HIV Risk Reduction in Migrant Workers

Florida International University, Miami FL

Investigators

Linked publications & trials

Abstract

This proposed study targeting Alcohol and Other Drug-(AOD) using Migrant Workers (MWs) is a 5-year randomized trial of a Cognitive Behavioral HIV Prevention Intervention (CBI), enhanced/adapted (CBI-A) compared with a Health Promotion (HPC) condition. This application proposes to expand on current "effective" behavioral interventions to include contextual components (e.g., Peer Counseling and Motivational Enhancement) that are likely to produce long term maintenance of HIV risk reduction effects. The CBI-A integrates key contextual components targeting peer counseling and motivational interviewing linked to maintaining HIV risk reduction effects. Only two HIV prevention outcome studies of MWs, conducted by our research team, have assessed participants for longer than 6 months. Both studies used a CBI approach and documented a moderate short-term HIV risk reduction effect that diminished at the later follow-up points. The proposed sample (N=320) will be predominantly Hispanic and African-American, low income, sexually active, AOD-using MWs?a group disproportionately affected by HIV and other health disparities. We hypothesize that 1) the CBI-A will produce a greater beneficial effect than the HPC on HIV sexual risk behaviors of 'ratio of protected to unprotected sex following intervention'and frequency of unsafe sex;2) that the CBI-A will produce more beneficial effects than the HPC in the mediator variables (social influence, stages of change, attitude-motivation-skills);and 3) that the CBI-A will be more effective for participants who are women, acculturated, have high levels of cognitive functioning and no history of traumatic abuse. Structural Equation Modeling analyses will be used to explore how study variables interrelate to affect outcomes. This project addresses the problem of health disparities in HIV risks and the potential to adapt "effective" interventions to reach this new population. The proposed project further responds to the NIH priority on rapidly translating and disseminating new knowledge, which emphasizes bringing intervention strategies developed during efficacy trials in a rigorous academic setting, into community settings in a manner adaptable to "real world" conditions. If successful, this research will delineate important HTV intervention strategies that can be practically implemented to improve maintenance of HIV risk behaviors of high-risk AOD-using MWs.