|
Individual-Level -
Heterosexual |
|
El-Bassel, N., Witte, S.S., Gilbert, L., Wu, E., Chang, M.,
Hill, J., and Steinglass, P. (2005) Long-Term Effects of an HIV/STI
Sexual Risk Reduction Intervention for Heterosexual Couples.
AIDS and Behavior, Vol. 9, No. 1, 1 - 13 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
|
Heterosexual Couples |
This randomized trial wanted to examine the
efficacy of a relationship based HIV/STI prevention
intervention. A total of 217 heterosexual couples were randomly
assigned to one of three intervention conditions. 1) Six
sessions to both partners, 2) the same intervention to
the woman alone, or 3) a one session health education
(control) provided to the female participant only. Each
intervention incorporated concepts from the ARRM, ecological
perspective, information from the development phase, and an NIMH
HIV/STI prevention with couples trial from 1998. |
During the 12 month follow-up post intervention interview,
results showed that the intervention was effective in reducing
unprotected sex for those who participated in the intervention
conditions 1 and 2 compared to those who participated in the
health education intervention. However, there was not a
significant difference when comparing whether couples attended
together or the woman received the intervention alone. |
|
Prevention Case Management - Heterosexual Back
to Top |
| The CDC
has endorsed Prevention Case Management (PCM) as an effective
intervention to reach HIV positive and/or very high-risk
HIV negative persons. PCM is a client-centered HIV
prevention activity with the fundamental goal of promoting the
adoption and maintenance of HIV risk reduction behaviors by
clients with multiple, complex problems and risk reduction
needs. PCM provides client-centered, multiple-session HIV
risk reduction counseling while using the service brokerage of
traditional case management to address competing needs that may
make HIV prevention a lower priority. This HIV prevention
activity addresses the relationship between HIV risk and other
issues such as substance use, mental health, adherence issues,
social and cultural factors, and physical health problems.
While PCM has yet to be rigorously evaluated, intensive case
management interventions for clients with multiple, complex
problems have been shown to be effective in other health fields.
CDC HIV Prevention Case Management – Guidance September
1997
CDC HIV Prevention Case Management – Literature Review and Current
Practice September 1997
CDC Abbreviations and Acronyms |
|
Group-Level -
Heterosexual
Back to Top |
|
Kalichman, S.C., Sikkema, J., Kelly, J.A., Bulto, M., (1995) Use
of a brief behavioral Skills Intervention to Prevent HIV
Infection Among Chronic Mentally Ill Adults. Psychiatric
Services 46(3), 275-280 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
|
Heterosexual |
This is a brief behavioral skills
intervention conducted in small groups during four 90 minute
sessions. Sessions were: 1) AIDS risk reduction
education; 2) behavioral skills to reduce AIDS risk;
3) communication and negotiation skills; and 4)
review & reinforcement. The goal of the intervention was to
inform adults about HIV/AIDS and ways they can protect
themselves and others from contracting HIV. The intervention is
based on theory of reasoned action, social cognitive theory, and
information-motivation-behavior skills (IMB) model. The
intervention was originally conducted in two psychiatric clinics
in Milwaukee, Wisconsin. The participants (27 men and 25 women)
were recruited and randomly assigned to either the immediate
intervention, or the four-week waiting list control group.
An
intervention package, Let’s Chat, is available from Sociometrics
(www.socio.com).
Check web site for the package price. |
Overall, the researchers concluded the
intervention had a positive, short-term effect on sexual risk
behaviors. Of the 52 participants who completed the baseline
assessment, 44 (85%) completed the intervention. Completion was
defined as having attended a minimum of two of the four
sessions. When compared with the waiting list control group,
the immediate intervention group reported changes in condom-use
and AIDS risk knowledge, and intentions to change their risk
behavior. The immediate group also reported a substantial
reduction in rates of unprotected sexual intercourse and an
increase in condom use. |
| Baker S et al. (1999)
Personal communication |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Women |
Choices Project. Women randomly
assigned to Relapse Prevention intervention (experiment) or
health education and social support intervention (control). Both
interventions 16-session, 2-hour weekly groups. |
Both groups reduced number of risky
sexual acts at 4 months and change is sustained at 12 months. No
difference between groups. Both groups also increased and
maintained safer sex negotiation skills. |
| Basen-Engquist K,
Coyle K, et al. (2001) Schoolwide Effects of a Multicomponent
HIV, STD, and Pregnancy Prevention Program for High School
Students. Health Education & Behavior 28 (2): 166-185. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Youth |
School-based Safer Choices program,
a multicomponent, behavioral-theory-based HIV, STD, and
pregnancy prevention program. 20 urban high schools randomized
into intervention and control. |
At 19 months, decreased frequency
of sex without a condom. At 31 months, less sexual intercourse
without a condom with fewer partners. Program did not influence
prevalence of recent sexual intercourse. Cost-effectiveness
study showed that Safer Choices is a cost saving program under a
wide range of estimates (Wang LY et al.).
Concern:
Setting specific? |
Cohen D, Dent C, et
al. (1991) Condom Skills Education and Sexually Transmitted
Disease Reinfection. Journal of Sex Research
28(1): 139-144. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC (mostly African-Am) |
Los Angeles, California. 192 STD
clinic patients most of who were African-Am. Increase
familiarity and skill with condoms was a single group session
(30 mins) for men and women registered at the STD clinic. The
brief condom skills education session was led by a female health
educator during regular clinic hours at the STD clinic. |
Compared with controls, men and
women exposed to the group intervention in the STD clinic
waiting room were approximately half as likely to return to the
clinic within the next 12 months with a new STD. This was a
significant decrease in return rates.
Concern: Setting specific? |
| Cohen D, MacKinnon DP,
et al. (1992) Group Counseling at STD Clinics to Promote Use of
Condoms. Public Health Reports 107(6): 727-730. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC (mostly African-Am) |
Los Angeles, California. 426 STD
clinic patients most of who were African-Am. Small group format
while patients were waiting for their STD clinic appointments.
