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Sample records for evaluating hiv intervention

  1. Evaluating social outcomes of HIV/AIDS interventions: a critical assessment of contemporary indicator frameworks

    PubMed Central

    Mannell, Jenevieve; Cornish, Flora; Russell, Jill

    2014-01-01

    Introduction Contemporary HIV-related theory and policy emphasize the importance of addressing the social drivers of HIV risk and vulnerability for a long-term response. Consequently, increasing attention is being given to social and structural interventions, and to social outcomes of HIV interventions. Appropriate indicators for social outcomes are needed in order to institutionalize the commitment to addressing social outcomes. This paper critically assesses the current state of social indicators within international HIV/AIDS monitoring and evaluation frameworks. Methods We analyzed the indicator frameworks of six international organizations involved in efforts to improve and synchronize the monitoring and evaluation of the HIV/AIDS response. Our analysis classifies the 328 unique indicators according to what they measure and assesses the degree to which they offer comprehensive measurement across three dimensions: domains of the social context, levels of change and organizational capacity. Results and discussion The majority of indicators focus on individual-level (clinical and behavioural) interventions and outcomes, neglecting structural interventions, community interventions and social outcomes (e.g. stigma reduction; community capacity building; policy-maker sensitization). The main tool used to address social aspects of HIV/AIDS is the disaggregation of data by social group. This raises three main limitations. Indicator frameworks do not provide comprehensive coverage of the diverse social drivers of the epidemic, particularly neglecting criminalization, stigma, discrimination and gender norms. There is a dearth of indicators for evaluating the social impacts of HIV interventions. Indicators of organizational capacity focus on capacity to effectively deliver and manage clinical services, neglecting capacity to respond appropriately and sustainably to complex social contexts. Conclusions Current indicator frameworks cannot adequately assess the social

  2. Evaluation of an Intervention among Adolescents to Reduce Preventive Misconception in HIV Vaccine Clinical Trials

    PubMed Central

    Lally, Michelle; Goldsworthy, Richard; Sarr, Moussa; Kahn, Jessica; Brown, Larry; Peralta, Ligia; Zimet, Greg

    2014-01-01

    Purpose Placebo and randomization are important concepts that must be understood before youth can safely participate in HIV vaccine studies or other biomedical trials for HIV prevention. These concepts are central to the phenomenon of preventive misconception which may be associated with an increase in risk behavior among study participants related to mistaken beliefs. Persuasive messaging, traditionally used in the field of marketing, could enhance educational efforts associated with randomized clinical trials. Methods Two educational brochures were designed to increase knowledge about HIV vaccine clinical trials via 1 and 2-sided persuasive messaging. Through the Adolescent Medicine Trials Network, 120 youth were enrolled, administered a mock HIV vaccine trial consent, and then randomized to receive either no supplemental information or one of the two brochures. Results The 2-sided brochure group in which common clinical trial misconceptions were acknowledgedand then refuted had significantly higher scores on knowledge of randomization and interpretation of side effects than the consent-only control group, and willingness to participate in an HIV vaccine trial was not decreased with the use of this brochure. Conclusion Two sided persuasive messaging improves understanding of the concepts of randomization and placebo among youth who would consider participating in an HIV vaccine trial. Further evaluation of this approach should be considered for at-risk youth participating in an actual trial of a biomedical intervention for HIV prevention. PMID:24613097

  3. A Process Evaluation of an HIV/STI Intervention for Rural African American Youth

    PubMed Central

    Albritton, Tashuna; Hodge-Sallah, Stepheria; Akers, Aletha; Blumenthal, Connie; O'Brien, Sarah; Council, Barbara; Muhammad, Melvin; Corbie-Smith, Giselle

    2015-01-01

    We evaluated the fidelity and implementation of an HIV/AIDS and sexually transmitted infections intervention for rural African American youth. Using a community-based evaluation approach, community partners and researchers monitored four core process-evaluation components: reach, fidelity, dose delivered, and dose received. Researchers collected evaluation data through session observations, facilitator debriefing interviews, a youth focus group, and a satisfaction survey. For reach, more than half of the participants attended the 13 sessions. Participation varied between 62% and 100%. For fidelity, not all sessions were implemented as intended; multiple modifications occurred across sessions. For dose delivered, some lessons were missing materials and content was omitted; facilitators omitted content when there was insufficient time to complete a lesson. For dose received, engagement varied across lessons but youth reported high levels of satisfaction with the intervention. This formative process evaluation enabled us to identify and address multiple challenges to implementation. PMID:24939390

  4. Evaluation of a socio-cultural intervention to reduce unprotected sex for HIV among African American/Black women.

    PubMed

    Boekeloo, B; Geiger, T; Wang, M; Ishman, N; Quinton, S; Allen, G; Ali, B; Snow, D

    2015-10-01

    African American/Black (Black) women suffer disproportionately to other women from HIV. An HIV prevention intervention combining two previous evidenced-based intervention programs; "Coping with Work and Family Stress" and "Hip Hop 2 Prevent Substance Abuse and HIV", was evaluated in a diverse sample of Black women (n = 205). Study participants at ten recruitment sites were assigned non-randomly to either the intervention or comparison group and then surveyed at baseline, immediate posttest, and 6-month follow-up. General Estimating Equation modeling revealed that participants in the comparison group reported less unprotected sex at immediate post-test and the intervention group less unprotected sex at 6-month follow-up. Despite the initial drop in reported unprotected sex in the comparison group, this study suggests that an HIV risk reduction intervention tailored to address Black women's socio-cultural stress and enhance their coping may reduce their unprotected sex at 6-months. PMID:25645327

  5. Evaluating the Acceptability and Feasibility of Project ACCEPT: An Intervention for Youth Newly Diagnosed with HIV

    ERIC Educational Resources Information Center

    Hosek, Sybil G.; Lemos, Diana; Harper, Gary W.; Telander, Kyle

    2011-01-01

    Given the potential for negative psychosocial and medical outcomes following an HIV diagnosis, Project ACCEPT, a 12-session behavioral intervention, was developed and pilot-tested for youth (aged 16-24) newly diagnosed with HIV. Fifty participants recently diagnosed with HIV were enrolled from 4 sites selected through the Adolescent Medicine…

  6. A Mixed-Methods Outcome Evaluation of a Mentorship Intervention for Canadian Nurses in HIV Care

    PubMed Central

    Worthington, Catherine A.; O’Brien, Kelly K.; Mill, Judy; Caine, Vera; Solomon, Patty; Chaw-Kant, Jean

    2016-01-01

    We assessed the impact of an HIV care mentorship intervention on knowledge, attitudes, and practices with nurses and people living with HIV (PLWH) in Canada. We implemented the intervention in two urban and two rural sites with 16 mentors (eight experienced HIV nurses and eight PLWH) and 40 mentees (nurses with limited HIV experience). The 6- to 12-month intervention included face-to-face workshops and monthly meetings. Using a mixed-methods approach, participants completed pre- and postintervention questionnaires and engaged in semistructured interviews at intervention initiation, mid-point, and completion. Data from 28 mentees (70%) and 14 mentors (87%) were included in the quantitative analysis. We analyzed questionnaire data using McNemar test, and interview data using content analysis. Results indicated positive changes in knowledge, attitudes, and practices among nurse mentees, with qualitative interviews highlighting mechanisms by which change occurred. Mentorship interventions have the potential to engage and educate nurses in HIV treatment and care. PMID:27039195

  7. Positive Transitions (POST): Evaluation of an HIV Prevention Intervention for HIV-Positive Persons Releasing from Correctional Facilities.

    PubMed

    MacGowan, Robin J; Lifshay, Julie; Mizuno, Yuko; Johnson, Wayne D; McCormick, Lyle; Zack, Barry

    2015-06-01

    People with HIV who are released from custody frequently do not maintain the viral suppression and other health benefits achieved while incarcerated. This study was conducted to provide preliminary evidence of efficacy of an intervention to reduce HIV risk behaviors and increase use of HIV medical services following release from custody. People with HIV were recruited from San Francisco County jails, San Quentin State Prison and the California Medical Facility (Vacaville, CA), and randomly assigned to the "standard of care" or POST intervention. POST consisted of 4 sessions pre-release and 2 sessions post-release, focusing on HIV prevention and access to care. Behavioral data were obtained for the 3 months before incarceration and 3 months after release. Although POST participants reported a statistically significant increase in receiving health care at HIV clinics (62.5-84.4 %), there were no significant differences between the POST and control participants with respect to any primary outcomes. PMID:25190222

  8. Community-based interventions that work to reduce HIV stigma and discrimination: results of an evaluation study in Thailand

    PubMed Central

    Jain, Aparna; Nuankaew, Ratana; Mongkholwiboolphol, Nungruthai; Banpabuth, Arunee; Tuvinun, Rachada; Oranop na Ayuthaya, Pakprim; Richter, Kerry

    2013-01-01

    Introduction HIV stigma and discrimination are major issues affecting people living with HIV in their everyday lives. In Thailand, a project was implemented to address HIV stigma and discrimination within communities with four activities: (1) monthly banking days; (2) HIV campaigns; (3) information, education and communication (IEC) materials and (4) “Funfairs.” This study evaluates the effect of project interventions on reducing community-level HIV stigma. Methods A repeated cross-sectional design was developed to measure changes in HIV knowledge and HIV-related stigma domains among community members exposed to the project. Two cross-sectional surveys were implemented at baseline (respondent n=560) and endline (respondent n=560). T-tests were employed to assess changes on three stigma domains: fear of HIV infection through daily activity, shame associated with having HIV and blame towards people with HIV. Baseline scales were confirmed at endline, and each scale was regressed on demographic characteristics, HIV knowledge and exposure to intervention activities. Results No differences were observed in respondent characteristics at baseline and endline. Significant changes were observed in HIV transmission knowledge, fear of HIV infection and shame associated with having HIV from baseline to endline. Respondents exposed to three specific activities (monthly campaign, Funfair and IEC materials) were less likely to exhibit stigma along the dimensions of fear (3.8 points lower on average compared to respondents exposed to none or only one intervention; 95% CI: −7.3 to −0.3) and shame (4.1 points lower; 95% CI: −7.7 to −0.6), net of demographic controls and baseline levels of stigma. Personally knowing someone with HIV was associated with low fear and shame, and females were less likely to possess attitudes of shame compared to males. Conclusions The multivariate linear models suggest that a combination of three interventions was critical in shifting

  9. A Comparative Evaluation of Two Interventions for Educator Training in HIV/AIDS in South Africa

    ERIC Educational Resources Information Center

    Chao, Li-Wei; Gow, Jeff; Akintola, Olagoke; Pauly, Mark

    2010-01-01

    The purpose of this study was to compare two different methods to teach educators about HIV/AIDS. Sixty educators were selected from eight schools in KwaZulu-Natal Province, South Africa, to undergo HIV/AIDS training using an interactive CD-ROM intervention. Another sixty educators from other schools were selected to undergo a two-day Life Skills…

  10. A COMPARATIVE EVALUATION OF TWO INTERVENTIONS FOR EDUCATOR TRAINING IN HIV/AIDS IN SOUTH AFRICA

    PubMed Central

    CHAO, LI-WEI; GOW, JEFF; AKINTOLA, OLAGOKE; PAULY, MARK V.

