This SBIR application hypothesizes that a tailored, interactive, literacy-scaffolded, web-based intervention that is based on an adaptation of a validated, behavioral model can 1) improve understanding of transmission of HIV/AIDS and 2) improve intent to reduce risky behavior more than a static website with similar content. Our specific aims are to: 1) develop a pilot version of a literacy-scaffolded intervention to promote understanding of HIV/AIDS transmission and improve intent to reduce risky behavior; 2) evaluate the feasibility of using the intervention for both those with HIV or at risk for acquiring it to improve understanding of HIV/AIDS transmission, improve intent to reduce risky behavior, and obtain feedback on the intervention; and 3) develop our Phase II application. With assurances of anonymity and explanation of potential value of the intervention, we will recruit participants 18 to 35 years old from HIV clinics and testing facilities. A review team from the target audience will assist with content development and help evaluate the Phase I pilot. In a pre-website survey, we will assess participants' knowledge about HIV/AIDS (especially transmission), perception of personal susceptibility of acquiring or spreading HIV, reported behaviors that increase their risk of acquiring or spreading HIV, perception of peer group norms, balance of barriers to and benefits of changing their risk behavior, and feelings of self-efficacy. By combining this input with discrete approaches for those with and without HIV, and guided by an adaptation of the Health Belief Model, we will tailor what each participant sees by providing personalized, content written at three levels of reading ability. In comparison with controls viewing a conventional website, this individualized website is expected to 1) motivate and engage participants, 2) help all, including those with low literacy, to understand better what they need and want to know about HIV/AIDS, 3) improve intention to reduce risky behavior, 4) increase rates of HIV screening among at-risk participants, and 5) have a positive effect on perception of peer group norms. We anticipate that customized versions of the resulting product will have commercial applications leading to widespread dissemination via license to physicians, clinics, and health care support groups; corporations; universities, colleges, community colleges, preparatory schools, and high schools; and individuals. With 40,000 people/yr continuing to be infected with HIV, an effective means to reduce risk behaviors for contracting/transmitting HIV that could be disseminated widely at low cost would have great public health value.
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