Groups were 10 to 25 people per session. Led by African American
female health educator – soap opera-formatted video showing
condom use as socially acceptable, a facilitated group
discussion on methods of preventing STDs and promoting condom
use and role playing, skill-building exercises to enhance condom
negotiation with sex partner. |
The rate of STD reinfection was
significantly lower for men who participated in the intervention
than for men who did not participate in the intervention.
Concerns: No effect for women. Setting specific? |
| DiClemente RJ, Wingood
GM (1995) A Randomized controlled trial of an HIV sexual
risk-reduction intervention for young African-American Women.
Journal of American Medical Association October 25; 274(16):
1271-1276. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
POC/
young women"SISTA Project" |
Peer mediated 128 sexually active
women aged 18-29. Five 2-hour weekly group sessions. Session
focused on gender, ethnic prided, knowledge of HIV risk
behaviors, prevention strategies, sexual assertiveness, modeling
and role playing; correct condom use; norm setting exercises and
coping skills, sexual self-control, communication skills, and
practicum’s. This intervention was outlined in
CDC’s
Procedural Guidance for selected strategies and
interventions for CBOs under Program Announcement 04064.
|
At 3-month follow-up. The social
skills intervention was effective in increasing consistent
condom use. |
| El-Bassel N, Schilling
RF (1992) 15- Month Follow-up of Women Methadone Patients Taught
Skills to reduce Heterosexual HIV Transmission. Public Health
Reports 107(5): 500-4 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| IDU/ POC (African-Am/ Hispanic) |
15-month follow-up of study
summarized above (Schilling RF, EL-Bassel et al. (1991) Building
Skills of Recovering Women Drug Users to Reduce Heterosexual
AIDS Transmission. Public Health Reports 106(3):
297-304). |
Compared to the information-only
group, women in the skills-building group showed an increase in
frequency of condom use at 15-month follow-up. The groups did
not differ significantly in number of sex partners. |
| Eldridge, GD, St.
Lawrence JS, Little CE et al. (1997) Evaluation of an HIV risk
reduction intervention for women entering inpatient substance
abuse treatment. AIDS 9: 62-77. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Women/Drug Use |
117 drug-using women court-ordered
into inpatient drug tx. Compared effectiveness of an educational
intervention and a behavioral skills training intervention at
reducing sexual risk. Both groups reported high rates of sexual
risk prior to intervention. |
At 2-month follow-up, women in
skills training groups showed improvement in communication
skills, condom application skill, and condom use. Both groups
showed decreased drug use and drug-related high-risk sex
activity.
Concern: short follow-up |
| Hobfoll
SE, Jackson AP (1994) Reducing Inner-City Women’s AIDS Risk
Activities: A Study of Single, Pregnant Women. Health
Psychology 13(5): 397-403. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Pregnant Women |
206 participants, who
were single pregnant women, attended four 90-120 min. group
sessions of 2-8 women, taped segments of assertiveness,
negotiation, planning, and AIDS prevention skills including role
plays, cognitive rehearsal, formulate health action plan. |
6 mo. Follow-up
improvement in condom use for vaginal sex, condom and spermicide
acquisitions for intervention and not for control.
Concern: Applicability to non-pregnant persons. |
| Howard M,
McCabe J (1990) Helping teenagers postpone sexual involvement.
Family Planning Perspectives 22:21-6. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC/ Youth |
Henry W. Grady Memorial
hospital, recruited 536 students from their low-income
population. Those recruited were less than 16 years old, part
of the hospital’s family planning program, and were recruited
through medical records. Intervention was peer-led 5 sessions,
emphasis on postponing sexual involvement, discussing peer
pressures, skill practice to resist pressure. |
18 month follow-up fewer students initiated
sex in intervention group.
Concern: Emphasis on postponing sex. |
| Jemmott JB,
Jemmott LS et al. (1992) Reductions in HIV risk-associated
sexual behaviors among black male adolescents: Effects of an
AIDS Prevention Intervention. American Journal of Public
Health 82(3): 372-377 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC/Youth (African Am) |
157 participated in
5-hour intervention based on theory of reasoned actions.
Intervention provided information, video, games, exercises, and
skills building. The control group received an intervention on
career opportunities. |
3 mo. follow-up, fewer
sexual partners in intervention group, more condom use and less
anal intercourse. Cost-effectiveness data: Pinkerton SD,
Holtgrave DR, and Jemmott JB (2000). Economic Evaluation of HIV
Risk Reduction Intervention in African-American Male
Adolescents. JAIDS 25(2): 164-72. |
| Jemmott JB,
Jemmott LS, Fong GT (1998) Abstinence and safer sex HIV risk
reduction interventions for African-American Adolescents: A
randomized controlled trial. Journal of the American Medical
Association 279: 1529-36. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| African-Am Youth |
Randomized controlled
trial with 3, 6, and 12 month follow-up. 659 male and female
African-American 6th and 7th graders.
Eight
1 hour modules, adult facilitators or peer co-facilitators.
Abstinence intervention stressed delaying intercourse or
reducing frequency; safer sex intervention stressed condom use;
control intervention concerned health issues unrelated to sexual
behavior. |
Abstinence: less
likely to report sex at 3 months, but not at 6 or 12 months.
Safer-sex: more consistent condom use than control at 3 months
and higher frequency of condom use at all follow-ups. Among
youth sexually experienced at baseline, safer-sex intervention
participants reported less sex at 3 months than the control
intervention participants. Additionally, those attending the
safer sex intervention reported less sex at 6 months and 12
months than the abstinence and control interventions. No
differences in intervention effects with adult facilitators
compared with peer co-facilitators. |
| Kalichman
SC, Cherry C and Browne-Sperling F (1999) Effectiveness of a
Video-Based Motivational Skills-Building HIV Risk-Reduction
Intervention for Inner-City African American Men. Journal of
Consulting and Clinical Psychology 67:959-966. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| African-Am men |
117 heterosexually
active African-American men recruited from public clinic.