    2010-01-01

    The purpose of this study was to compare two different methods to teach educators about HIV/AIDS. Sixty educators were selected from eight schools in KwaZulu-Natal Province, South Africa, to undergo HIV/AIDS training using an interactive CD-ROM intervention. Another sixty educators from other schools were selected to undergo a two-day Care & Support Training Programme provided by the Department of Education. The outcomes both before and after the interventions were measured by surveying the educators’ knowledge and attitudes related to HIV/AIDS, as well as their self-efficacy with respect to dealing with HIV/AIDS in the classroom setting. Both interventions resulted in significant changes in knowledge and attitudes as well as in the self-efficacy with respect to ability to teach about HIV/AIDS and to deal with classroom situations involving HIV and blood. The Care & Support Training Programme proved superior in enhancing basic knowledge about HIV, and the CD-ROM was superior in teaching about HIV transmission risks. PMID:20852677

  11. A COMPARATIVE EVALUATION OF TWO INTERVENTIONS FOR EDUCATOR TRAINING IN HIV/AIDS IN SOUTH AFRICA.

    PubMed

    Chao, Li-Wei; Gow, Jeff; Akintola, Olagoke; Pauly, Mark V

    2010-01-01

    The purpose of this study was to compare two different methods to teach educators about HIV/AIDS. Sixty educators were selected from eight schools in KwaZulu-Natal Province, South Africa, to undergo HIV/AIDS training using an interactive CD-ROM intervention. Another sixty educators from other schools were selected to undergo a two-day Care & Support Training Programme provided by the Department of Education. The outcomes both before and after the interventions were measured by surveying the educators' knowledge and attitudes related to HIV/AIDS, as well as their self-efficacy with respect to dealing with HIV/AIDS in the classroom setting. Both interventions resulted in significant changes in knowledge and attitudes as well as in the self-efficacy with respect to ability to teach about HIV/AIDS and to deal with classroom situations involving HIV and blood. The Care & Support Training Programme proved superior in enhancing basic knowledge about HIV, and the CD-ROM was superior in teaching about HIV transmission risks. PMID:20852677

  12. The cost of HIV medication adherence support interventions: results of a cross-site evaluation.

    PubMed

    Schackman, B R; Finkelstein, R; Neukermans, C P; Lewis, L; Eldred, L

    2005-11-01

    The objective of this study was to determine the direct cost of HIV adherence support programmes participating in a cross-site evaluation in the US. Data on the frequency, type, and setting of adherence encounters; providers' professions; and adherence tools provided were collected for 1,122 patients enrolled in 13 interventions at 9 sites. The site staff estimated the average duration of each type of encounter and national wage rates were used for labour costs. The median (range) adherence encounters/year among interventions was 16.5 (4.3-104.6) per patient; encounters lasted 24.6 (8.9-40.9) minutes. Intervention direct cost was correlated with the average frequency of encounters (r = 0.57), but not with encounter duration or providers' professions. The median direct cost/month was 35 dollars(5 dollars-58 dollars) per patient, and included direct provider costs (66%); incentives (17%); reminders and other tools (8%); and direct administrative time, provider transportation, training, and home delivery (9%). The median direct cost/month from a societal perspective, which includes patient time and travel costs, was 47 dollars(24 dollars-114 dollars) per patient. Adherence interventions with moderate efficacy costing < or =100 dollars/month have been estimated to meet a cost-effectiveness threshold that is generally accepted in the US. Payers should consider enhanced reimbursement for adherence support services. PMID:16265786

  13. A Mixed-Methods Outcome Evaluation of a Mentorship Intervention for Canadian Nurses in HIV Care.

    PubMed

    Worthington, Catherine A; O'Brien, Kelly K; Mill, Judy; Caine, Vera; Solomon, Patty; Chaw-Kant, Jean

    2016-01-01

    We assessed the impact of an HIV care mentorship intervention on knowledge, attitudes, and practices with nurses and people living with HIV (PLWH) in Canada. We implemented the intervention in two urban and two rural sites with 16 mentors (eight experienced HIV nurses and eight PLWH) and 40 mentees (nurses with limited HIV experience). The 6- to 12-month intervention included face-to-face workshops and monthly meetings. Using a mixed-methods approach, participants completed pre- and postintervention questionnaires and engaged in semistructured interviews at intervention initiation, mid-point, and completion. Data from 28 mentees (70%) and 14 mentors (87%) were included in the quantitative analysis. We analyzed questionnaire data using McNemar test, and interview data using content analysis. Results indicated positive changes in knowledge, attitudes, and practices among nurse mentees, with qualitative interviews highlighting mechanisms by which change occurred. Mentorship interventions have the potential to engage and educate nurses in HIV treatment and care. PMID:27039195

  14. Strategies used by community-based organizations to evaluate their locally developed HIV prevention interventions: Lessons learned from the CDC's innovative interventions project.

    PubMed

    Painter, Thomas M; Ngalame, Paulyne M; Lucas, Basil; Lauby, Jennifer L; Herbst, Jeffrey H

    2010-10-01

    Community-based organizations (CBOs) play an important role in health promotion efforts and the delivery of HIV prevention interventions for at-risk minority populations. CBOs may also develop their own interventions but often lack the capacity or funds to rigorously evaluate them. The Innovative Interventions project of the Centers for Disease Control and Prevention (CDC) funded three CBOs to rigorously evaluate the efficacy of interventions they had developed and were delivering to Black women, Black men who have sex with men (MSM), and adolescent males in juvenile justice settings, respectively. The evaluation results have been reported elsewhere. This article describes operational issues that the CBOs identified as being particularly salient to their evaluations and the strategies they developed to address the issues and successfully complete their evaluations. These issues included the development of organizational capacity to conduct a rigorous outcome evaluation, difficulties with recruitment and retention of evaluation participants, and the use of process monitoring data to improve intervention delivery. The strategies described in this article can be used by CBOs when evaluating their locally developed HIV prevention interventions and may be of interest to funding agencies and researchers that collaborate with CBOs to evaluate their interventions. PMID:20973660

  15. Implementation and Evaluation of the Keep It Up! Online HIV Prevention Intervention in a Community-Based Setting.

    PubMed

    Greene, George J; Madkins, Krystal; Andrews, Katie; Dispenza, Jill; Mustanski, Brian

    2016-06-01

    Once HIV prevention programs have proven efficacy in research settings, it is important that ongoing data are collected to demonstrate effects in public health applications, yet such evaluations are rare in the published literature. This project describes the adaptation, implementation, and outcome evaluation of the Keep It Up! (KIU!) online HIV prevention intervention as a prevention service delivered in a community-based organization. Compared to pilot research examining KIU! feasibility and efficacy, intervention outcomes were robust to service delivery and client characteristics. In a sample of ethnically and racially diverse young men who have sex with men (N = 343), the intervention produced significant decreases in condomless anal sex acts with casual male partners at the 3-month follow-up compared to baseline (p < .05). In both qualitative and quantitative measures, participants reported that the intervention was highly acceptable and valuable to their sexual health needs. PMID:27244191

  16. SOMOS: evaluation of an HIV prevention intervention for Latino gay men.

    PubMed

    Vega, Miriam Y; Spieldenner, Andrew R; DeLeon, Dennis; Nieto, Bolivar X; Stroman, Carolyn A

    2011-06-01

    Latino gay men face multiple barriers to human immunodeficiency virus (HIV) prevention, in particular a lack of intervention programs that integrate prevention messages with cultural norms and address issues of social marginalization from multiple communities (gay community and Latino community), homophobia and racism. In order to address these specific issues, a multilayered HIV intervention was designed to incorporate and integrate psychosocial and community factors through multiple session groups, social marketing and community presentations. Participants learned strategies for effective community leadership and were encouraged to provide HIV education and address internalized homophobia in their communities. There were a total of 113 Latino gay male participants. Pretests and post-tests at 90-day follow-up were administered to measure knowledge, attitudes and behaviors related to HIV infection, self-efficacy, internalized homophobia and connectedness (i.e. gay community affiliation and social provisions); a risk index was calculated to measure level of behavioral risk for HIV infection. Participants demonstrated lower risk indices and a decrease in partners at 3 and 6 months after the intervention. There was also an increase in reported social support resources, along with an increase in group identification. Connectedness was a strong predictor of the number of sexual partners at the 90-day follow-up. This homegrown program represents a culturally responsive, highly needed and relevant intervention that should be subjected to further rigorous testing. PMID:21059799

  17. Quasi-Experimental Evaluation of a National Primary School HIV Intervention in Kenya

    ERIC Educational Resources Information Center

    Maticka-Tyndale, Eleanor; Wildish, Janet; Gichuru, Mary

    2007-01-01

    This study examined the impact of a primary-school HIV education initiative on the knowledge, self-efficacy and sexual and condom use activities of upper primary-school pupils in Kenya. A quasi-experimental mixed qualitative-quantitative pre- and 18-month post-design using 40 intervention and 40 matched control schools demonstrated significant…

  18. SOMOS: Evaluation of an HIV Prevention Intervention for Latino Gay Men

    ERIC Educational Resources Information Center

    Vega, Miriam Y.; Spieldenner, Andrew R.; DeLeon, Dennis; Nieto, Bolivar X.; Stroman, Carolyn A.

    2011-01-01

    Latino gay men face multiple barriers to human immunodeficiency virus (HIV) prevention, in particular a lack of intervention programs that integrate prevention messages with cultural norms and address issues of social marginalization from multiple communities (gay community and Latino community), homophobia and racism. In order to address these…

  19. Impact Evaluation of a Policy Intervention for HIV Prevention in Washington, DC.

    PubMed

    Ruiz, Monica S; O'Rourke, Allison; Allen, Sean T

    2016-01-01

    Syringe exchange programs (SEPs) lower HIV risk. From 1998 to 2007, Congress prohibited Washington, DC, from using municipal revenue for SEPs. We examined the impact of policy change on IDU-associated HIV cases. We used surveillance data for new IDU-associated HIV cases between September 1996 and December 2011 to build an ARIMA model and forecasted the expected number of IDU-associated cases in the 24 months following policy change. Interrupted time series analyses (ITSA) were used to assess epidemic impact of policy change. There were 176 IDU-associated HIV cases in the 2 years post-policy change; our model predicted 296 IDU-associated HIV cases had the policy remained in place, yielding a difference of 120 averted HIV cases. ITSA identified significant immediate (B = -6.0355, p = .0005) and slope changes (B = -.1241, p = .0427) attributed to policy change. Policy change is an effective structural intervention for HIV prevention when it facilitates the implementation of services needed by vulnerable populations. PMID:26336945

  20. Pilot Evaluation of the MEN [Making Employment Needs] Count Intervention: Addressing Behavioral and Structural HIV Risks in Heterosexual Black Men

    PubMed Central

    Dasgupta, Anindita; Goldson, Irvienne; LaFontant, Dumas; Freeman, Elmer; Silverman, Jay G.

