4Mount Sinai Hospital, 5University of Chicago, and 6Family Planning Association of Trinidad and Tobago

Background South Africa and Trinidad and Tobago are disproportionately impacted by high rates of HIV/AIDS among adolescents. Objective The article describes the HIV crises in these countries; outlines a community participatory research framework to adapt and deliver family-based prevention; and presents preliminary data from intervention pilots in each setting. Methods Adapted interventions were piloted with N = 140 families in South Africa and N=16 families in Trinidad and Tobago to refine recruitment and retention efforts and to assess the adapted interventions ’ impact on family and risk-related constructs. Results Both settings reported promising results including high recruitment and retention and favourable pre to post changes in parent/youth frequency and comfort in talking about sensitive subjects, HIV transmission knowledge and attitudes about persons with HIV/AIDS. Conclusion International HIV-prevention alliances are increasing. Such alliances are challenged by trust issues, power-differentials and ideological differences. Recommendations are provided on how some challenges can be overcome. Key words adolescent HIV/AIDS; community collaboration; international HIV/AIDS preven-tion; South Africa; Trinidad and Tobago. Sub-Saharan Africa is the epicenter of the human immu-nodeficiency virus and acquired immune disease syndrome (HIV/AIDS) with an estimated 25 million infected peo-ple (UN, AIDS, and WHO, 2004). The much smaller Caribbean region is second only to sub-Saharan Africa in adult HIV/AIDS cases (around 500,000; Camera, Lee