Randomly assigned to either a 6-hr video-based small group
motivational-skills intervention or a 6-hr video-based HIV
education comparison group. |
Men in
motivational-skills group decreased rate of unprotected vaginal
intercourse and used more condoms at 3 months. Both groups
showed increased condom use at 6-month follow-up. |
| Kelly JA,
Murphy DA et al. (1994) The effects of HIV/AIDS Intervention
Groups for High-risk Women in Urban Clinics. American Journal
of Public Health 84(12): 1918-1922 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Women (African-Am) |
197 women at urban
primary care clinic randomly assigned to intervention or
control. Intervention included four 90 min group sessions and
1-month group follow-up with 8-10 women in-group with two
leaders. Provided information, role-plays, managing ‘triggers’,
group problem solving and active support. Comparison group
attended sessions on health topics unrelated to AIDS. |
At 3-month follow-up,
intervention group had increased communication and negotiation
skills, decreased UVI, and increased condom use. Control group
showed no change.
Concern: short follow-up |
| Kirby D,
Barth RP et al. (1991) Reducing the risk: Impact of a new
curriculum on sexual risk taking. Family Planning
Perspectives 23(6): 253-263. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Youth |
A school-based program
conducted over 15 classroom periods. 758 students were assigned
to a treatment or control group. The treatment group received
the Reducing the Risk curriculum that was based on several
somewhat interrelated theoretical approaches. Those assigned to
the comparison group received a mandatory health education
class. |
Intervention group had
prolonged first onset of intercourse than control group. After
18 months, 29% of the intervention group had initiated
intercourse compared with 38% of the control group. Outcomes
regarding unprotected sex refer generally to birth control, not
specifically to condoms.
Concerns: Small effect, if any, for high-risk sexually
active youths. Setting specific? |
| Levy JA,
Fox SE (1998) The Outreach-assisted Model of Partner
Notification with IDUs. Public Health Report 113(S-1):
160-9. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Youth |
School-based program
with 15 school districts randomly assigned to 3 conditions a)
parent interactive; b) parent non-interactive and c) wait list.
Intervention was lecture, small group discussion, and skills
building to: resist social pressures; obtain preventive
practices, role-play, practice, and homework. 10 session
provided to 7th graders and 5 sessions
provided to the 8th graders. |
Intervention groups use
of condoms and foam from 14% to 24%. Had sex less often. No
difference in use of condoms alone.
Concern: Setting
specific? |
| Magura S,
Kang S. et al. (1994) Outcomes of Intensive AIDS Education for
Male Adolescent Drug Users in Jail. Journal of Adolescent
Health 15(6): 457-463. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Young POC/ drug users |
NYC DOC Adolescent
Reception and Detention Center. 157 youths aged 16-19, most were
African-American or Hispanic. 4 1-hour small-group sessions of
eight led by male counselor. Sessions focused on health
education issues relevant to male adolescent drug users, with an
emphasis on HIV/AIDS. Group activities included role-play and
rehearsal techniques. |
Youth in the
intervention were more likely to use condoms during vaginal,
oral or anal sex, had fewer high-risk sex partners, and had more
favorable attitudes toward condoms than youth not in the
intervention.
Comment: None of youth admitted to using
injection drugs; however, there was a high incidence of crack
and intranasal cocaine use. Curriculum focused on sexual risk reduction. |
| Main DS,
Iverson DC et al. (1994) Preventing HIV Infection Among
Adolescents: Evaluation of School-Based Education Programs.
Preventive Medicine 23(4):409-417. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Youth |
School-based program
conducted over 15 sessions (40 hours). Program consist of 3 HIV
knowledge sessions, 2 normative determinates of risky behavior,
one on teen vulnerability and eight on development skills to
identify and manage risking situations. |
At 6-month follow-up,
sexually active students reported significantly fewer partners
and greater frequency of condom use.
Concern: Setting
specific? |
| Malow RE,
West JA et al. (1994) Outcome of Psychoeducation of HIV risk
reduction. AIDS Education and Prevention 6(2): 113-125. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC/ Drug use (African
American cocaine users) |
152 African American
males at in-patient tx program participated in group-level
sessions. Non-peer led, held for 2 hours over 3 consecutive
days, 6-8 people. Sessions included HIV knowledge/risk;
demonstrated cleaning works, condom use, condom negotiating, and
skills-building exercises; and review and discussion of HIV testing
procedures. |
47.5% of intervention
group participants reported having more than one partner at
three-month follow-up compared to 76% at the baseline in the
comparison group. The change from 76% at baseline to 59% at the
follow-up was considered to be not statistically significant.
Sexual risk taking in those receiving the intervention decreased
from 75% (pre intervention) to 32% (follow-up). |
| The
National Institute of Mental Health (NIMH) Multisite HIV
Prevention Trial Group (1998). The NIMH Multisite HIV Prevention
Trial: Reducing HIV sexual risk behavior. Science 280:
1889-94. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC |
Project Light.
Randomized, controlled trial with 3 high-risk populations at 37
inner city, community-based clinics at 7 US sites. 1855 control
and 1851 intervention participants, mostly African-American or
Hispanic. Experimental condition: Small-group (5-15), twice
weekly 7 session program, 90-120 minutes per session. Separate
male and female groups. Co-led by a male and a female
facilitator. Control condition: 1-hour AIDS education session
that included videotape and Q&A period. |
Both groups decreased
frequency of unprotected sex at follow-up. Compared to controls,
intervention group reported fewer unprotected sexual acts, had
higher levels of condom use, and were more likely to use condoms
consistently over a 12-month follow-up period. In intervention
group, more sessions attended associated with greater behavior
change. No difference in overall STD reinfection rate. Among men
recruited from STD clinics, lower gonorrhea incidence at
follow-up. |
| Nyamathi
AM, Flaskenis J et al. (1994) Evaluation of Two AIDS Education
Programs for Impoverished Latina Women. AIDS Education and
Prevention 6(4): 296-309. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
POC Women
drug using/homeless |
The purpose was to
evaluate and contrast the effectiveness of two culturally
sensitive AIDS education programs. 131 women participated in
the traditional program where they received one hour of AIDS
education and community resource information. 82 women
participated in a specialized program where the information was
extended to include reinforcement of risk skills and enhancement
of self-esteem and control. |
Over the two-week interval, significant
improvements were found in both groups for all cognitive and
psychological variables, except problem-focused coping.