    2013-01-01

    Few community-based HIV interventions exist for Black men at heterosexual risk for HIV. None focus on structural HIV risks such as unemployment and unstable housing. This study involved a pilot evaluation of the MEN [Making Employment Needs] Count HIV intervention, a three session peer counselor-delivered program of HIV risk reduction and gender equity counseling, and employment and housing case management. A single-arm intervention trial of MEN Count was conducted with Black men recruited from a community men’s clinic and social services program. Eligible men were those who reported 2 or more sex partners in the past 6 months and current unemployment and/or recent homelessness. Most participants (68%) had a history of incarceration. Participants (N=50) were surveyed on outcomes at baseline (Time 1), posttest (Time 2; 60–90 days after baseline), and 2 month follow-up (Time 3). The majority of participants were retained in the program (86%) and the final follow-up survey (76%). McNemar tests revealed significant reductions in past 30 day unprotected sex from Time 1 (74%) to Time 2 (47%) and to Time 3 (47%), and in homelessness from Time 1 (58%) to Time 3 (32%). Significant increases in employment from Time 1 (8%) to Time 2 (29%) and Time 3 (32%) were also seen. Participants completed a brief participant satisfaction survey at posttest. Most (n=28, 65%) rated the program as excellent, and an additional 10 (23%) rated it as good. Although there was no significant reduction in multiple sex partners, a trend was observed from Time 1 (56%) to Times 2 (44%) and 3 (42%). Findings suggest that the MEN Count model is a feasible and promising HIV prevention program for Black men at heterosexual risk for HIV. Larger scale implementation and more rigorous evaluation of MEN Count are needed to confirm study findings. PMID:23767788

  1. Pilot evaluation of the Making Employment Needs [MEN] count intervention: addressing behavioral and structural HIV risks in heterosexual black men.

    PubMed

    Raj, Anita; Dasgupta, Anindita; Goldson, Irvienne; Lafontant, Dumas; Freeman, Elmer; Silverman, Jay G

    2014-02-01

    Few community-based HIV interventions exist for Black men at heterosexual risk for HIV. None focus on structural HIV risks such as unemployment and unstable housing. This study involved a pilot evaluation of the MEN (Making Employment Needs) Count HIV intervention, a three session peer counselor-delivered program of HIV risk reduction and gender-equity counseling, and employment and housing case management. A single-arm intervention trial of MEN Count was conducted with Black men recruited from a community men's clinic and social services program. Eligible men were those who reported two or more sex partners in the past six months and current unemployment and/or recent homelessness. Most participants (68%) had a history of incarceration. Participants (N = 50) were surveyed on outcomes at baseline (Time 1), posttest (Time 2; 60-90 days after baseline), and two-month follow-up (Time 3). The majority of participants were retained in the program (86%) and the final follow-up survey (76%). McNemar tests revealed significant reductions in the past 30-day unprotected sex from Time 1 (74%) to Time 2 (47%) and to Time 3 (47%), and in homelessness from Time 1 (58%) to Time 3 (32%). Significant increases in employment from Time 1 (8%) to Time 2 (29%) and Time 3 (32%) were also seen. Participants completed a brief participant satisfaction survey at posttest. Most (n=28, 65%) rated the program as excellent, and an additional 10 (23%) rated it as good. Although there was no significant reduction in multiple sex partners, a trend was observed from Time 1 (56%) to Time 2 (44%) and Time 3 (42%). Findings suggest that the MEN Count model is a feasible and promising HIV prevention program for Black men at heterosexual risk for HIV. Larger scale implementation and more rigorous evaluation of MEN Count are needed to confirm the study findings. PMID:23767788

  2. Systematic assessment of condom use measurement in evaluation of HIV prevention interventions: need for standardization of measures

    PubMed Central

    Fonner, Virginia A.; Kennedy, Caitlin E.; O’Reilly, Kevin R.; Sweat, Michael D.

    2013-01-01

    When evaluating HIV prevention interventions, condom use is a common outcome measure used to assess changes in HIV-related behaviors; however, no widely accepted standards exist for its measurement. Using systematic review data on HIV prevention interventions conducted in low- and middle-income countries, we examined trends in condom use measurement since 1990. We abstracted data from standardized forms on six dimensions of condom use: partner type, temporal period, measurement scale, consistency, controlling for abstinence, and type of sex. Of 215 studies reviewed, 109 studies (51%) measured condom use as a primary outcome. Outcomes were stratified by partner type in 47 studies (43%). Assessing condom use at last sex was the most common measurement. Consistency of condom use was assessed in 47 studies (43%). Developing and utilizing standards for condom use measurement would increase comparability of findings across studies and benefit HIV prevention research. Recommendations include measuring condom use at last sex, frequency of condom use, and number of protected sex acts in studies evaluating the efficacy of behavioral interventions on sexual risk behavior. PMID:24197972

  3. Quasi-experimental evaluation of a national primary school HIV intervention in Kenya.

    PubMed

    Maticka-Tyndale, Eleanor; Wildish, Janet; Gichuru, Mary

    2007-05-01

    This study examined the impact of a primary-school HIV education initiative on the knowledge, self-efficacy and sexual and condom use activities of upper primary-school pupils in Kenya. A quasi-experimental mixed qualitative-quantitative pre- and 18-month post-design using 40 intervention and 40 matched control schools demonstrated significant program impact on targeted objectives of (1) adequate program delivery and, for standard 6 and 7 pupils (ages 11-16 years), (2) increased HIV-related knowledge; (3) increased communication with parents and teachers about HIV and sexuality; (4) increased assistance to fellow pupils to avoid sexual activity; (5) increased self-efficacy related to abstinence and condom use; (6) decreased exposure to HIV through delayed first intercourse, decreased sexual activity and increased condom. Results support the conclusions that the existing infrastructure is adequate for national roll-out of the program; that the program has its most beneficial effect on sexually inexperienced youth and should therefore be implemented with the youngest age groups possible; and that gains are gender specific, with boys reporting increased condom use while girls are more likely to decrease or delay sexual activity. Based on these results, the program began national roll-out to all primary schools in 2005. By June 2006, the program was operating in 11,000 of the country's nearly 19,000 schools. PMID:17689323

  4. Self-Deferral, HIV Infection, and the Blood Supply: Evaluating an AIDS Intervention.

    ERIC Educational Resources Information Center

    Kaplan, Edward H.; Novick, Alvin

    1990-01-01

    This paper evaluates the effectiveness of self-deferral, a social screen implemented to protect the U.S. blood supply from human immunodeficiency virus (HIV) infection prior to the advent of laboratory testing. Mathematical models are developed to estimate the number of infectious transfusions ultimately leading to AIDS prior to self-deferral.…

  5. Evaluation of a School-Based Intervention for HIV/AIDS Prevention among Belizean Adolescents

    ERIC Educational Resources Information Center

    Kinsler, Janni; Sneed, Carl D.; Morisky, Donald E.; Ang, Alfonso

    2004-01-01

    The purpose of this study was to evaluate the impact of a cognitive-behavioral peer-facilitated school-based HIV/AIDS education program on knowledge, attitudes and behavior among primary and secondary students in Belize. Students (N = 150) were recruited from six schools in Belize City. A quasi-experimental research design was used to assess the…

  6. A University and Community-Based Organization Collaboration to Build Capacity to Develop, Implement, and Evaluate an Innovative HIV Prevention Intervention for an Urban African American Population

    ERIC Educational Resources Information Center

    Oliva, Geraldine; Rienks, Jennifer; Udoh, Ifeoma; Smith, Carla Dillard

    2005-01-01

    Through forming a collaborative relationship to develop, pilot and evaluate an innovative bio-psycho-behavioral (BPB) HIV prevention intervention, capacity was built in developing an effective intervention and conducting community based research at both the California Prostitutes Prevention and Education Project (CAL-PEP) and the University of…

  7. Implementation and Evaluation of an HIV/STD Intervention in Peru

    PubMed Central

    Andre, Maiorana; Susan, Kegeles; Percy, Fernandez; Ximena, Salazar; Carlos, Cáceres; Clara, Sandoval; Ana María, Rosasco; Thomas, Coates

    2009-01-01

    This paper presents the lessons learned through a process evaluation (PE) after one year of implementation of a two-year community intervention in Lima, Peru. The intervention consisted of training and motivating community popular opinion leaders (CPOLs) for three marginal population segments to disseminate prevention messages among their peers. PE data included: observations, qualitative interviews with CPOLS, conversations and messages delivered by CPOLs, training facilitators' perceptions about implementation, and a survey of CPOLs. The PE helped to document and enhance the intervention. CPOLs were motivated to talk to their peers. CPOLs perceived that their participation had an effect on their own risk behaviors and saw their role as beneficial to their community. The PE was helpful in examining training delivery and the feasibility and acceptability of the intervention in order to assess the elements related to program success necessary to replicate the CPOL model. PMID:17689315

  8. Implementation and evaluation of an HIV/STD intervention in Peru.

    PubMed

    Maiorana, Andre; Kegeles, Susan; Fernandez, Percy; Salazar, Ximena; Cáceres, Carlos; Sandoval, Clara; Rosasco, Ana María; Coates, Thomas

    2007-02-01

    This paper presents the lessons learned through a process evaluation (PE) after 1 year of implementation of a 2-year community intervention in Lima, Peru. The intervention consisted of training and motivating community popular opinion leaders (CPOLs) for three marginal population segments to disseminate prevention messages among their peers. PE data included: observations, qualitative interviews with CPOLS, conversations and messages delivered by CPOLs, training facilitators' perceptions about implementation, and a survey of CPOLs. The PE helped to document and enhance the intervention. CPOLs were motivated to talk to their peers. CPOLs perceived that their participation had an effect on their own risk behaviors and saw their role as beneficial to their community. The PE was helpful in examining training delivery and the feasibility and acceptability of the intervention in order to assess the elements related to program success necessary to replicate the CPOL model. PMID:17689315

  9. Thirty-Month Quasi-Experimental Evaluation Follow-Up of a National Primary School HIV Intervention in Kenya

    ERIC Educational Resources Information Center

    Maticka-Tyndale, Eleanor; Wildish, Janet; Gichuru, Mary

    2010-01-01

    School-based programmes to combat the spread of HIV have been demonstrated to be effective over the short-term (i.e. 6-24 months), but few studies have addressed the sustainability of such interventions. Primary School Action for Better Health (PSABH) is an intervention delivered in upper primary-school grades in Kenya using regular classroom…

  10. A Quasi-Experimental Evaluation of a Community-Based HIV Prevention Intervention for Mexican American Female Adolescents: The SHERO's Program

    ERIC Educational Resources Information Center

    Harper, Gary W.; Bangi, Audrey K.; Sanchez, Bernadette; Doll, Mimi; Pedraza, Ana

    2009-01-01

    This article describes a quasi-experimental evaluation of a community-based, culturally and ecologically tailored HIV prevention intervention for Mexican American female adolescents grounded in the AIDS risk reduction model. A total of 378 Mexican American female adolescents (mean age = 15.2) participated in either the nine-session SHERO's (a…

  11. eHealth interventions for HIV prevention.

    PubMed

    Noar, Seth M; Willoughby, Jessica Fitts

    2012-01-01

    The rapidly changing media landscape and proliferation of new technologies creates vast new opportunities for HIV prevention. The fast growth of the relatively new eHealth field is a testament to the excitement and promise of these new technologies. eHealth interventions in HIV prevention tested to date include computer- and Internet-based interventions; chat room interventions; text messaging interventions; and social media. The current article provides a brief review of these types of interventions in HIV prevention, including their unique advantages and evidence of efficacy. Implications for future research in the eHealth HIV prevention field are discussed. PMID:22519523

  12. Evaluation of two school-based HIV prevention interventions in the border city of Tijuana, Mexico.

    PubMed

    Martinez-Donate, Ana P; Hovell, Melbourne F; Zellner, Jennifer; Sipan, Carol L; Blumberg, Elaine J; Carrizosa, Claudia

    2004-08-01

    This research project examined the individual and combined effectiveness of an HIV prevention workshop and a free condom distribution program in four high schools in Tijuana, Mexico. Adolescents (N = 320) completed baseline measures on sexual practices and theoretical correlates and participated in a two-part study. In Study 1, students were randomly assigned to an HIV prevention workshop or a control condition, with a 3-month follow-up assessment. Results indicate three significant workshop benefits regarding HIV transmission by altering sexual initiation, access to condoms, and traditional beliefs regarding condoms. In Study 2, we set up a condom distribution program at two of the participating schools, and students completed a 6-month follow-up assessment. Results indicate that exposure to the workshop followed by access to the condom distribution program yielded two beneficial results for reducing HIV transmission: moderating sexual initiation and increasing condom acquisition. Access to the condom distribution program alone had no effects on behavioral and psychosocial correlates of HIV transmission. We discuss implications of these results. PMID:15497055

  13. An Online Randomized Controlled Trial Evaluating HIV Prevention Digital Media Interventions for Men Who Have Sex with Men

    PubMed Central

    Hirshfield, Sabina; Chiasson, Mary Ann; Joseph, Heather; Scheinmann, Roberta; Johnson, Wayne D.; Remien, Robert H.; Shaw, Francine Shuchat; Emmons, Reed; Yu, Gary; Margolis, Andrew D.

