The current study investigated if condom outcomes vary as a function of perceived group support (from members of the group) and ethnic identity among participants in an HIV prevention intervention. The peer-led intervention consisted of an empirically supported curriculum, Sisters Informing Sisters on Topics about AIDS (SISTA) with an additional component that addressed the role of alcohol/drugs in risky sexual behavior. Participants included 263 unmarried, heterosexual, African American women who were recruited from three universities. At post-test, perception of a supportive group environment was associated with positive attitudes towards condom use. In addition, ethnic identity was associated with positive attitudes toward condom use and with higher condom negotiation efficacy. However, the study hypotheses were not supported because after controlling for pre-test scores, partner status, and relationship length these associations were no longer significant. The findings also indicated that participants reported more consistent condom use and condom protective attitudes at post- than at pre-test. Findings suggest that further research is needed to understand the role that support and ethnic identity plays in interventions for African American women.

In the past thirty years, HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome) transformed from a mysteriously lethal disease affecting limited portions of the population to a true global pandemic. Although HIV/AIDS is responsible for the deaths of approximately 30 million people worldwide, prevalence rates are now increasing significantly due to increasing survival rates. However, overall increasing incidence rates now serve as a primary concern for researchers. Avert (2011) suggests that there is a lack of behavioral interventions and prevention programs aimed at decreasing the number of newly affected individuals. This is problematic as it may create not only physical and mental stress upon patients but also a source of financial and resource stress upon service organizations. In Asia, HIV/AIDS is primarily apparent in three high-risk groups: sex workers, men who have sex with men, and intravenous drug users (Avert, 2011). Service organizations target these high-risk groups with prevention programs in order to decrease infection rates and raise general awareness of the disease. This study aims to evaluate two HIV/AIDS prevention program theories(the Sonagachi Project and the 100% Condom Use Program) and the studies that implement them. This proposed evaluation assesses the effectiveness of these HIV/AIDS prevention programs in reducing infection rates and raising awareness of the disease. Due to the widespread use and apparent effectiveness of the 100% Condom Use Program and The Sonagachi Project, this study aims to assess the interventions in lessening HIV infection rates and critique the methods outlined by both. This thesis also employs a systemic review of the literature by using the program theories of The 100% Condom Use Program and The Sonagachi Project.

The purpose of this thesis is to report on issues concerning the continuous spread of HIV/AIDS in Mozambique in spite of the HIV/AIDS prevention interventions that are in place. This research was conducted in Dondo and Maringue districts, both situated in the Sofala Province. Sofala Province had higher prevalence that was 25 percent higher than the national average of 16.2 percent. An ethnographic research methodology was used in order to understand the reasons behind the continuous escalation of HIV/AIDS. It was significant for one to get to know the people that live in Dondo and Maringue, especially their daily lives, including their cultural practices as the driving force in people’s behaviour and the manner in which people make sense of their daily lives. It was important to understand their cultural practices, because of their relevance to the issue of HIV/AIDS in terms of the manner in which cultural practices influence people in decision-making about their social life, which escalate to the issue of health practices. Although the concept of HIV/AIDS is acknowledged in Dondo and Maringue, xirombo and phiringaniso were continuously used as local concepts in health issues and practiced as indigenous knowledge together with kupitakufa, kupitamabzwade, and kupitamoto rituals, and these practices were extended in dealing with HIV/AIDS. The acceptance of the Western medical interpretation of HIV/AIDS was low among the people in Dondo and Maringue. This reality is due to the preservation of local cultural knowledge in dealing with diseases. As a result, local medical concept and rituals becomes a challenge to the Western medical interpretation of HIV/AIDS and its health prevention and intervention strategies. In the context of Western medical interpretation of diseases the above local cultural practices are used as '" " resistance against the western medical interpretations HIV/AIDS concepts. These cultural practices have preferences among local people in dealing with, and promoting HIV/AIDS health prevention interventions when compared with the public biomedical HIV/AIDS concept and the general biomedical practices. In conclusion this thesis suggests that there is a need for integration of these cultural practices within the Western medical interpretation, prevention and intervention strategies in dealing with the HIV/AIDS pandemic and its concerns at a local level.

Despite increases in HIV awareness, prevention and treatment, little is known about the contributing factors to medication adherence among adherent Black women with HIV. Understanding the protective factors that improve medication adherence and CD4 cell count for Black HIV+ women is essential and necessary to improve the treatment outcomes for this understudied population. The purpose of this study was to examine the relationship between spirituality, social support, trust in physician, and medication adherence among HIV+ Black women. While this study was not designed to test the influence on medication adherence, it was hypothesized that increased levels of spirituality, social support and trust in physician would positively relate to adherence. In this study, medication adherence was measured by 1) self-report on The AIDS Clinical Trial Group (ACTG) Adherence Questionnaire and 2) CD4 T-cell count. Baseline data was collected from 82 Black women in the Miami-Dade community and participants were administered the Spiritual Well-Being Scale (SWB), the Social Support Questionnaire (SSQ), and the Trust in Physician Scale (TPS). The results of this study indicate that medication adherence is not related to spiritual well-being, social support, or trust in physician. However, a significant positive correlation between spiritual well-being and trust in physician was found. Findings suggest that additional research is needed to explore the multifarious nature of the factors that enhance medication adherence for this population. Implications for research and practice are discussed with respect to the inclusion of spirituality, social support and trust in physician components within prevention and intervention programs designed to increase adherent behaviors among Black HIV+ women.