Computer-Based HIV/STD Prevention For High-Risk Women

DESCRIPTION (provided by applicant): Women are one of the fastest growing populations being infected with HIV in the United States and face unique challenges when it comes to preventing the spread of the disease. Unlike men, heterosexual transmission accounts for over 75% of all new HIV cases in women. Primary male partners are the chief source of infection. Moreover, the risk of becoming infected with HIV is increased two to five times when infected with another STD. Indeed, two-thirds of new STD infections occur in women. Finally, the primary method to prevent the spread of HIV is the correct and consistent use of the male latex or polyurethane condom. For women this presents a significant challenge because male partner resistance to condoms is an important barrier in heterosexual relationships. The proposed Phase II project will involve expansion and completion of the Safe Sistah prototype program developed during Phase I. This will include enhancing the existing multimedia assets, providing more opportunities to personally tailor the program, and offering it in both Spanish and English. The full program will be guided by three core goals. First, teach users gender-specific prevention skills. Second, emphasize the importance of preventing and treating STDs besides HIV. Finally, enhance feelings of empowerment and gender identity. The effectiveness of the Safe Sistah program will be examined in a rigorous field test. The field test will involve randomly assigning 300 women to receive either the Safe Sistah program or to a treatment as usual condition, assessing participants before, 3-months, and 6-months after their program experience. The primary outcome measure will be self-reported consistent condom use as this has been shown to be effective in reducing sexually transmitted HIV. In addition, the use of alternative risk reducing strategies, mediators of risk reducing behavior, and the presence of STD symptoms will also be assessed. If significant impact of the web-based program is demonstrated, it will be revised and prepared for marketing to STD clinics. This project aims to develop a web-based HIV/STD prevention program for women who have sex with men attending publicly-funded STD clinics. For clinics, this will allow them to provide an empirically validated HIV/STD prevention intervention to their clients without creating additional demands on their already overburdened staff. For women, the skills contained in this program will help them reduce risk behaviors and, ultimately, prevent the spread of HIV/STDs.