Awareness of AIDS Can Help Prevention.

A CORNELL UNIVERSITY parent-education program has shown it can triple the likelihood that parents will discuss risk reduction and related information about H1V, the AIDS virus, with their children. The program also significantly increases the likelihood that the parents themselves will make personal risk behavior changes and obtain HIV testing.

Despite a popular misconception that the HIV/AIDS epidemic is under control in the United States because the rate of deaths from AIDS has flattened, infection rates continue to climb. A young New Yorker gets infected with HIV every two hours, on the average. Every year, 44,000 Americans become infected, and about one-fifth are New Yorkers. More than half of all new infections in the United States are among young people 25 years or younger.

"These numbers are devastating. It is such a sad and unnecessary toll in lives, dreams, and developing capabilities," says Jennifer Tiffany, director of the Cornell University Parent HIV/AIDS Education Project, which Tiffany and her colleagues have been running for more than a decade. Their program, Talking with Kids about HTV/AIDS, has directly reached 80,000 participants from every state and dozens of countries and has reaped five awards, including this year's Distinguished Service Award for Outstanding Achievement in the Provision of Prevention Services from the New York State Department of Health AIDS Institute. It also has proven effective in clinical trials. The curriculum is available, without charge, in English and Spanish on the World Wide Web at www.human.cornell.edu/pam/extensn/hivaids.

The effectiveness of the program was evaluated in a study of 375 parents on the Lower East Side of New York City who were randomly assigned to workshops and parent-child sessions based on the curriculum; the control group received carefully designed print materials but did not take part in the workshops. The 12-hour, six-session curriculum, which uses games, drawings, activities, role plays, and "homework," was so promising in the clinical trials in New York City that it has been duplicated in Mexico City. It also will be tested in a new National Institute for Mental Health--funded clinical trial to be conducted by the Center for Family Studies at the University of Miami, whose staff will be trained by Cornell educators.

Talking with Kids about HIV/AIDS focuses on communication skills for discussing difficult topics to help break down barriers between parents and children.

"Parents and guardians are often the primary health educators of children and teens, but they sometimes need support to feel comfortable and confident communicating about HIV-related issues," says Tiffany, who works on the project with Donald Tobias and Andrea Parrot, both associate professors in the Department of Policy Analysis and Management. "To make deep changes, you often have to change how parents interact with their kids. This program is designed to help parents, guardians, and other adults communicate accurate HIV-related information to children and teens in sensitive, age-appropriate, and developmentally appropriate ways. The goal is to help save lives by reducing new HIV infections among young people."

Volunteer parent-educators are trained to deliver the intensive, community-based workshops, which include basic information on the HIV epidemic and its impact, skills development in HIV risk assessment and risk reduction, and extensive parent-child communication. The Talking with Kids about HIV/AIDS Teaching Guide gives detailed descriptions of the workshop activities. About 3,000 volunteer parent-educators have participated, primarily through Cornell Cooperative Extension associations in New York State. The project is currently offered through Cornell Cooperative Extension in New York City and Albany, Schenectady, and Nassau counties.

The New York State Department of Health AIDS Institute, Adolescent HIV Prevention Initiative, provides primary funding for the project.

The New York City study is described in detail in a chapter in the book Working with Families in the Era of HIV/AIDS (edited by Willo Peguegnat and Jose Szapocznik, Sage Publications, Inc. 2000).