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Behavioral Ecological Model


This proposal is an extension of our recently completed UARP supported research concerning divorced women's risk of AIDS, in which we demonstrated significant increase in social skills to decrease risk behaviors for STDs/HIV. Furthermore we found a positive change in condom (p < .12). The proposed study will: 1) offer an enhanced treatment protocol building on our first study experience by increasing time for behavioral rehearsal; 2) add social support to the curriculum by adding formal strategies for participants to serve as their own support network; 3) increase the potential for condom use by providing free, easy access to condoms; 4) extend the study sample to include African American women given their rates of HIV/AIDS are highest; 5) closely examine the role of alcohol use/abuse as separate predictors of non-use of condoms, and 6) add biological measures of chlamydia which will enhance the validity of self-report measures. Thus, this study proposes to examine: 1) whether social skills training plus provision of free condoms, in the context of STD and HIV screening increases condom use, decreases number of partners, decreases anal intercourse, and changes the qualitative nature of partners selected for sexual intercourse; 2) whether training decreases substance use prior to sexual intercourse; 3) whether experimental training increases assertiveness/social skills for AIDS risk reduction; 4) the prevalence and incidence of STDs, HIV sero-status, and condom use by training group; 5) the prevalence and incidence of psycho/social characteristics theoretically related to risk practices, including social support and history of violence; and 6) the multivariate relationship between theoretical psycho/social characteristics and condom use. 114 separated women will be randomly assigned to an Experimental or Didactic Training Control condition. Those in the each group will receive 20 hours of didactic education, and the Experimental group will also receive behavioral rehearsal, free condoms, and social support to decrease risk behaviors for STDs/HIV. The primary dependent variable will be increases in skills and condom use. Additional dependent variables include: chlamydia/HIV screening results; avoidance of anal intercourse and drug use with sex; and process measures. Confidential interviews, videotaped role-play tests, and urine STD and Orasure HIV tests will be conducted at pre- & post-training, 3- and/or 6-month follow-up. A generalized estimating equation will be used to assess the relative effects of the intervention, time, covariates, group/time interactions, and interactions among main effects & covariates, following a Behavioral-Ecological Model.

Principal Investigator: Mel Hovell, PhD, MPH

Project Coordinator: Audrey Shillington, PhD, MSW, MPE

Funded 1998-2000

Source: Universitywide AIDS Research Program


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