    2012-01-01

    Background As HIV infection continues unabated, there is a need for effective interventions targeting at-risk men who have sex with men (MSM). Engaging MSM online where they meet sexual partners is critical for HIV prevention efforts. Methods A randomized controlled trial (RCT) conducted online among U.S. MSM recruited from several gay sexual networking websites assessed the impact of 2 HIV prevention videos and an HIV prevention webpage compared to a control condition for the study outcomes HIV testing, serostatus disclosure, and unprotected anal intercourse (UAI) at 60-day follow-up. Video conditions were pooled due to reduced power from low retention (53%, n = 1,631). No participant incentives were provided. Principal Findings Follow-up was completed by 1,631 (53%) of 3,092 eligible men. In the 60 days after the intervention, men in the pooled video condition were significantly more likely than men in the control to report full serostatus disclosure (‘asked and told’) with their last sexual partner (OR 1.32, 95% CI 1.01–1.74). Comparing baseline to follow-up, HIV-negative men in the pooled video (OR 0.70, 95% CI 0.54–0.91) and webpage condition (OR 0.43, 95% CI 0.25–0.72) significantly reduced UAI at follow-up. HIV-positive men in the pooled video condition significantly reduced UAI (OR 0.38, 95% CI 0.20–0.67) and serodiscordant UAI (OR 0.53, 95% CI 0.28–0.96) at follow-up. Conclusions/Significance Findings from this online RCT of MSM recruited from sexual networking websites suggest that a low cost, brief digital media intervention designed to engage critical thinking can increase HIV disclosure to sexual partners and decrease sexual risk. Effective, brief HIV prevention interventions featuring digital media that are made widely available may serve as a complementary part of an overall behavioral and biomedical strategy for reducing sexual risk by addressing the specific needs and circumstances of the target population, and by changing

  14. Evaluation of a Brief Intervention to Improve the Nursing Care of Young Children in a High HIV and AIDS Setting

    PubMed Central

    Richter, Linda M.; Rochat, Tamsen J.; Hsiao, Celia; Zuma, Thembelihle H.

    2012-01-01

    The HIV epidemic in South Africa is putting great strain on health services, including the inpatient care of young children. Caregivers and young children (107 pairs) and 17 nurses participated in an intervention to improve the care of young children in hospital in a high HIV and AIDS setting. The intervention addressed caregiver expectations about admission and treatment, responsive feeding, coping with infant pain and distress, assistance with medical procedures, and preparation for discharge and home care. Following a preparatory and piloting phase, measures of nurse burnout, caregiver physical and emotional well-being, and caregiver-child interaction were made before and after intervention. No changes were found between before and after intervention on assessments of caregiver wellbeing. However, mothers in the postintervention phase rated nurses as more supportive; mother-child interaction during feeding was more relaxed and engaged, and babies were less socially withdrawn. While the intervention proved useful in improving certain outcomes for children and their caregivers, it did not address challenging hospital and ward administration or support needed by caregivers at home following discharge. To address the latter need, the intervention has been extended into the community through home-based palliative care and support. PMID:22530114

  15. Intergenerational Benefits of Family-Based HIV Interventions

    ERIC Educational Resources Information Center

    Rotheram-Borus, Mary Jane; Lester, Patricia; Song, Juwon; Lin, Ying-Ying; Leonard, Noelle R.; Beckwith, Leila; Ward, Mary J.; Sigman, Marian; Lord,Lynwood

    2006-01-01

    The longitudinal impact of a family-based intervention on grandchildren of parents with HIV (PWH) is evaluated. Because PWH and their daughters demonstrated gains over 6 years when randomized to a coping skills intervention compared with a control condition, the adjustment of the PWH's grandchildren was also compared across conditions.…

  16. An HIV-Preventive Intervention for Youth Living with HIV

    ERIC Educational Resources Information Center

    Lightfoot, Marguerita; Rotheram-Borus, Mary Jane; Tevendale, Heather

    2007-01-01

    As the number of youth infected with HIV rises, secondary prevention programs are needed to help youth living with HIV meet three goals: (1) increase self-care behaviors, medical adherence, and health-related interactions; (2) reduce transmission acts; and (3) enhance their quality of life. This article describes an intervention program for youth…

  17. HIV/AIDS Prevention Program Evaluation Report.

    ERIC Educational Resources Information Center

    Amaro, Hortensia; Barker, Marybeth; Cassisy, Theresa; Hardy-Fanta, Carol; Hereen, Tim; Levenson, Suzette; McCloskey, Lois; Melendez, Michael

    This report addresses the four research objectives that were established by the Massachusetts Primary Prevention Group (MPPG) and the Massachusetts Department of Public Health's HIV/AIDS Bureau. The objectives were to: (1) review and summarize literature that formally evaluated HIV prevention interventions; (2) describe how currently funded…

  18. An STD/HIV prevention intervention framework.

    PubMed

    Cohen, D A; Scribner, R

    2000-01-01

    Historically, interventions to prevent STD/HIV transmission have been categorized by program methodology rather than defining the content and nature of the intervention. A new taxonomy is needed to help expand the scope of interventions that can be used to prevent STD and HIV transmission. The taxonomy defines two major types of interventions, individual-level and structural level. The former targets risk factors attributable to individuals. Structural interventions target conditions outside the control of the individual. Individual-level interventions focus on counseling, screening, and treatment. They include psychological and biological interventions. Structural-level interventions address accessibility of relevant consumer products (condoms, needles), physical structures (e.g. blighted and abandoned housing, lighting, design of social facilities), social structures (policies that facilitate or constrain behaviors such as supervision of youth, and enforcement of alcohol beverage laws); and media messages (messages and images in the broadcast and print media that portray high-risk behaviors as positive and without serious consequences). A new taxonomy not only clarifies the content of preventive interventions but highlights neglected strategies involving individual biological interventions and structural interventions to prevent STD/HIV transmission. PMID:12240881

  19. Intervention Outcomes among HIV-affected Families Over 18 Months

    PubMed Central

    Rotheram-Borus, Mary Jane; Rice, Eric; Comulada, W. Scott; Best, Karin; Elia, Carla; Peters, Katherine; Li, Li; Green, Sara; Valladares, Ena

    2012-01-01

    We evaluate the efficacy of a family-based intervention over time among HIV-affected families. Mothers Living with HIV (MLH; n=339) in Los Angeles and their school-aged children were randomized to either an intervention or control condition and followed for 18 months. MLH and their children in the intervention received 16 cognitive-behavioral, small-group sessions designed to help them maintain physical and mental health, parent while ill, address HIV-related stressors, and reduce HIV-transmission behaviors. At recruitment, MLH reported few problem behaviors related to physical health, mental health, or sexual or drug transmission acts. Compared to MLH in the control condition, intervention MLH were significantly more likely to monitor their own CD4 cell counts and their children were more likely to decrease alcohol and drug use. Most MLH and their children had relatively healthy family relationships. Family-based HIV interventions should be limited to MLH who are experiencing substantial problems. PMID:22020758

  20. Toward reducing the spread of HIV in northeastern Thai villages: evaluation of a village-based intervention.

    PubMed

    Elkins, D; Maticka-Tyndale, E; Kuyyakanond, T; Miller, P; Haswell-Elkins, M

    1997-02-01

    This paper presents results of the evaluation of an intervention designed for northeastern Thai villages and particularly for village women. The intervention was based on established principles of behavior change, social learning theory, and community health promotion, and it was grounded in elicitation research. A total of 600 women and 479 men and 12 villages participated in the evaluation which used data collected from face-to-face knowledge, attitude, practices (KAP) surveys, focus groups, and village meetings in a quasi-experimental pre- and post-control group design. Eight of the nine outcome goals set for the intervention were achieved with significant increases in married women taking the initiative in reducing the risk posed to them by the sexual activities of their husbands. PMID:9083591

  1. Lay Counsellor-Based Risk Reduction Intervention with HIV Positive Diagnosed Patients at Public HIV Counselling and Testing Sites in Mpumalanga, South Africa

    ERIC Educational Resources Information Center

    Peltzer, Karl; Tabane, Cily; Matseke, Gladys; Simbayi, Leickness

    2010-01-01

    Objective: To evaluate the feasibility, fidelity, and effect of a human immunodeficiency virus (HIV) risk reduction intervention delivered to HIV-infected patients by lay counsellors during routine HIV counselling and testing (HCT) public service in Mpumalanga, South Africa. Methods: A total of 488 HIV-infected patients, aged 18 years and older,…

  2. Immune Activation and HIV Persistence: Considerations for Novel Therapeutic Interventions

    PubMed Central

    Hatano, Hiroyu

    2014-01-01

    Purpose of review One of the potential barriers to current HIV cure strategies is the persistence of elevated levels of immune activation despite otherwise effective antiretroviral therapy (ART). The purpose of this review is to examine the relationship between immune activation and HIV persistence, and to review novel therapeutic interventions that are currently being pursued to target immune activation in treated HIV disease. Recent findings Multiple groups have consistently observed that elevated levels of inflammation, immune activation, and immune dysfunction persist in ART-treated individuals, despite successful suppression of plasma viremia. Increased immune activation may lead to viral persistence through multiple mechanisms. Several novel interventions aimed at decreasing persistent immune activation are being pursued and include studies aimed at decreasing low-level viral replication, approaches aimed at decreasing microbial translocation, interventions to treat co-infections, and therapies that directly target immune activation. Summary There appears to be a clear and consistent relationship between immune activation and viral persistence in treated HIV disease. Whether this relationship is causal or mediated through other mechanisms is still unknown. Small-scale, pathogenesis-oriented interventional studies are necessary to further evaluate this relationship and the effect of potential interventions. PMID:23454864

  3. A review of HIV/AIDS system-level interventions

    PubMed Central

    Bauermeister, José A.; Tross, Susan; Ehrhardt, Anke A.