High-risk IV drug use (in those who reported this behavior
during the pre test) decreased from 18 to 7 in the traditional
group and from 14 to 0 in the specialized group. Likewise,
reports of non-IV drug use and sexual activity with multiple
partners decreased in both groups.
Concern: Very short follow-up.
|
| O’Donnell
CR, O’Donnell L et al. (1998) Reductions in STD infections
subsequent to an STD clinic visit: Using video-based patient
education to supplement provider interactions. Sexually
Transmitted Diseases 25(3): 161-168. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC/African Am and
Hispanic males "VOICES/VOCES" |
2,004 adult males in
South Bronx, New York. Tested video-based STD prevention. Random
assignment to three groups: video plus discussion, video only,
usual clinic services (control). Interactive session was small
group format (three to eight patients) at the clinic and
facilitated by an STD counselor. Two culturally sensitive videos
(Let’s Do Something Different for African Americans and Porque
Si for Hispanics). This intervention was
outlined in CDC’s
Procedural Guidance for selected
strategies and interventions for CBOs under Program Announcement
04064. |
Men who participated in
experimental groups had significantly lower rates of new STD
infection than those in comparison group. No difference between
video only group and video plus discussion group. Clients with
multiple sex partners experienced greatest effect. |
| Raj A,
Amaro H, Cranston K, et al. (2001). Is a General Women’s Health
Promotion Program as Effective as an HIV-Intensive Prevention
Program in Reducing HIV Risk Among Hispanic Women? Public
Health Reports 116: 599-607. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Latina |
Study included 162
Hispanic women ages 18 to 35, most of them low-income
immigrants, in Boston area. Assessed whether participation in an
HIV intensive prevention program or in a general women’s health
promotion program led to greater risk reduction than being in
the wait-list control group. Both interventions lasted 12 weeks
(12 sessions of 90-120 minutes each) and were group-level
interventions. |
Measurements at
baseline, intervention completion, and 3 months. Both
interventions showed increased condom use at post-test and
follow-up. HIV intensive program participants also reported
increased safer sex negotiation. Health promotion program
participants reported increased HIV testing. |
| Rhodes R,
Wolitski RJ et al. (1992) An experiential program to reduce AIDS
risk among female sex partners of injection drug users.
Health and Social Work 17:261-272. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Women (Sex partners of
IDUs) |
69 women recruited
though street outreach participated in 3 90-min group sessions
held on consecutive days then a fourth session one week later
and underwent HIV C/T. Sessions focused on AIDS education,
condom use, needle cleaning, negotiation, problem-solving skills
building, referrals, and post-intervention weekly support
groups. |
At immediate
post-intervention, 91% reported having made positive changes to
reduce AIDS risk and 68% of women who did not use condoms before
intervention reported they had since entering intervention (no
control). |
|
Rotheram-Borus MJ, Koopman C et al. (1991) Reducing HIV sexual
risk behaviors among runaway adolescents. Journal of American
Medical Association 266(9): 1237-1241. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC/ Youth "Street
Smart" |
Non-random control 197
runaways. Small group sessions 90-120 min., 4 days/week. Each up
to 30 sessions at least 3 private session, develop soap opera
dramas, review videos, and skills coping. This
intervention was outlined in CDC’s
Procedural Guidance
for selected strategies and interventions for CBOs under Program
Announcement 04064. |
3 and 6-month
follow-up. Increased number of sessions associated with
increased condom use and decreased risk behaviors. An update of
the intervention in 1997 CDC compendium shows similar results. |
| Schilling
RF, EL-Bassel et al. (1991) Building Skills of Recovering Women
Drug Users to Reduce Heterosexual AIDS Transmission. Public
Health Reports 106(3): 297-304. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Women/ POC |
91 African-American and
Hispanic women enrolled for at least 3 months in five clinics in
large methadone maintenance program in NYC. Non-peer led
skills-building groups held five 2-hour sessions offered to
groups of 9-10. Topics included: HIV 101; identification of
high-risk sexual practices; discussion of barriers to adopting
safer sex practices; discussion of negative associations with
condoms; condom use skills; role-played negotiation of condom
use; assertiveness; problem solving; and communication skills
involving safer sex scenarios. Comparison group received one
session of AIDS information routinely provided by the clinic.
|
The skill-building
intervention group showed statistically significant higher use
of condoms than those in the control group at follow-up.
Participants also more comfortable taking and carrying condoms,
talking about safer sex with partners, had more favorable
attitudes toward condoms. No drug use differences between
groups.
Comment: Initial follow-up was 2-week post. |
| Schilling
RF, Ivanoff A et al. (1994) HIV-related risk reduction among
women offenders in jail and in the community.
