Peter Vanable - US grants

This proposal is submitted in response to the PA # 99-134 "Exploratory and Development Grants for Mental Health Intervention Research (R21)." AIDS-related deaths have declined due to improved treatments, but new HIV infections continue to occur at a stable rate. Although new infections must involve already infected persons, few prevention programs are available for persons living with HIV. Particularly conspicuous by their absence are interventions for men who have sex with men (MSM), a subgroup that includes more than 50% of HIV+ persons in the U.S. The central goal of the proposed research is to develop and provide an initial evaluation of an intensive risk reduction intervention that reflects the unique prevention needs of HIV+ MSM. Three research phases are proposed, consistent with the R21 mechanism. First, during a formative research phase, 50 HIV+ MSM will participate in focus groups (n = 30) and key informant interviews (n = 20), and will complete quantitative surveys (n = 50) in order to (a) tailor intervention content, (b) assess barriers to participation, and (c) pilot our evaluation instruments. Second, during the intervention development phase, an intensive, group-based risk-reduction intervention for HIV+ MSM will be developed and manualized. Intervention design will be guided by the empirical literature, our formative research, and the Information-Motivation-Behavioral Skills (IMB) model. During this phase, the intervention will be piloted with a small group of MSM, and revised based on this pilot experience. Third, during an evaluation phase, 80 HIV+ MSM will be randomized to either: (a) HIV risk reduction intervention, or (b) a standard care control condition. Assessments of sexual risk behavior and hypothesized risk antecedents will be obtained at baseline, post-intervention, and a 3 month follow-up. The feasibility and acceptability of the intervention will be evaluated with qualitative and quantitative data, including intervention attendance, patient satisfaction ratings, and exit interviews. Preliminary evidence of intervention effectiveness will be obtained through effect-size estimates and a comparison of the treated and control group on sexual risk behavior and theoretical antecedents of risky sex. If effective, the proposed intervention promises to have a significant public health impact by averting new HIV infections and improving health outcomes among HIV+ MSM.

[unreadable] DESCRIPTION (provided by applicant): This multisite project provides a unique test of a multilevel HIV/STD prevention strategy for high-risk youth. A total of 1600 African American adolescents, ages 12-16, will be recruited through CBOs in 4 cities, two in the Northeast (Providence and Syracuse) and two in the Southeast (Columbia and Macon), to participate in this HIV/STD prevention trial. Adolescents will complete a baseline ACASI administered survey to assess their attitudes, beliefs and sexual behaviors, and provide a urine specimen for detection of three prevalent STDs. Following baseline assessment, all adolescents will be randomly assigned to receive either the Focus on Kids HIV-prevention intervention or a General Health Promotion control. Subsequently, adolescents will be followed longitudinally and complete similar assessments at 6-, 12- and 18-months follow-up. The second level of intervention involves tailored HIV/STD prevention messages through local mass media. One city in each regional city-pair will be randomly assigned to receive the HIV prevention media campaign while the other city will serve as a control city (no media campaign). Thus, the media messages will be directed to African American youth in only one of the two cities in each geographic region. The media program will deliver HIV-prevention messages that are culturally sensitive and age appropriate; these programs will promote both abstinence and risk reduction practices. Cross-sectional surveys of 1200 African American youth using random-digit-dialing telephone interviews in the two cities that receive the media campaign and the two media control cities will be conducted over a 30-month period to determine the community-wide effects of the HIV media campaign. This design will enable a test of the joint and separate effects of the two interventions over an 18-month follow-up for the youth participating in the small-group interventions. In addition, the media campaign is predicted to independently enhance adolescents' adoption of HIV-preventive attitudes, beliefs and behaviors on a community-wide basis compared to youth in the non-media control cities. Causal modeling methodology will be employed to assess the effects of the two levels of intervention and to identify the role of supportive messages received through the media and from peers that are predicted to maintain safer sexual behavior as adolescents mature. [unreadable] [unreadable]

The National Science Foundation (NSF) Graduate Research Fellowship Program (GRFP) is a highly competitive, federal fellowship program. GRFP helps ensure the vitality and diversity of the scientific and engineering workforce of the United States. The program recognizes and supports outstanding graduate students who are pursuing research-based master's and doctoral degrees in science, technology, engineering, and mathematics (STEM) and in STEM education. The GRFP provides three years of financial support for the graduate education of individuals who have demonstrated their potential for significant research achievements in STEM and STEM education. This award supports the NSF Graduate Fellows pursuing graduate education at this GRFP institution.

This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.