    2010-01-01

    The escalating HIV/AIDS epidemic worldwide demands that on-going prevention efforts be strengthened, disseminated, and scaled-up. System-level interventions refer to programs aiming to improve the functioning of an agency as well as the delivery of its services to the community. System-level interventions are a promising approach to HIV/AIDS prevention because they focus on (a) improving the agency’s ability to adopt evidence-based HIV prevention and care programs; (b) develop and establish policies and procedures that maximize the sustainability of on-going prevention and care efforts; and (c) improve decision-making processes such as incorporating the needs of communities into their tailored services. We reviewed studies focusing on system-level interventions by searching multiple electronic abstracting indices, including PsycInfo, PubMed, and ProQuest. Twenty-three studies out of 624 peer-reviewed studies (published from January 1985 to February 2007) met study criteria. Most of the studies focused on strengthening agency infrastructure, while other studies included collaborative partnerships and technical assistance programs. Our findings suggest that system-level interventions are promising in strengthening HIV/AIDS prevention and treatment efforts. Based on our findings, we propose recommendations for future work in developing and evaluating system-level interventions. PMID:18369722

  4. Evaluation of a real-time virtual intervention to empower persons living with HIV to use therapy self-management: study protocol for an online randomized controlled trial

    PubMed Central

    2012-01-01

    Background Living with HIV makes considerable demands on a person in terms of self-management, especially as regards adherence to treatment and coping with adverse side-effects. The online HIV Treatment, Virtual Nursing Assistance and Education (Virus de I’immunodéficience Humaine–Traitement Assistance Virtuelle Infirmière et Enseignement; VIH-TAVIE™) intervention was developed to provide persons living with HIV (PLHIV) with personalized follow-up and real-time support in managing their medication intake on a daily basis. An online randomized controlled trial (RCT) will be conducted to evaluate the efficacy of this intervention primarily in optimizing adherence to combination anti-retroviral therapy (ART) among PLHIV. Methods/design A convenience sample of 232 PLHIV will be split evenly and randomly between an experimental group that will use the web application, and a control group that will be handed a list of websites of interest. Participants must be aged 18 years or older, have been on ART for at least 6 months, and have internet access. The intervention is composed of four interactive computer sessions of 20 to 30 minutes hosted by a virtual nurse who engages the PLHIV in a skills-learning process aimed at improving self-management of medication intake. Adherence constitutes the principal outcome, and is defined as the intake of at least 95% of the prescribed tablets. The following intermediary measures will be assessed: self-efficacy and attitude towards antiretroviral medication, symptom-related discomfort, and emotional support. There will be three measurement times: baseline (T0), after 3 months (T3) and 6 months (T6) of baseline measurement. The principal analyses will focus on comparing the two groups in terms of treatment adherence at the end of follow-up at T6. An intention-to-treat (ITT) analysis will be carried out to evaluate the true value of the intervention in a real context. Discussion Carrying out this online RCT poses various

  5. HIV stigma intervention in a low-HIV prevalence setting: a pilot study in an Egyptian healthcare facility.

    PubMed

    Lohiniva, Anna-Leena; Benkirane, Manal; Numair, Tarek; Mahdy, Abdelrahman; Saleh, Hanan; Zahran, Amin; Okasha, Omar; Talaat, Maha; Kamal, Walid

    2016-05-01

    This pilot study is the first to evaluate stigma-reduction intervention in a healthcare setting in Egypt and in the Middle East and North Africa region. It also contributes to knowledge on how to address stigma in low-HIV prevalence settings. A quasi-experimental study design was used to evaluate the effect of anti-HIV stigma intervention in one hospital in Egypt. A control hospital was selected and matched to the intervention hospital by type, size and location. The intervention focused on HIV-related stigma, infection control and medical ethics. Stigma was measured at baseline and at three months post-intervention. A standardized, 10-point scale was developed to measure stigmatizing attitudes and fear-based stigma among participants. Comparisons of overall and job-stratified stigma scores were made across the intervention and control hospitals, before and after the intervention, using two-sample t-test and multivariate regression analysis. Mean stigma scores did not reveal significant differences between the intervention and control hospitals at baseline. After intervention, the overall value-based and fear-based stigma scores were significantly lower in the intervention hospital compared to the control hospital (2.1 and 1.1 compared to 3.8 and 3.2, respectively; p < .001). Context-specific and culturally appropriate HIV stigma-reduction interventions in low-HIV prevalence settings can reduce fear-based and value-based stigma among physicians and nurses. PMID:26717980

  6. Identification of structural interventions for HIV/AIDS prevention: the concept mapping exercise.

    PubMed

    Abdul-Quader, Abu S; Collins, Charles

    2011-01-01

    Structural interventions have been defined as those prevention interventions that include physical, social, cultural, organizational, community, economic, legal, and policy factors. In an effort to examine the feasibility, evaluability, and sustainability of structural interventions for HIV prevention, the Centers for Disease Control and Prevention implemented a project that involved asking experts in HIV prevention and other areas of public health-including injury and violence prevention, tobacco control, drug abuse, and nutrition-to provide input on the identification of structural interventions based on the aforementioned definition. The process resulted in a list of 123 interventions that met the definition. The experts were asked to group these interventions into categories based on similarity of ideas. They were also asked to rate these interventions in terms of impact they would have, if implemented, on reducing HIV transmission. The findings highlight the need for conducting further research on structural interventions, including feasibility of implementation and effectiveness of reducing HIV transmission risks. PMID:22043093

  7. Linearity and Nonlinearity in HIV/STI Transmission: Implications for the Evaluation of Sexual Risk Reduction Interventions

    ERIC Educational Resources Information Center

    Pinkerton, Steven D.; Chesson, Harrell W.; Crosby, Richard A.; Layde, Peter M.

    2011-01-01

    A mathematical model of HIV/sexually transmitted infections (STI) transmission was used to examine how linearity or nonlinearity in the relationship between the number of unprotected sex acts (or the number of sex partners) and the risk of acquiring HIV or a highly infectious STI (such as gonorrhea or chlamydia) affects the utility of sexual…

  8. The Acceptability of Psychosocial Support Interventions for Children Orphaned by HIV/AIDS: An Evaluation of Teacher Ratings

    ERIC Educational Resources Information Center

    Chitiyo, Morgan; Changara, Darlington; Chitiyo, George

    2010-01-01

    The AIDS epidemic has created many orphans around the globe. A majority of these orphans live in sub-Saharan Africa. Children orphaned by HIV/AIDS face many daunting challenges in their struggle to cope with life. The issues they face due to the loss of their parent(s) include poverty, the stigma associated with HIV/AIDS and stress. This study…

  9. Efficacy of a Preventive Intervention for Youths Living with HIV.

    ERIC Educational Resources Information Center

    Rotheram-Borus, Mary Jane; Lee, Martha B.; Murphy, Debra A.; Futterman, Donna; Duan, Naihua; Birnbaum, Jeffrey M.; Lightfoot, Marguerita

    2001-01-01

    Examined HIV transmission behaviors and health practices among HIV-infected youths over 15 months following participation in a preventive intervention that emphasized coping with HIV and reducing risky behaviors. The intervention resulted in increases in social support coping and reductions in risky sexual and lifestyle behaviors specifically…

  10. Investigating combination HIV prevention: isolated interventions or complex system

    PubMed Central

    Brown, Graham; Reeders, Daniel; Dowsett, Gary W.; Ellard, Jeanne; Carman, Marina; Hendry, Natalie; Wallace, Jack

    2015-01-01

    Introduction Treatment as prevention has mobilized new opportunities in preventing HIV transmission and has led to bold new UNAIDS targets in testing, treatment coverage and transmission reduction. These will require not only an increase in investment but also a deeper understanding of the dynamics of combining behavioural, biomedical and structural HIV prevention interventions. High-income countries are making substantial investments in combination HIV prevention, but is this investment leading to a deeper understanding of how to combine interventions? The combining of interventions involves complexity, with many strategies interacting with non-linear and multiplying rather than additive effects. Discussion Drawing on a recent scoping study of the published research evidence in HIV prevention in high-income countries, this paper argues that there is a gap between the evidence currently available and the evidence needed to guide the achieving of these bold targets. The emphasis of HIV prevention intervention research continues to look at one intervention at a time in isolation from its interactions with other interventions, the community and the socio-political context of their implementation. To understand and evaluate the role of a combination of interventions, we need to understand not only what works, but in what circumstances, what role the parts need to play in their relationship with each other, when the combination needs to adapt and identify emergent effects of any resulting synergies. There is little development of evidence-based indicators on how interventions in combination should achieve that strategic advantage and synergy. This commentary discusses the implications of this ongoing situation for future research and the required investment in partnership. We suggest that systems science approaches, which are being increasingly applied in other areas of public health, could provide an expanded vocabulary and analytic tools for understanding these

  11. “If I Take My Medicine, I Will Be Strong:” Evaluation of a Pediatric HIV Disclosure Intervention in Namibia

    PubMed Central

    Beima-Sofie, Kristin; Feris, Larissa; Shepard-Perry, Mark; Hamunime, Ndapewa; John-Stewart, Grace; Kaindjee-Tjituka, Francina; Brandt, Laura

    2015-01-01

    Background: Despite known benefits, only a small proportion of HIV-infected children in sub-Saharan Africa know their status and limited disclosure interventions exist. Namibia's Ministry of Health and Social Services developed and implemented a multipronged intervention to support health care workers (HCWs) and caregivers in the disclosure process. Methods: The intervention included a staged disclosure cartoon book, child and caregiver readiness assessment tools, a monitoring form to track progress over visits, and HCW training curriculum. We conducted qualitative interviews with 35 HCWs and 46 caregivers of HIV-positive children at 4 high volume HIV clinics. Interviews elicited detailed information about intervention uptake and impact. HCWs also participated in a self-efficacy survey. Results: The intervention improved HCW and caregiver confidence and communication skills in pediatric disclosure. The most valuable intervention component was the disclosure cartoon book, which provided structure, language, and guidance for a gradual disclosure process. HCWs reported it greatly reduced caregiver resistance to disclosure. Both caregivers and HCWs reported improved knowledge and ability to support the pediatric patient, improved child understanding of how HIV medications work, increased child hopefulness for their future, and improved child adherence to care and treatment. HCW self-efficacy surveys found that HCWs who received training felt more confident in their ability to engage in the disclosure process. Conclusions: HCWs and caregivers highly endorsed the intervention. Given the urgency to address pediatric HIV disclosure in Africa, and the utility and low cost of the locally-produced disclosure tool, this approach may be useful in other similar settings. PMID:25296096

  12. LifeSkills for Men (LS4M): Pilot Evaluation of a Gender-Affirmative HIV and STI Prevention Intervention for Young Adult Transgender Men Who Have Sex with Men.