X International Conference on AIDS. 10,43 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Women/Drug Use |
159 Drug-abusing female
offenders, approaching release from a 3-12 month sentence, were
recruited from Rikers Island. Women were randomly assigned to
(1) 8 group session conducted in prison and 8 individual session
in the community post-release, focussing on AIDS information;
condom use; needle-cleaning; and negotiation skills building and
social support; or (2) an information-only. |
At follow-up, there was
a trend for intervention participants to report greater condom
use improvements. |
| Sikkema
KJ, Winett RA et al. (1995) Development and Evaluation of an
HIV-Risk Reduction Program for Female College Students. AIDS
Education and Prevention 7(2): 145-159. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| College women |
43 heterosexual college
women participated in four 75 to 90-min. sessions held over a
one-month period with groups of seven to 10 participants. Female
doctoral students served as group mediators. The intervention
covered topics such as risk behavior education, behavioral
self-management, assertiveness training, decision-making, safer
sex negotiation, condom use and maintenance of risk-reduction
behavior. The control group received one 90-min. session
covering the same topics but using a didactic education
approach. |
The intervention was
effective at improving one key determinant of sexual risk
behavior: sexual assertiveness and communication skills. The
skill-building participants showed greater improvement from
baseline to the immediate follow up in overall assertiveness
skill, in the sum of four components of skill and in two of the
four components: acknowledgment of partners’ request for sex and
suggestion of alternative lower-risk behavior.
Concern:
Applicability of results to other (non-college, high-risk)
populations. |
| Shain RN,
Piper JM, Newton ER, et al. (1999) A randomized, controlled
trial of a behavioral intervention to prevent sexually
transmitted disease among minority women. New England Journal
of Medicine 340: 93-100. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Women of Color |
424 Mexican-American
and 193 African-American women with nonviral STDs. Randomized
trial. Intervention 3 weekly small-group sessions, 3-4 hours
each. 5-6 women per group and female facilitator, all of same
race/ethnicity. Sessions designed to help recognize personal
susceptibility, commit to changing behavior, and acquire
skills. Based on AIDS Risk Reduction Model. 6 and 12 mo
follow-up |
High rates of session
attendance and retention in study. This intervention decreased
the rates of Chlamydia and gonorrheal infection among
Mexican-American and African American women at high risk for
sexually transmitted disease; rates of subsequent infection was
significantly lower in intervention group at both follow-ups.
Comment: Very strong study design. |
| Stanton
BF, Li X et al. (1996) A Randomized, Controlled Effectiveness
Trial of an AIDS Prevention Program for Low-Income
African-American Youth. Archives of Pediatrics and Adolescent
Medicine. 150(4): 363-372. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| African-Am youth |
Public Housing
developments/rural campsites. 383 African-American youth, 9 to
15 years of age, in peer groups. 7 weekly sessions (1½ hour
each) and one day-long session. Each session led by a pair of
interventionists, recruited from the community, most of whom
were African-American. Group sessions included communication and
negotiating skills, value clarification, goal setting and peer
norms. Small-group discussions, lectures, videos etc. In session
7 the group developed community projects with intervention
messages. |
Condom use in the short
term (6 month after intervention) showed significant improvement
for intervention youth compared with control youth. Long-term
follow-up (2 years) showed that intervention youth were less
likely than control youth to adopt a risk behavior, though they
were not less likely to experiment with a risk behavior.
Concern: Condom use difference disappeared at 12-month
follow-up. |
| St.
Lawrence JS, Brasfield TL et al. (1995) Cognitive-behavioral
Intervention to Reduce African-American Adolescents’ Risk for
HIV Infection. Journal of Consulting and Clinical Psychology
63(2): 221-237. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC/ Youth (African-
Am) |
Public health clinic
serving low-income families in a mid-size southern US city. 246
inner-city youth ages 14-18. Intervention was 8 group sessions
(1½ to 2 hours each) of 5 to 15 participants. Group sessions
were co-led by trained facilitators. The group members used
role-playing techniques and practiced skills-building activities
in smaller groups of two to three persons. Sessions included
HIV/AIDS education; peer pressure and sexual decision making;
communication and assertiveness skills-building activities;
meeting an HIV positive youth; discussion on the most beneficial
components of the intervention and how they increased
self-efficacy. Control group received 2 hours of education. |
Male and female
adolescents who received the intervention increased condom use
significantly. The males in the group also lowered their rates
of unprotected intercourse to a greater extent than did males in
the information-only intervention. The females, who received
skills training, compared with those who received information
only, decreased the frequency of unprotected intercourse. Thus,
the skills training intervention was more successful both in
lowering risky behaviors and in sustaining safe alternatives
such as condom use among youth who remained sexually active. |
| St.
Lawrence JS, Brasfield TL, and O’Bannon RE (2002). Reducing STD
and HIV Risk Behavior of Substance-Dependent Adolescents: A
Randomized Controlled Trial. Journal of Consulting and
Clinical Psychology 70(4): 1010-1021. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Youth |
Conducted in
Mississippi with high-risk adolescents in two residential drug
treatment programs. Assessed 3 interventions designed to
increase safer sex behaviors of substance-dependent adolescents.
Mixed gender cohorts of 6 to 10 adolescents met three times each
week over a 4-week period for a total of twelve 90-minute
sessions. Total N=161 participants (68% male, 75% white, 22%
African American). Randomly assigned to either a health
information intervention (I only); information plus behavioral
skills safer sex training (i.e., correct condom use, partner
negotiation, refusal of unwanted sexual invitations, and peer
information provision) (I+B); or the same experimental condition
plus a motivation component that confronted adolescents’
illusion of invulnerability and then emphasized their ability to
prevent the negative outcome (I+M+B). The intervention
conditions were in addition to the existing drug treatment
programs. |
Assessments at
baseline, 6 months, and 12 months. The I+B and I+M+B conditions,
as compared with the I only condition: (a) produced more
favorable attitudes toward condoms; (b) reduced the frequency of
unprotected vaginal sex; and (c) increased behavioral skill
performance, frequency of condom-protected sex, percentage of
intercourse occasions that were condom protected, and number of
adolescents who abstained from sex. The I+M+B intervention was
more resistant to decay. |
| Walters HJ,
Vaughn RD (1993) AIDS risk reduction among a multi-ethnic sample
of urban high school students. Journal of American Medical
Association 270(6): 725-730. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC/ Youth |
School-based program
with two intervention schools and two comparison schools, 1316
students. Six 1-hour lessons on AIDS facts, risk appraisal,
personal values, norm change, role-play, negotiating skills, and
how to use condoms. |
At the three-month
follow-up, significant efforts in five of the eight variables
(knowledge, benefits, norms, self-efficacy and behaviors)
favored those students who participated in the intervention.
