DEVELOPMENT AND TESTING OF A JAMAICAN MOTHER-DAUGHTER HIV RISK-REDUCTION PROGRAM

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Caribbean nations, including Jamaica, exhibit HIV rates that are second only to sub-Saharan Africa. Jamaican young women and adolescent girls are at particularly high risk due to a number of cultural factors, gender norms, partnering with older male partners, and lack of knowledge and skills related to sexual refusal and HIV prevention. U.S. studies have shown that mothers may act as a key influence of their daughters' sexual risk beliefs and behaviors. However, no studies have documented these effects outside of the U.S. and no studies have evaluated HIV risk-reduction interventionswith Jamaican adolescent girls and their mothers. Hence, the purpose of the proposed project is to partner with the University of the West Indies, Jamaican community based organizations (CBOs) and families in order to develop and test a culture-specific mother-daughter HIV risk-reduction intervention in a randomized pilot field experiment. Specifically, we propose to test whether a culture-specific, theory-based, skill-building intervention with Jamaican adolescent girls and their mothers can directly and/or indirectly reduce these girls' HIV risk-associated sexual behaviors. Jamaican girls, ages 14-18, and their mothers/female guardians will be recruited from CBOs and randomly assigned to either: (a) a mother-daughter HIV risk-reduction intervention condition or (b) a "no intervention" control condition. The HIV risk-reduction intervention includes 8 modules scheduled over 2 days and implemented by trained adult Jamaican women recruited from among CBO staff. The mother component is designed to increase parenting behaviors (e.g., parental monitoring, parent-child sexual communication [PCSC]) associatedwith reduced adolescent sexual risk-taking; the teen component is designed to improve girls' beliefs and skills related to abstinence, sexual negotiation and condom use. A "no intervention" control condition is being employed as the proposed project is a pilot study of the HIV risk-reduction intervention. Primary outcomes include mothers'/daughters' reports of parenting behaviors and daughters' self-reports of sexual risk behaviors (sexual intercourse, unprotected sex, condom use, number of partners). Secondary outcomes include mothers' beliefs regarding parenting behaviors and daughters beliefs regarding sexual risk behaviors-the theoretical mediators of intervention effects. Findings from this study will contribute to the development of effective HIV risk-reduction programs for Jamaicanadolescent girls and young women.