    PubMed

    Reisner, Sari L; Hughto, Jaclyn M White; Pardee, Dana J; Kuhns, Lisa; Garofalo, Rob; Mimiaga, Matthew J

    2016-02-01

    Young adult transgender men who have sex with men (TMSM) engage in sexual behaviors that place them at risk of sexually transmitted infections (STIs) including HIV. To date, no HIV and STI prevention interventions have been developed specifically for young adult TMSM. To address this gap, the current study aimed to (1) adapt a small group-based behavioral HIV prevention intervention designed for young transgender women ("LifeSkills") to address the unique HIV and STI prevention needs of young TMSM ages 18-29 years and (2) conduct a pilot evaluation of the intervention ("LifeSkills for Men"; LS4M). LS4M was carried out in an iterative approach with community input along the way, which allowed for refinement of the intervention manual and enhanced participant acceptability. A LS4M Task Force was convened to guide intervention development/adaptation and study implementation. Initially, focus groups were conducted to examine the sexual health needs, concerns, and stressors facing young TMSM (n = 12; mean age = 23.8 years; 16.7% people of color). Next, LS4M was pilot tested (n = 17; mean age = 24.3 years; 23.5% people of color) to assess acceptability with the study population and feasibility of all study procedures. Overall attendance, participation rates, and positive feedback from participants demonstrate that LS4M is highly acceptable and feasible to carry out with young TMSM. Trends in outcome measures across 4 months of follow-up suggest that participation in the intervention may improve mental health, reduce internalized stigma, and reduce HIV- and STI-related risk behaviors. Further testing of the intervention enrolling young TMSM with recent sexual risk behavior at baseline and with a control group is warranted. Lessons learned for future work with young TMSM are discussed. PMID:26753882

  13. A "Common Factors" Approach to Developing Culturally Tailored HIV Prevention Interventions.

    PubMed

    Owczarzak, Jill; Phillips, Sarah D; Filippova, Olga; Alpatova, Polina; Mazhnaya, Alyona; Zub, Tatyana; Aleksanyan, Ruzanna

    2016-06-01

    The current dominant model of HIV prevention intervention dissemination involves packaging interventions developed in one context, training providers to implement that specific intervention, and evaluating the extent to which providers implement it with fidelity. Research shows that providers rarely implement these programs with fidelity due to perceived incompatibility, resource constraints, and preference for locally generated solutions. In this study, we used the concept of "common factors," or broad constructs shared by most evidence-based HIV prevention interventions, to train service providers to develop their own programs. We recruited eight Ukrainian HIV prevention organizations from regions with HIV epidemics concentrated among people who inject drugs. We trained staff to identify HIV risk behaviors and determinants, construct behavior change logic models, and develop and manualize an intervention. We systematically reviewed each manual to assess intervention format and content and determine whether the program met intervention criteria as taught during training. All agencies developed programs that reflected common factors of effective behavior change HIV prevention interventions. Each agency's program targeted a unique population that reflected local HIV epidemiology. All programs incorporated diverse pedagogical strategies that focused on skill-building, goal-setting, communication, and empowerment. Agencies struggled to limit information dissemination and the overall scope and length of their programs. We conclude that training service providers to develop their own programs based on common elements of effective behavior change interventions can potentially transform existing processes of program development, implementation, and capacity building. Expanding this model will require committed training and support resources. PMID:27178497

  14. An Alternative Model of the Reproductive Rate of HIV Infection: Formulation, Evaluation, and Implications for Risk Reduction Interventions.

    ERIC Educational Resources Information Center

    Pinkerton, Steven D.; Abramson, Paul R.

    1994-01-01

    Estimates of the reproductive rate of infection with the human immunodeficiency virus (HIV), obtained through a Bernoulli process model, indicate that decreasing the infectivity of the virus, through the use of condoms, for example, is more effective at reducing the infection rate than is limiting the number of sexual partners. (SLD)

  15. Monitoring HIV Risk and Evaluating Interventions among Young People in Urban West Africa: Development and Validation of an Instrument

    ERIC Educational Resources Information Center

    Boileau, Catherine; Rashed, Selim; Sylla, Mohamed; Zunzunegui, Maria Victoria

    2008-01-01

    We developed an instrument for HIV/AIDS behavioral surveillance applicable to youth living in urban West Africa. The instrument includes a comprehensive set of constructs borrowed from the sociocognitive theory of planned behavior as well as measures of parental and peer communication An exploratory (n = 189) and validation sample (n = 342) of…

  16. Enhancing HIV Prevention Among Young Men Who Have Sex With Men: A Systematic Review of HIV Behavioral Interventions for Young Gay and Bisexual Men.

    PubMed

    Hergenrather, Kenneth C; Emmanuel, Diona; Durant, Sarah; Rhodes, Scott D

    2016-06-01

    Men who have sex with men (MSM) represent 64.0% of people living with HIV (PLWH) over the age of 13 years. Young men who have sex with men (YMSM) are particularly affected by HIV/AIDS; the rate of HIV infection for YMSM between the ages of 13 and 24 represents 72.0% of new infections among youth. To understand the current state of the science meant to prevent HIV for YMSM, we reviewed studies of HIV behavioral prevention interventions for YMSM. Five literature databases were searched, from their inception through October 2015, using key words associated with HIV prevention intervention evaluation studies for YMSM. The review criteria included behavioral HIV/AIDS prevention interventions, articles published in English-language peer-reviewed journals, YMSM between 13 and 24 years of age, and longitudinal repeated measures design. A total of 15 YMSM behavioral HIV prevention intervention studies were identified that met inclusion criteria and reported statistically significant findings. Common outcomes included unprotected sexual intercourse, HIV/AIDS risk behavior, condom use, HIV testing, safer sex attitude, and HIV prevention communication. Participant age, representation of Black/African American YMSM, application of theoretical and model underpinnings, congruence of assessment measures used, follow-up assessment times, and application of process evaluation were inconsistent across studies. To advance HIV prevention intervention research for YMSM, future studies should be theory-based, identify common constructs, utilize standard measures, include process evaluation, and evaluate sustained change over standard periods of time. HIV prevention interventions should incorporate the needs of the diverse, well-educated, web-connected millennial generation and differentiate between adolescent YMSM (13 to 18 years of age) and young adulthood YMSM (19 to 24 years of age). Because Black/African American YMSM represent more than 50% of new HIV infections, future HIV

  17. A "Common Factors" Approach to Developing Culturally Tailored HIV Prevention Interventions

    ERIC Educational Resources Information Center

    Owczarzak, Jill; Phillips, Sarah D.; Filippova, Olga; Alpatova, Polina; Mazhnaya, Alyona; Zub, Tatyana; Aleksanyan, Ruzanna

    2016-01-01

    The current dominant model of HIV prevention intervention dissemination involves packaging interventions developed in one context, training providers to implement that specific intervention, and evaluating the extent to which providers implement it with fidelity. Research shows that providers rarely implement these programs with fidelity due to…

  18. Veterans' Perspectives on Interventions to Improve Retention in HIV Care.

    PubMed

    Minick, Sophie G; Stafford, Crystal L; Kertz, Barbara L; Cully, Jeffery A; Stanley, Melinda A; Davila, Jessica A; Dang, Bich N; Rodriguez-Barradas, Maria C; Giordano, Thomas P

    2016-01-01

    Poor retention in HIV medical care is associated with increased mortality among patients with HIV/AIDS. Developing new interventions to improve retention in HIV primary care is needed. The Department of Veteran Affairs (VA) is the largest single provider of HIV care in the US. We sought to understand what veterans would want in an intervention to improve retention in VA HIV care. We conducted 18 one-on-one interviews and 15 outpatient focus groups with 46 patients living with HIV infection from the Michael E. DeBakey VAMC (MEDVAMC). Analysis identified three focus areas for improving retention in care: developing an HIV friendly clinic environment, providing mental health and substance use treatment concurrent with HIV care and encouraging peer support from other Veterans with HIV. PMID:26829641

  19. Maximizing the impact of HIV prevention efforts: Interventions for couples

    PubMed Central

    Medley, Amy; Baggaley, Rachel; Bachanas, Pamela; Cohen, Myron; Shaffer, Nathan; Lo, Ying-Ru

    2015-01-01

    Despite efforts to increase access to HIV testing and counseling services, population coverage remains low. As a result, many people in sub-Saharan Africa do not know their own HIV status or the status of their sex partner(s). Recent evidence, however, indicates that as many as half of HIV-positive individuals in ongoing sexual relationships have an HIV-negative partner and that a significant proportion of new HIV infections in generalized epidemics occur within serodiscordant couples. Integrating couples HIV testing and counseling (CHTC) into routine clinic- and community-based services can significantly increase the number of couples where the status of both partners is known. Offering couples a set of evidence-based interventions once their HIV status has been determined can significantly reduce HIV incidence within couples and if implemented with sufficient scale and coverage, potentially reduce population-level HIV incidence as well. This article describes these interventions and their potential benefits. PMID:23656251

  20. Veterans’ Perspectives on Interventions to Improve Retention in HIV Care

    PubMed Central

    Kertz, Barbara L.; Cully, Jeffery A.; Stanley, Melinda A.; Davila, Jessica A.; Dang, Bich N.; Rodriguez-Barradas, Maria C.; Giordano, Thomas P.

    2016-01-01

    Poor retention in HIV medical care is associated with increased mortality among patients with HIV/AIDS. Developing new interventions to improve retention in HIV primary care is needed. The Department of Veteran Affairs (VA) is the largest single provider of HIV care in the US. We sought to understand what veterans would want in an intervention to improve retention in VA HIV care. We conducted 18 one-on-one interviews and 15 outpatient focus groups with 46 patients living with HIV infection from the Michael E. DeBakey VAMC (MEDVAMC). Analysis identified three focus areas for improving retention in care: developing an HIV friendly clinic environment, providing mental health and substance use treatment concurrent with HIV care and encouraging peer support from other Veterans with HIV. PMID:26829641

  1. The evaluation of the JEWEL project: an innovative economic enhancement and HIV prevention intervention study targeting drug using women involved in prostitution.

    PubMed

    Sherman, S G; German, D; Cheng, Y; Marks, M; Bailey-Kloche, M

    2006-01-01

    The JEWEL (Jewellery Education for Women Empowering Their Lives) pilot study examined the efficacy of an economic empowerment and HIV prevention intervention targeting illicit drug-using women (n=50) who were involved in prostitution in Baltimore, Maryland. The intervention was comprised of six 2-hour sessions that taught HIV prevention risk reduction and the making, marketing and selling of jewellery. Bivariate comparisons examined behaviour change pre- and 3-months post-intervention. The intervention's effect on the change in the number of sex trade partners from baseline to follow-up was explored with multiple linear regression. Participants were 62.0% African American, 5.0% were currently employed, and the median age was 39 years old (Inter Quartile Range [IQR]: 34-45). Women attended an average of six (IQR: 4.5-6.0) sessions. The women sold over $7,000 worth of jewellery in eleven sales. In comparing self-reported risk behaviours pre and 3-month post intervention participation, we found significant reductions in: receiving drugs or money for sex (100% versus 71.0%, p<0.0005); the median number of sex trade partners per month (9 versus 3, p=0.02); daily drug use (76.0% vs. 55.0%, p=0.003); the amount of money spent on drugs daily (US$52.57 versus US$46.71, p = 0.01); and daily crack use (27.3% versus 13.1.0%, p = 0.014). In the presence of other variables in a multivariate linear model, income from the jewelry sale was associated with a reduction in the number of sex trade partners at follow-up. The pilot indicated effectiveness of a novel, HIV prevention, economic enhancement intervention upon HIV sexual risk behaviours and drug utilization patterns. PMID:16282070

  2. Implementation Process of a Canadian Community-based Nurse Mentorship Intervention in HIV Care.

    PubMed

    Caine, Vera; Mill, Judy; O'Brien, Kelly; Solomon, Patricia; Worthington, Catherine; Dykeman, Margaret; Gahagan, Jacqueline; Maina, Geoffrey; De Padua, Anthony; Arneson, Cheryl; Rogers, Tim; Chaw-Kant, Jean

    2016-01-01

    We describe salient individual and organizational factors that influenced engagement of registered nurses in a 12-month clinical mentorship intervention on HIV care in Canada. The intervention included 48 nurses and 8 people living with HIV (PLWH) who were involved in group-based and one-on-one informal mentorship informed by transformative learning theory. We evaluated the process of implementing the mentorship intervention using qualitative content analysis. The inclusion of PLWH as mentors, the opportunities for reciprocal learning, and the long-term commitment of individual nurses and partner organizations in HIV care were major strengths. Challenges included the need for multiple ethical approvals, the lack of organizational support at some clinical sites, and the time commitment required by participants. We recommend that clinical mentorship interventions in HIV care consider organizational support, adhere to the Greater Involvement of People Living with HIV/AIDS principles, and explore questions of professional obligations. PMID:26644019

  3. Implementation Process of a Canadian Community-based Nurse Mentorship Intervention in HIV Care

    PubMed Central

    Caine, Vera; Mill, Judy; O’Brien, Kelly; Solomon, Patricia; Worthington, Catherine; Dykeman, Margaret; Gahagan, Jacqueline; Maina, Geoffrey; De Padua, Anthony; Arneson, Cheryl; Rogers, Tim; Chaw-Kant, Jean

    2016-01-01

    We describe salient individual and organizational factors that influenced engagement of registered nurses in a 12-month clinical mentorship intervention on HIV care in Canada. The intervention included 48 nurses and 8 people living with HIV (PLWH) who were involved in group-based and one-on-one informal mentorship informed by transformative learning theory. We evaluated the process of implementing the mentorship intervention using qualitative content analysis. The inclusion of PLWH as mentors, the opportunities for reciprocal learning, and the long-term commitment of individual nurses and partner organizations in HIV care were major strengths. Challenges included the need for multiple ethical approvals, the lack of organizational support at some clinical sites, and the time commitment required by participants. We recommend that clinical mentorship interventions in HIV care consider organizational support, adhere to the Greater Involvement of People Living with HIV/AIDS principles, and explore questions of professional obligations. PMID:26644019

  4. Behavioral Interventions to Reduce Sexual Risk Behavior in Adults with HIV/AIDS Receiving HIV Care: A Systematic Review.