The intervention appeared to have the greatest effect on
involvement in sexually intercourse, was associated with
favorable tends in STD rates, but did not effect sexual
abstinence.
Concern: Setting specific? |
| Wenger NS,
Greenberg JM et al. (1992) Effect of HIV Antibody Testing and
AIDS Education on Communication About HIV Risk and Sexual
Behavior. Annals of Internal Medicine 117(11): 905-911. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| College students |
435 university students
at outpatient student health clinic. Consisted of a multimedia
presentation in a single 1-hour small-group session. Led by
physicians familiar with HIV counseling. The session began with
an 11 min video, 15 min scripted lecture (AIDS 101, routes of
transmission, and safer sex behaviors, obstacles to using
condoms, communication with sex partners, and the role of drugs
and alcohol in promoting unsafe sex behaviors). Following the
lecture, participants engaged in 15 minutes of role-play and 15
minutes group discussion. Students randomly assigned to get HIV
testing. |
After 6 months,
heterosexual university student who received education about HIV
infection plus HIV testing were more likely compared with
students in the control group to increase communication with
their sexual partners about the risk of HIV infection. No
difference in condom use or number of sexual partners.
Concern: Applicability of results to other (non-college,
high-risk) populations. |
|
Community-Level
- Heterosexual
Back to Top |
| The CDC
AIDS Community Demonstration Projects Research Group (1999)
Community-level HIV intervention in 5 Cities: Final outcome data
from the CDC AIDS Community Demonstration Projects. American
Journal of Public Health 89: 336-45. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Multiple sub-pops |
Role model stories
distributed with condoms and bleach by community members who
encouraged behavior change. Quasi-experimental design. Over 3
years, 15,205 interviews conducted with 10 intervention and
comparison community pairs. Outcomes measured on stage-of-change
scale.
Sub-populations: IDUs, their female sex partners,
sex workers, NGI MSM, high-risk youth, residents of areas with
high STD rates. |
By end of intervention,
54% of persons interviewed in intervention communities had been
exposed to materials in past 3 months. Consistent condom use
with main and non-main partners, esp. for VI, and increased
condom carrying, greater in intervention communities. At
individual level, respondents recently exposed to intervention
more likely to carry condoms and to have higher stage-of-change
scores for condom and bleach use. |
| Lauby JL,
Smith PJ, Stark M et al. (2000) A community-level HIV prevention
intervention for inner-city women: Results of the Women and
Infants Demonstration Projects. American Journal of Public
Health 90 (2): 216-222. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Women (mostly
African-American) "Real AIDS Prevention Project (RAPP)" |
Low-income, primarily
AA women in 4 urban communities. Pre-post surveys in matched
intervention and comparison communities. Targeted sexually
active. Activities: development and distribution of prevention
materials, mobilization of peer network of community volunteers,
delivery of prevention messages by trained outreach specialists
through individual contacts and small-group activities. Role
model stories. A total of 225-240 women interviewed in each
intervention and comparison community in each wave of survey.
This intervention was outlined in CDC’s
Procedural Guidance
for selected strategies and interventions for CBOs under Program
Announcement 04064. |
After 2 years,
significant increase (11%) in rates of talking with main
partner about condoms, also significant increase (13%) in
proportion who had tried to get main partners to use condoms.
Almost significant (p=054) decrease (9%) in never using
condoms. Effects stronger for women who reported exposure to
intervention. No intervention effects for condom use during most
recent sex or for consistent condom use, but both groups
increased over time. Trends for condom use for other partners
similar but not significant. |
| Sellers D,
McGraw S et al. (1994) Does the promotion and distribution of
condoms increase teen sexual activity? Evidence form an HIV
prevention program from Latino youth. American Journal of Public
Health 84(12): 1952-1959. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC/ Youth (Latinos) |
The purpose of the
study was to see if condom distribution increases sexual
activity. Boston was the intervention city and Hartford was
the comparison city. The intervention included condom
distribution, workshop in schools, group discussion, large
community events, presentations, and door-to-door street
outreach. |
Males, in the
intervention city wee less likely to initiate first sexual
activity. Females were less likely to have multiple sex
partners. Conclusion: HIV prevention programs that include
condom distribution did not increase sexual activity.
Concern: Applicability. |
| Sikkema
KJ, Kelly JA, Winett RA et al. (2000) Outcomes of a randomized
community-level HIV prevention intervention for women living in
18 low-income housing developments. American Journal of
Public Health 90: 57-63. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Low-income women |
690 low-income women
living in 18 housing developments. Community-level intervention
in 5 US cities. HIV risk reduction workshops and community
prevention events implemented by women who were popular opinion
leaders. |
At 12-month follow-up,
proportion of women who had any UI decreased and percentage of
protected sex acts increased in intervention group. Little
behavior change in control group. |
| Tross S,
Abdul-Quader AS, Simons PS, Sanchez M, Silvert HM (1993).
Evaluation of a peer outreach HIV prevention program for female
partners of injecting drug users (IDUs) in New York City. IX
International Conference on AIDS. Berlin, June 1993
[abstract PO-D13-3737]. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Female sex partners (FSPs)
of IDU |
658 FSPs in high
drug-use housing project in NYC randomly assigned to
intervention or control. Intervention was peer outreach and
media distribution program. |
Significant increase in
percentage of intervention group always using condoms and
decrease in percentage never using condoms. No change in control
group.
Comment: Information from abstract only so few
details available. |
| Vincent L,
Clearie A et al (1987) Reducing adolescent Pregnancy through
school and community-based education. Journal of American
Medical Association 254(4): 3382-3386 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC/ Youth |
Intervention to reduce
adolescent pregnancies. Three-hour courses for teachers. Sex
education in all grades. Training for clergy, church leaders and
parents. Mass media speakers. |
2-year follow-up.
