"Much like rural America itself, the road to effective HIV/STD prevention and control may be unpaved and winding. Yet, the moral obligation to develop and smooth this road is clearly evident. The challenges are inherently difficult and the available research and financial support are modest at best. Innovative, collaborative responses and solutions are required to contain and reduce HIV and other STDs in rural locations."

– from the RCAP publication Tearing Down Fences: HIV/STD Prevention in Rural America

HIV/STD Prevention Research

RCAP conducts research on the behavioral and social factors related to HIV/STD risk behavior that have implications for improved HIV/STD prevention efforts in rural communities. Further, RCAP develops and examines innovative education interventions designed to minimize and eliminate HIV/STD risk behavior.

RCAP–affiliated researchers and prevention specialists are from the United States, Canada, and the United Kingdom. Indiana University Bloomington researchers come from a variety of departments and offices including the Departments of Applied Health Science, Epidemiology and Biostatistics, Gender Studies, Counseling and Educational Psychology, Speech, Language, and Hearing Sciences;School of Nursing, and the world-famous Kinsey Institute.

Current research studies and community leadership of RCAP researchers include:

• Assessing via randomized control trial the effectiveness of a new blended learning healthy relationships program, About Us, designed to reduce sexually transmitted diseases and unintended pregnancies among vulnerable youth.
• Addressing social determinants of health and STDs among Latino/a youth in the South Bay region of San Diego Country, California.
• Examining, in collaboration with The Kinsey Institute, how the coronavirus pandemic is affecting sexual behavior including HIV/STDand unintended pregnancy prevention, marital quality, single life and dating, reproductive planning and health, and individual and family well-being.
• Conducting a feasibility study of United Kingdom version of The Kinsey Institute Home-based Exercises for Responsible Sex (HERS) intervention to promote correct and consistent condom use aligned with sexual pleasure among young women.
• Evaluating the United Kingdom version of The Kinsey Institute Home-based Intervention Strategy (HIS-UK) to reduce new chlamydia infection among young men aged 16–25 years by promoting correct and consistent condom use. The objective is to determine cost effectiveness of two different delivery models: face-to-face and digital deliver.
• Examining HIV prevention, treatment and testing information among minorities in Indiana with the goal of understanding what people of color believe about prevention methods such as PrEP and U=U (undetectable equals untransmittable).
• Accessing discomfort in accessing HIV services among people of color in Indiana to inform development of a community facing intervention to improve the uptake of HIV prevention and treatment measures.
• Examining the potential for poverty alleviation programs to improve the sexual health of South Africans, Kenyans, and Haitians.
• Assessing feasibility of conducting a randomized clinical trial of a microenterprise intervention for economically-vulnerable African-American adults that aims to reduce sexual risk behaviors and increase employment and uptake of HIV preventive behaviors in Baltimore, MD.
• Developing and pilot testing a set of microeconomic interventions (e.g., vouchers, financial literacy training, etc.) to reduce the risk of HIV transmission among economically disadvantaged transgender women in Richmond, VA and St. Louis MO/IL.
• Assessing accidental needle-sticks among first responder and primary healthcare providers in Indiana on providing care for people who use drugs and HIV knowledge among injection drug users.
• Examining factors that contribute to high pregnancy and birth rates among rural youth and designing and testing an intervention.
• Evaluating transportation as a critical component of staying connected to care: (1) assessing the geographic distribution of people living with HIV in Indiana counties (Marion and surrounding counties) and ease of public transit access to nearby HIV physicians; (2) assessing the contributions of individual difficulties in obtaining transportation and neighborhood ease of access to public transit to HIV viral load suppression.
• Assessing differences in adherence between antiretroviral therapy regimens that include protease inhibitors (effective, but taste bad) versus non-nucleoside reverse transcriptase inhibitors (less effective, but don't taste bad) among pediatric patient populations who are living with HIV.
• Examining the socioemotional components of living with HIV/AIDS in Botswana.
• Evaluating, in partnership with the STD Prevention Training Centers, the quality of STD services delivered by STD clinics in the U.S.
• Assessing the HIV prevention efficacy of a video-based program for young black boys and their parents.
• Comparing the socio-economic environment influencing HIV risk behaviors of transgender women in three U.S. cities.
• Conducting a feasibility study of The Kinsey Institute condom use program, Home-based intervention (KI-HIS), adapted for men who have sex with men couples.

The Kinsey Institute Condom Use Research Team (KI-CURT), a joint project of KI and the Rural Center for AIDS/STD Prevention, is an internationally recognized, multidisciplinary team that was formed in 2000 and is vested in advancing global sexual health through its research on the behavioral aspects of male condom use. KI-CURT is comprised of

• KI senior scientists Stephanie Sanders and William Yarber at Indiana University, and
• KI research fellows Cynthia Graham at the University of Southampton, United Kingdom; Richard Crosby at University of Kentucky; and Robin Milhausen of the University of Guelph, Ontario.

KI-CURT has published over 50 articles and two book chapters on various condom use-associated variables such as pleasure, sexual arousal, fit and feel, use errors and problems, erection difficulties, circumcision status, motivation, self-efficacy, relationship type, and alcohol and drug use. In 2012 KI-CURT edited a special issue of the journal Sexual Health: Condom use to prevent sexually transmitted infections: a global perspective.