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

性传播感染，特别是艾滋病毒/艾滋病方面的种族/族裔差异最为明显。 在黑人女性中，她们占美国女性艾滋病病例的三分之二，而只占13% 人口数量。这些感染中的大多数被归因于与男性的性行为。存在以下风险 行为上的双性恋男性的传播在加利福尼亚州特别相关，那里的男性发生了性行为 男男性接触者(MSM)占所有艾滋病毒/艾滋病感染者的65%。非洲独有的社会文化因素 美国社区和异性伴侣呼吁专门为 有高危男性伴侣的非裔美国人妇女(例如，行为上的双性恋或吸毒男子)。我们 建议测试两个小群体干预的有效性：非裔美国女性遗产 赋权自我(FemALES)--一种理论指导下的创新和文化契合的干预 理性行动和有计划的行为，批判性思维和文化肯定(CTCA)模式，以及 赋权理论，它结合了新媒体，以增强信息获取和 获得服务和社会支持，以及艾滋病毒项目降低风险的健康替代方案 (HARRP)~一种基于行为改变跨理论模型的“本土”干预。 FemAALES是一项针对性别和种族的干预，包括六个两小时的核心干预和三个两小时的干预 以技术和项目为重点的小组会议。HARRP是一种非种族特定的、信息化和技能建设 干预由四个一小时的会议组成，由我们的 社区合作伙伴。这两项研究都在四周内进行。我们建议对540名非裔美国人进行评估 使用三臂均匀随机对照试验的女性与高危男性伴侣：女性与 HARRP与控制/标准护理。基线、3个月和9个月干预后评估 同时进行淋病和衣原体(STL)检测，并进行比较。具体目标 是为了：1)测试女性艾滋病和HARRP干预措施的有效性，以减少艾滋病毒风险因素，包括 A)性伴数量，b)无保护的肛交/阴道性行为，c)细菌性传播疾病的发病率，2)检测 女性和HARRP干预对改善心理社会结果的有效性，包括自我效能 与伴侣就艾滋病毒/性传播感染检测和风险进行更安全的性行为谈判和讨论， 女性干预对使用新媒体提供社会支持和建立联系的影响， 获取健康信息，并确定资源和服务。

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.