    PubMed

    Laisaar, Kaja-Triin; Raag, Mait; Rosenthal, Marika; Uusküla, Anneli

    2015-05-01

    Regular interactions with people living with HIV/AIDS (PLWHA) who are receiving care provide caregivers opportunities to deliver interventions to reduce HIV-related risks. We conducted a systematic review of behavioral interventions for PLWHA (provided at individual level by caregivers at HIV care settings) to determine their efficacy in reducing sexual risk behavior. Conference websites and biomedical literature databases were searched for studies from 1981 to 2013. Randomized and quasi-randomized controlled trials (with standard-of-care control groups), considering at least one of a list of HIV-related behavioral or biological outcomes in PLWHA aged ≥18 receiving HIV care with at least 3-month follow-up were included. No language or publication status restrictions were set. Standardized search, data abstraction, and evaluation methods were used. Five randomized controlled trials were included in the review. We found limited evidence that sexual risk reduction interventions increase condom use consistency in HIV transmission risk acts, and reduce the number of (casual) sexual partners. We still believe that regular interactions between HIV care providers and PLWHA provide valuable opportunities for theory-based sexual risk reduction interventions to restrain the spread of HIV. PMID:25844941

  5. Project Eban: An HIV/STD Intervention for African American Couples

    PubMed Central

    2010-01-01

    Objective To describe the Eban HIV/STD Risk Reduction Intervention being evaluated in the NIMH Multisite HIV/STD Prevention trial for heterosexual African American couples, including the integrated theoretical framework, the structure, core elements and procedures of the intervention and how the content was shaped by culturally congruent concepts to address the needs of the study target population. Design The Eban HIV/STD Risk Reduction Intervention is designed to address multilevel individual, interpersonal and community level factors that contribute to HIV/STD transmission risk behaviors among heterosexual African American couples who are HIV serodiscordant. Methods The Eban HIV/STD Risk Reduction Intervention employs a mixed modality, couples-based approach that is based on an integrated ecological framework incorporating social cognitive theory and uses an Afro-centric paradigm that is informed by previous evidence-based couples HIV prevention interventions. For this randomized controlled trial, African American serodiscordant couples were recruited from four urban sites (Atlanta, Los Angeles, New York and Philadelphia) and were randomized to either the Eban HIV/STD Risk Reduction Intervention (treatment condition) or a Health Promotion Intervention that served as an attentional control condition. Both interventions had 4 individual couple sessions and 4 group sessions, but only the treatment condition was focused on reducing HIV/STD risk behaviors. Behavioral and biological data were collected at baseline, immediately after the intervention, and at 6 and 12 months. The theoretical framework, core elements and content of each session are described and lessons learned from this intervention trial are discussed. Results An HIV prevention intervention combining couple and group sessions can be feasibly implemented with African American HIV serodiscordant couples who remain at high risk of HIV/STD transmission. The lessons learned from the trial suggest that the

  6. HIV risk and preventive interventions in transgender women sex workers

    PubMed Central

    Poteat, Tonia; Wirtz, Andrea L; Radix, Anita; Borquez, Annick; Silva-Santisteban, Alfonso; Deutsch, Madeline B; Khan, Sharful Islam; Winter, Sam; Operario, Don

    2015-01-01

    Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population. PMID:25059941

  7. HIV risk and preventive interventions in transgender women sex workers.

    PubMed

    Poteat, Tonia; Wirtz, Andrea L; Radix, Anita; Borquez, Annick; Silva-Santisteban, Alfonso; Deutsch, Madeline B; Khan, Sharful Islam; Winter, Sam; Operario, Don

    2015-01-17

    Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population. PMID:25059941

  8. Combination HIV Prevention Interventions: The Potential of Integrated Behavioral and Biomedical Approaches

    PubMed Central

    Brown, Jennifer L.; Sales, Jessica M.; DiClemente, Ralph J.

    2014-01-01

    Background Combination HIV prevention interventions that integrate efficacious behavioral and biomedical strategies offer the potential to reduce new HIV infections. Purpose We overview the efficacy data for three biomedical HIV prevention approaches: microbicides, pre-exposure prophylaxis (PrEP), and an HIV vaccination, review factors associated with differential acceptability and uptake of these methods, and suggest strategies to optimize the effectiveness and dissemination of combination HIV prevention approaches. Methods A narrative review was conducted highlighting key efficacy data for microbicides, PrEP, and an HIV vaccination and summarizing acceptability data for each of the three biomedical HIV prevention approaches. Recommendations for the integration and dissemination of combined behavioral and biomedical HIV prevention approaches are provided. Results To date, microbicides and an HIV vaccination have demonstrated limited efficacy for the prevention of HIV. However, PrEP has demonstrated efficacy in reducing HIV incident infections. A diverse array of factors influences both hypothetical willingness and actual usage of each biomedical prevention method. Conclusions Strategies to effectively integrate and evaluate combination HIV prevention interventions are urgently needed. PMID:25216985

  9. Criteria for Evaluating Interventions

    ERIC Educational Resources Information Center

    Miles, T. R.

    2007-01-01

    By common consent there is a "gold standard" in reference to which the efficacy of medical interventions needs to be evaluated. It is suggested in this paper that in educational research achievement of this gold standard is rarely possible. It does not follow, however, that research that falls short of this standard is therefore valueless; there…

  10. HIV/AIDS interventions in an aging U.S. population.

    PubMed

    Jacobson, Stephanie A

    2011-05-01

    According to the Centers for Disease Control and Prevention (CDC), 25 percent of people living with HIV in the United States in 2006 were age 50 and older. HIV prevention for people over 50 is an important health concern, especially as the U.S. population grows older. Scholarly research has identified the need for HIV/AIDS interventions in the population of people over age 50, but few interventions have been established. The ecological perspective, which integrates intrapersonal, interpersonal, organizational, community, and policy factors, was used to review the current interventions and propose possible new HIV/AIDS prevention efforts for older adults. Intrapersonal interventions are often based on the health belief model. The precaution adoption process model was explored as an alternative intrapersonal theory for modeling prevention efforts. Community interventions using diffusion of innovations theory are fully explored, and new interventions are proposed as an option for preventing HIV/AIDS in older adults. An agenda for future research and interventions is proposed. Social workers will be at the forefront of the effort to prevent HIV/AIDS in older adults. They must accept this responsibility, propose interventions, and evaluate their effectiveness. PMID:21661304

  11. The Chinese Life-Steps Program: A Cultural Adaptation of a Cognitive-Behavioral Intervention to Enhance HIV Medication Adherence

    ERIC Educational Resources Information Center

    Shiu, Cheng-Shi; Chen, Wei-Ti; Simoni, Jane; Fredriksen-Goldsen, Karen; Zhang, Fujie; Zhou, Hongxin

    2013-01-01

    China is considered to be the new frontier of the global AIDS pandemic. Although effective treatment for HIV is becoming widely available in China, adherence to treatment remains a challenge. This study aimed to adapt an intervention promoting HIV-medication adherence--favorably evaluated in the West--for Chinese HIV-positive patients. The…

  12. Group Intervention to Reduce HIV Transmission Risk Behavior Among Persons Living With HIV/AIDS

    ERIC Educational Resources Information Center

    Kalichman, Seth C.; Rompa, David; Cage, Marjorie

    2005-01-01

    Results of a randomized controlled trial show that a behavioral intervention grounded in social cognitive theory reduces unprotected sexual behaviors among men and women living with HIV infection, with the greatest reductions in HIV transmission risk behaviors occurring with non-HIV-positive sex partners. In this article, the authors describe the…

  13. A Randomized Trial to Evaluate the Efficacy of a Web-Based HIV Behavioral Intervention for High-Risk African American Women

    PubMed Central

    Billings, Douglas W.; Leaf, Samantha L.; Spencer, Joy; Crenshaw, Terrlynn; Brockington, Sheila; Dalal, Reeshad S.

    2015-01-01

    The aim of this study was to develop and test a cost-effective, scalable HIV behavioral intervention for African American women. Eighty-three African American women were recruited from a community health center and randomly assigned to either the web-based Safe Sistah program or to a delayed HIV education control condition. The primary outcome was self-reported condom use. Secondary measures assessed other aspects of the gender-focused training included in Safe Sistah. Participants completed self-report assessments prior to randomization, 1- and 4-months after their program experience. Across the entire study period, women in the experimental condition significantly increased their condom use relative to controls (F = 5.126, p = 0.027). Significant effects were also found for sexual communication, sex refusal, condom use after alcohol consumption, and HIV prevention knowledge. These findings indicate that this web-based program could be an important component in reducing the HIV disparities among African American women. PMID:25616838

  14. Factors That Influence HIV Risk among Hispanic Female Immigrants and Their Implications for HIV Prevention Interventions

    PubMed Central

    Hernandez, Amy M.; Zule, William A.; Karg, Rhonda S.; Browne, Felicia A.; Wechsberg, Wendee M.