Pregnancy rates decreased by half in target county only.
Concern: Applicability. |
|
HIV Antibody
Counseling & Testing - Heterosexual
Back to Top |
| Bevier P,
Ewing W et al. Effects of counseling on HIV risk behaviors in
patient at a New York City sexually transmitted disease clinic.
VII International Conference on AIDS 7, 458. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Women (STD clients) |
1016 total STD clinic
patients received one-session of HIV risk behavior counseling.
Total percentage of women unknown. |
At 6-month follow-up,
women significantly reduced their total number of partners from
5.9 to 4.3 in a 6-month period. Condom use ‘increased slightly’,
but sex partners of IDs reported condom use only 10% of the
time. |
| Corby N,
Barchi P et al. (1990) Effects of condom skills training and HIV
testing on AIDS prevention behaviors among sex workers. VI
International Conference on AIDS. 6, 267. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Sex workers |
64 sex workers were
randomly selected into four groups. Group 1: HIV
counseling/testing. Group 2: 15-min. AIDS prevention program
with rehearsal of condom use. Group 3: both 1 & 2. Group 4: No
intervention |
At 1-month follow-up,
women in group 3 showed increase in condom use during vaginal
intercourse with customers. Women in group 1 reported a decrease
in proportion of condom us during oral sex with customers. |
| Higgins
DL, C Galavotti et al. (1991) Evidence for the Effects of HIV
Antibody Counseling and Testing on Risk Behaviors. Journal of
American Medical Association 266(17): 2419-2429. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| General |
A review of 10 studies
on the effects of C/T on behavior change (condom use, reduction
of sexual partners) of heterosexuals (actual study reviews
several populations). |
Of the studies: 80%
showed increase in condom use; 30% showed increase in safer sex
(undefined) and 1% showed decrease in sexual partners (Note:
most were measuring for condom usage – 1% may not be reflective
of real change). |
| Kamb ML,
Fishbein M et al. (1998) Does HIV/STD Prevention Counseling
Work? Results From a Multicenter, Randomized Controlled Trail
Evaluating Counseling Among STD Clinic Patients (Project
RESPECT). Journal of American Medical Association 280:
1161-1167. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| General |
Project Respect. Five
publicly funded STD clinics located in US inner cities
(Baltimore, Denver, Long Beach, Newark and San Francisco). 5758
heterosexual HIV negative men and women who initially came to
the clinics for STD diagnosis and treatment. Three face-to-face
interventions: enhanced counseling (3-hours interactive
sessions), brief counseling (2 40-minutes interactive session)
and didactic message (personalized 10-minutes informational
messages about HIV/STD prevention). |
3 and 6-month follow-up
visits, any condom use and consistent condom use were
significantly higher among participants in both enhanced and
brief counseling compared with control. Through the 6-month
interval, 30% fewer participants had new STDs compared with
control. Through 12 months, 20% fewer participants in each
counseling intervention had new STDs compared with didactic
group.
Comment: Supported by Branson et al. (1998)
Sex Transm Dis 25: 553-559. |
|
Higginbotham, S., Holmes, R., Stone, H., Beil, J., Datu, Costa,
S., G.B., Paul, S., (2000) Adoption of Protective Behaviors
Among Persons With Recent HIV Infection and Diagnosis---
Alabama, New Jersey, and Tennessee, 1997--1998. MMWR June 16,
2000/49(23); 512-515 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
|
|
To examine risk behaviors (e.g., condom use and number of sex
partners) after HIV diagnosis, CDC analyzed data on HIV Testing
history and sexual behavior of persons who may have recently
acquired HIV infection as part of a CDC sponsored study in
Alabama, New Jersey, and Tennessee. For purpose of the study,
criteria for recent HIV infection included persons with
diagnosed and reported HIV infection with CD4 T-lymphocyte
counts >700 cells/ul or percentage>36, documented HIV
seroconversion within 18 months of confirmed HIV infection
diagnosis, or persons aged 13-24 years when diagnosed. During
January 1997 through September 1998, 615 persons with HIV
infection diagnosed and reported met the criteria for the
study. These persons represented 15% of all persons reported
with HIV in the three states. Prior to diagnosis, the females
reporting having vaginal sex with males and males reporting anal
sex with males 25% reported never using a condom, 69% reported
sometimes using a condom, and 6% reported always using condoms. |
Of the 543 persons eligible after follow-up, 180 persons
completed the interview within 12 months of the self-reported
date learning they were HIV infected (median: 6 months). Among
those, 99 (55%) were female; 96 (53%) were <25 years old; and
105 were non-Hispanic blacks, 49 were non-Hispanic white, 24
were Hispanic, and two self reported as “other”. 162 (90%)
responded that they had changed their behavior since learning of
their HIV infection. After diagnosis, the females reporting
having vaginal sex with males and males reporting anal sex with
males, 30% reported not having sex, 6% reported never using a
condom, 11% reported sometimes using a condom, and 47% reported
always using condoms. The number of sexual partners for the
males and females decreased as well. |
|
Further information can be found in
The Revised
Guidelines for HIV Counseling, Testing, and Referral (Adobe
Acrobat, 110 pages) published by the CDC. An
alternative
format of this publication is also available upon request. |
|
Partner
Notification - Heterosexual
Back to Top |
| Jordan WC,
Tolbert L (1998) Partner Notification and Focused Intervention
as a Means of Identifying HIV-positive Patients. Journal
National Medical Association 90:542-6. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| General |
Los Angeles. 22 of 22
women, 5 of 8 heterosexual men and 6 of the 44 MSM interviewed
were able to provide locating information on all of their
enumerated/reported partners. Intervention divided MSM into two
focus groups. Group 1 was asked: Who do you know that’s HIV
positive and still practicing unsafe sex? Group 2 was asked: Who
do you know that’s HIV positive but not in treatment? |
13 of the 14 MSM in
group 1 were able to identify 30 person they felt were still
practicing unsafe sex; 17 of the 30 tested HIV positive and 9
were unaware of their status. Group 2 identified 15 people they
felt were HIV positive. 11 were found to be HIV positive and 8
were unaware of their status. |
| Landis SE,
Schoenback VJ et al. (1992) Results of a Randomized Trail of
Partner Notification in Cases of HIV infected in North Carolina.
