Computer-Based HIV Prevention Package for Drug Using African American Women

DESCRIPTION provided by applicant HIV AIDS has been especially devastating to African American women The reason for this health disparity can largely be understood within the context of the unique prevention challenges faced by African American women Specifically of new infections among women are the result of heterosexual contact with the primary male partner the chief source of infection In African American women heterosexual transmission plays an even larger role Sexually transmitted infections STIs also disproportionately affect African American women The risk of becoming infected with HIV is increased two to five times when infected with an STI Finally the impact of HIV on African American women is further augmented among those who use drugs While this combination of factors accounts for some of the prevention challenges faced by African American women it does not account for the primary challenge Beyond abstinence the most effective way to prevent HIV infection is correct and consistent use of the male latex condom For men increasing condom use is a behavior For women it is a goal Therefore HIV behavioral interventions for women require a special focus on womenandapos s lack of power in relationships and their asymmetrical subordination of personal protective behavior in deference to relationship maintenance This is especially true for African American women While the challenges are clear the solutions are not Of the HIV behavioral interventions identified by the Centers for Disease CDC control as effective only two were developed for drug using African American women Neither has an intervention package and neither is being actively disseminated by CDC To address this substantial need we intend to computer enable Female and Culturally Specific Negotiation Intervention FCSNI one of the effective interventions identified by the CDC FCSNI was specifically developed for drug using African American women who have sex with men Based on formative research with service providers we intend to call the computer enabled version of FCSNI Safe Sistah While the scalability of computer based programs allows for efficient dissemination clinics still face significant implementation barriers when tryng to deliver empirically validated interventions As such we will develop a second module called Safe Sistah in your Clinic This module will provide clinics with strategies to help them adopt and integrate Safe Sistah into their clinical offerings The results of Phase I strongly support the feasibility and potential effectiveness of the programs far exceeding the three usability benchmarks established in the Phase I proposal In Phase II we will complete development of the Safe Sistah and Safe Sistah in your Clinic modules We will test the effectiveness of Safe Sistah in a randomized controlled trial with drug using African American women Participants will be randomly assigned to receive either the Safe Sistah program or to an attention control condition Before and at two points after random assignment participantsandapos sexual and drug use behaviors will be assessed PUBLIC HEALTH RELEVANCE This project aims to develop two computer based modules an HIV behavioral intervention for drug using African American women and a program designed to help clinics adopt and integrate computer based interventions into their clinical offerings For clinics this will allow them to provide an empirically validated HIV prevention intervention to their clients without creating additional demands on their already overburdened staff For drug using African American women the skills contained in this program will help them reduce risk behaviors and ultimately prevent the spread of HIV