult women with mild intellectual disabilities (ID) (age 18 +). Using elements of Mastery-based learning (ML), Direct Instruction (DI), and Universal Design for Learning (UDL), the three IMM programs will be highly effective at teaching adult women with ID. Each of the three Phase II programs will have a companion video DVD and instructor guide developed as part of the Phase II program series. Formative procedures (i.e., advisor groups and telephone interviews) will be used to inform the expanded programs in terms of content, scriptwriting, and framing. We will evaluate the program with 80 women with mild ID using a randomized treatment-control design, and with 30 service providers, and 30 parents for usability, appeal, functional value, and likelihood of purchase. This evaluative approach will allow us to establish that the program is useable by women with mild ID, effective at teaching them about the transmission and avoidance of HIV, HIV testing, and condom use, and that they rate it highly on essential consumer satisfaction factors. In addition, we will confirm that the program is seen by service providers as appropriate for their clients, that it provides vital information and that they would use it and recommend it to their colleagues, and that parents view the program and content as helpful and important for their daughters. This application supports the Division of AIDS and Health Behavior Research, National Institute of Mental Health, as its purpose is to develop and disseminate a behavioral intervention that prevents HIV transmission, especially among populations at high risk for HIV infection. Additionally it supports the development of curricula and computer software that provides communication skills and training for HIV risk reduction, and the development of methods to reduce or change HIV-associated risk behaviors. PUBLIC HEALTH RELEVANCE: While there continues to be little research on the prevalence of HIV/AIDS among people with intellectual disabilities (ID), there is reason to believe that the prevalence of HIV/AIDS in women with ID is similar to, if not greater than, that of the non-ID population. The CDC has identified unique challenges facing women in the fight against HIV/AIDS, and some of these challenges are amplified in women with mild ID, due to limited knowledge, limited communication skills, difficulty communicating with health care professionals, and the desire to be involved in intimate relationships while lacking some of the social judgment and decision-making skills that could help them identify and avoid high-risk fluids and high-risk sexual encounters.