New England Journal of Medicine 326:101-6. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| General |
North Carolina. Three
local health departments. 162 participated, 54% declined and 46%
agreed. 39 assigned to provider referral, 35 to patient
referral. |
In provider referral,
70 of 157 partners successfully notified; patient referral, 10 of 153
notified. 23% of partners notified and tested were positive. |
| Pavia AT,
Benyo M et al. (1993) Partner Notification for control of HIV:
Results after 2 years of a Statewide Program in Utah.
American Journal of Public Health 83:1418-24. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| General |
Utah. All persons
reported in state over 2 years (308) 79% cooperated with 890
named partners with 70% located. |
Of those located 34%
were previously positive. Of the remaining 2763 tested, 14%
newly identified as infected. IDU, women and confidential (vs.
anonymous) testers were more likely to cooperate and reported
more partners. Cost: about $3,000 per new infection identified. |
| Rutherford GW, Woo JM
et al. (1991) Partner Notification and the Control of Human
Immunodeficiency Virus Infection. Two year of experience in San
Francisco. Sexually Transmitted Disease 18:107-110. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| General |
San Francisco. 51 interviewed AIDS
patients named 135 opposite-sex partners. |
44%of partners located and
interviewed, 25% tested, 5% HIV infected. Cost: $454 per partner
notified. $2,203 per positive identified. |
| Toomey KE,
Peterman TA et al. (1998) Human Immunodeficiency Virus Partner
Notification Cost and Effectiveness Data From an Attempted
Randomized Controlled Trial. Sexually Transmitted Disease
25:310-6. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| General |
New Jersey and Florida.
8 partners reported per case, one located per case. |
25% previously
positive. 75% of the remainder were tested. 22% positive. New
positive partners per original case: 0.1. Cost: $250/index
patient; $427 partner notified; $2,200 new infection identified. |
|
Partner Counseling and Referral Services to Identified Persons
with Undiagnosed HIV---North Carolina. MMWR December 5,
2003/52 (48); 1181-118 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
|
|
In 1989, North Carolina Department of Health and Human Services
began offering PCRS to clients who tested positive in
confidential and anonymous testing venues. HIV infection became
reportable in 1990 and anonymous testing was discontinued in
1997. A trained disease intervention specialist (DIS) completed
six important steps. All notified partners received risk
reduction counseling and appropriate referrals. |
Data collected from 2001 revealed a total of 1,603 persons were
newly reported to have HIV infections. DIS were assigned to
conduct PCRS with 1,580 (99%) index clients, 1,378 (87%) were
located and PCRS identified 1,532 sex or needle sharing
partners. 1,359 partners were located and notified of their
possible exposure to HIV. After PCRS, from those who not
previously testing positive for HIV, 108 newly tested partners
were diagnosed HIV positive. |
|
CDC Technical Guidance for Partner Notification and Referral
Services
Procedural Guidance for Implementation of Partner Notification
and Referral Services (Adobe
Acrobat, 33 pages) An
alternative
format of this publication is also available upon request. |
|
Drug Treatment -
Heterosexual
Back to Top |
| Shoptaw S,
Frosch D, Rawson RA, Ling W (1997). Cocaine Abuse Counseling as
HIV Prevention. AIDS Education and Prevention 9(6):
511-520. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Non-IDU drug users |
Evaluated the efficacy
of cocaine abuse counseling alone as a strategy to reduce
HIV related sexual risk behaviors. Participants were 232
cocaine-abusing or dependent individuals who received up to 26
weeks of Matrix counseling but no formal HIV prevention
interventions. 157 (67.6%) participants completed assessments at
admission, during treatment, and at 6 months following
admission. Participants located for follow-up were significantly
more likely to be Caucasian, to be better educated, and to
complete longer treatment episodes than those not located.
Demographics: mostly heterosexual (89.9%), Caucasian (69.0%),
crack cocaine users (65.6%). |
Main study findings
indicated a significant association between safer sex behavior
and completion of a cocaine abuse counseling episode.
Participants who completed counseling were more likely to change
to safer sex or maintain safer sex over the 6-month period than
participants who terminated counseling prematurely. The primary
method for reducing sexual risk involved overall decreases in
reported numbers of partners (avg. at baseline = 5.32, avg. at
6-month follow up = 2.47) |
| Shoptaw S,
Reback CJ, Frosch DL, Rawson RA (1998). Stimulant Abuse
Treatment as HIV Prevention. Journal of Addictive Diseases
17(4): 19-32. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Non-IDU drug users |
Individuals who use
illicit stimulants, primarily cocaine and methamphetamine,
engage in substantial amounts of HIV related sexual risk
behaviors when under the influence. This paper presents the idea
that reductions in stimulant use consequent to drug treatment
makes stimulant drug treatment an important HIV prevention tool
for this high–risk population. |
Presents data to
describe HIV related sexual risks reported by out–of–treatment
methamphetamine users and by cocaine and methamphetamine abusers
at treatment entry and six months post treatment entry. Overall,
findings demonstrate that following initiation of a treatment
episode, stimulant abusers demonstrate significant reductions in
HIV related sexual behaviors, primarily by reducing the number
of sexual partners. |
|
No reviews on Mass &
Other Media, Social Marketing, Hotlines, and Clearinghouse for
Heterosexual.
Back to Top |
HIV/AIDS
Prevention and Education Services