    2012-01-01

    Hispanics are the fastest growing minority group in North Carolina with increasing incidence of HIV infection. Gender roles, cultural expectations, and acculturation of women may explain some of Hispanic women's risks. The perspectives of Hispanic female immigrants and community-based providers were sought to identify services they offer, understand HIV risk factors, and support the adaptation of a best-evidence HIV behavioural intervention for Hispanic women. Two sets of focus groups were conducted to explicate risks and the opportunities to reach women or couples and the feasibility to conduct HIV prevention in an acceptable manner. Salient findings were that Hispanic female immigrants lacked accurate HIV/AIDS and STI knowledge and that traditional gender roles shaped issues surrounding sexual behaviour and HIV risks, as well as condom use, partner communication, and multiple sexual partnerships. Intervention implications are discussed such as developing and adapting culturally appropriate HIV prevention interventions for Hispanics that address gender roles and partner communication. PMID:22518308

  15. Meta-analyses on behavioral interventions to reduce the risk of transmission of HIV.

    PubMed

    Vergidis, Paschalis I; Falagas, Matthew E

    2009-06-01

    Different behavioral interventions have found to be efficacious in reducing high-risk sexual activity. Interventions have been evaluated in both original research and meta-analytic reviews. Most of the studies have shown that interventions are efficacious among different study populations. In adolescents, both in- and out-of-the classroom interventions showed a decrease in the risk of unprotected sex. In African Americans, greater efficacy was found for interventions including peer education. For Latinos, effect was larger in interventions with segmentation in the same gender. Geographic and social isolation are barriers in approaching MSM. For IDUs, interventions provided within a treatment program have an impact on risk reduction above that produced by drug treatment alone. Finally, people diagnosed with HIV tend to reduce their sexual risk behavior. However, adherence to safe sex practices for life can be challenging. Relentless efforts for implementation of behavioral interventions to decrease high-risk behavior are necessary to decrease HIV transmission. PMID:19393911

  16. Criteria for evaluating interventions.

    PubMed

    Miles, T R

    2007-11-01

    By common consent there is a 'gold standard' in reference to which the efficacy of medical interventions needs to be evaluated. It is suggested in this paper that in educational research achievement of this gold standard is rarely possible. It does not follow, however, that research that falls short of this standard is therefore valueless; there may be many different kinds of good (and less good) reasons for accepting particular conclusions. PMID:17948881

  17. Outcomes of an HIV Prevention Peer Group Intervention for Rural Adults in Malawi

    ERIC Educational Resources Information Center

    Kaponda, Chrissie P. N.; Norr, Kathleen F.; Crittenden, Kathleen S.; Norr, James L.; McCreary, Linda L.; Kachingwe, Sitingawawo I.; Mbeba, Mary M.; Jere, Diana L. N.; Dancy, Barbara L.

    2011-01-01

    This study used a quasi-experimental design to evaluate a six-session peer group intervention for HIV prevention among rural adults in Malawi. Two rural districts were randomly assigned to intervention and control conditions. Independent random samples of community adults compared the districts at baseline and at 6 and 18 months postintervention.…

  18. The Amagugu Intervention: A Conceptual Framework for Increasing HIV Disclosure and Parent-Led Communication about Health among HIV-Infected Parents with HIV-Uninfected Primary School-Aged Children

    PubMed Central

    Rochat, Tamsen J.; Mitchell, Joanie; Stein, Alan; Mkwanazi, Ntombizodumo Brilliant; Bland, Ruth M.

    2016-01-01

    Advances in access to HIV prevention and treatment have reduced vertical transmission of HIV, with most children born to HIV-infected parents being HIV-uninfected themselves. A major challenge that HIV-infected parents face is disclosure of their HIV status to their predominantly HIV-uninfected children. Their children enter middle childhood and early adolescence facing many challenges associated with parental illness and hospitalization, often exacerbated by stigma and a lack of access to health education and support. Increasingly, evidence suggests that primary school-aged children have the developmental capacity to grasp concepts of health and illness, including HIV, and that in the absence of parent-led communication and education about these issues, HIV-exposed children may be at increased risk of psychological and social problems. The Amagugu intervention is a six-session home-based intervention, delivered by lay counselors, which aims to increase parenting capacity to disclose their HIV status and offer health education to their primary school-aged children. The intervention includes information and activities on disclosure, health care engagement, and custody planning. An uncontrolled pre–post-evaluation study with 281 families showed that the intervention was feasible, acceptable, and effective in increasing maternal disclosure. The aim of this paper is to describe the conceptual model of the Amagugu intervention, as developed post-evaluation, showing the proposed pathways of risk that Amagugu aims to disrupt through its intervention targets, mechanisms, and activities; and to present a summary of results from the large-scale evaluation study of Amagugu to demonstrate the acceptability and feasibility of the intervention model. This relatively low-intensity home-based intervention led to: increased HIV disclosure to children, improvements in mental health for mother and child, and improved health care engagement and custody planning for the child. The

  19. Evaluation of an HIV prevention intervention for African Americans and Hispanics: findings from the VOICES/VOCES Community-based Organization Behavioral Outcomes Project.

    PubMed

    Fisher, Holly H; Patel-Larson, A; Green, K; Shapatava, E; Uhl, G; Kalayil, E J; Moore, A; Williams, W; Chen, B

    2011-11-01

    There is limited knowledge about whether the delivery of evidence-based, HIV prevention interventions in 'real world' settings will produce outcomes similar to efficacy trial outcomes. In this study, we describe longitudinal changes in sexual risk outcomes among African American and Hispanic participants in the Video Opportunities for Innovative Condom Education and Safer Sex (VOICES/VOCES) program at four CDC-funded agencies. VOICES/VOCES was delivered to 922 high-risk individuals in a variety of community settings such as substance abuse treatment centers, housing complex centers, private residences, shelters, clinics, and colleges. Significant risk reductions were consistently observed at 30- and 120-days post-intervention for all outcome measures (e.g., unprotected sex, self-reported STD infection). Risk reductions were strongest for African American participants, although Hispanic participants also reported reducing their risky behaviors. These results suggest that, over a decade after the first diffusion of VOICES/VOCES across the U.S. by CDC, this intervention remains an effective tool for reducing HIV risk behaviors among high-risk African American and Hispanic individuals. PMID:21573724

  20. HIV prevention: integrating biomedical and behevioral interventions.

    PubMed

    Del Rio, Carlos

    Recommendations for HIV prevention in clinical care settings by an IAS-USA panel were recently published. They include recommendations on HIV testing, antiretroviral therapy initiation, risk-reduction counseling, and antiretroviral therapy adherence counseling for HIV-infected individuals. For individuals at risk for HIV infection, recommendations for preexposure prophylaxis, other risk-reduction strategies, adherence counseling, and postexposure prophylaxis are included. Many HIV-infected individuals in the United States are not fully engaged in HIV care and are not virologically suppressed, thus a crucial component of efforts to reduce HIV transmission is moving patients through the HIV care continuum. This article summarizes an IAS-USA continuing education webinar presented by Carlos del Rio, MD, in September 2014. PMID:25612180

  1. HIV Prevention for Adults With Criminal Justice Involvement: A Systematic Review of HIV Risk-Reduction Interventions in Incarceration and Community Settings

    PubMed Central

    Dumont, Dora; Operario, Don

    2014-01-01

    We summarized and appraised evidence regarding HIV prevention interventions for adults with criminal justice involvement. We included randomized and quasi-randomized controlled trials that evaluated an HIV prevention intervention, enrolled participants with histories of criminal justice involvement, and reported biological or behavioral outcomes. We used Cochrane methods to screen 32 271 citations from 16 databases and gray literature. We included 37 trials enrolling n = 12 629 participants. Interventions were 27 psychosocial, 7 opioid substitution therapy, and 3 HIV-testing programs. Eleven programs significantly reduced sexual risk taking, 4 reduced injection drug risks, and 4 increased testing. Numerous interventions may reduce HIV-related risks among adults with criminal justice involvement. Future research should consider process evaluations, programs involving partners or families, and interventions integrating biomedical, psychosocial, and structural approaches. PMID:25211725

  2. HIV prevention for adults with criminal justice involvement: a systematic review of HIV risk-reduction interventions in incarceration and community settings.

    PubMed

    Underhill, Kristen; Dumont, Dora; Operario, Don

    2014-11-01

    We summarized and appraised evidence regarding HIV prevention interventions for adults with criminal justice involvement. We included randomized and quasi-randomized controlled trials that evaluated an HIV prevention intervention, enrolled participants with histories of criminal justice involvement, and reported biological or behavioral outcomes. We used Cochrane methods to screen 32,271 citations from 16 databases and gray literature. We included 37 trials enrolling n = 12,629 participants. Interventions were 27 psychosocial, 7 opioid substitution therapy, and 3 HIV-testing programs. Eleven programs significantly reduced sexual risk taking, 4 reduced injection drug risks, and 4 increased testing. Numerous interventions may reduce HIV-related risks among adults with criminal justice involvement. Future research should consider process evaluations, programs involving partners or families, and interventions integrating biomedical, psychosocial, and structural approaches. PMID:25211725

  3. Developing family interventions for adolescent HIV prevention in South Africa.

    PubMed

    Kuo, Caroline; Atujuna, Millicent; Mathews, Catherine; Stein, Dan J; Hoare, Jacqueline; Beardslee, William; Operario, Don; Cluver, Lucie; K Brown, Larry

    2016-01-01

    Adolescents and young people account for 40% of all new HIV infections each year, with South Africa one of the hardest hit countries, and having the largest population of people living with HIV. Although adolescent HIV prevention has been delivered through diverse modalities in South Africa, and although family-based approaches for adolescent HIV prevention have great potential for highly affected settings such as South Africa, there is a scarcity of empirically tested family-based adolescent HIV preventive interventions in this setting. We therefore conducted focus groups and in-depth interviews with key informants including clinicians, researchers, and other individuals representing organizations providing HIV and related health services to adolescents and parents (N = 82). We explored family perspectives and interactions around topics such as communication about sex, HIV, and relationships. Participants described aspects of family interactions that presented both challenges and opportunities for family-based adolescent HIV prevention. Parent-child communication on sexual topics were taboo, with these conversations perceived by some adults as an invitation for children to engage in HIV risk behavior. Parents experienced social sanctions for discussing sex and adolescents who asked about sex were often viewed as disrespectful and needing discipline. However, participants also identified context-appropriate strategies for addressing family challenges around HIV prevention including family meetings, communal parenting, building efficacy around parent-adolescent communication around sexual topics, and the need to strengthen family bonding and positive parenting. Findings indicate the need for a family intervention and identify strategies for development of family-based interventions for adolescent HIV prevention. These findings will inform design of a family intervention to be tested in a randomized pilot trial (ClinicalTrials.gov #NCT02432352). PMID:26916841

  4. Developing family interventions for adolescent HIV prevention in South Africa

    PubMed Central

    Kuo, Caroline; Atujuna, Millicent; Mathews, Catherine; Stein, Dan J.; Hoare, Jacqueline; Beardslee, William; Operario, Don; Cluver, Lucie; K. Brown, Larry

    2016-01-01

    ABSTRACT Adolescents and young people account for 40% of all new HIV infections each year, with South Africa one of the hardest hit countries, and having the largest population of people living with HIV. Although adolescent HIV prevention has been delivered through diverse modalities in South Africa, and although family-based approaches for adolescent HIV prevention have great potential for highly affected settings such as South Africa, there is a scarcity of empirically tested family-based adolescent HIV preventive interventions in this setting. We therefore conducted focus groups and in-depth interviews with key informants including clinicians, researchers, and other individuals representing organizations providing HIV and related health services to adolescents and parents (N = 82). We explored family perspectives and interactions around topics such as communication about sex, HIV, and relationships. Participants described aspects of family interactions that presented both challenges and opportunities for family-based adolescent HIV prevention. Parent–child communication on sexual topics were taboo, with these conversations perceived by some adults as an invitation for children to engage in HIV risk behavior. Parents experienced social sanctions for discussing sex and adolescents who asked about sex were often viewed as disrespectful and needing discipline. However, participants also identified context-appropriate strategies for addressing family challenges around HIV prevention including family meetings, communal parenting, building efficacy around parent–adolescent communication around sexual topics, and the need to strengthen family bonding and positive parenting. Findings indicate the need for a family intervention and identify strategies for development of family-based interventions for adolescent HIV prevention. These findings will inform design of a family intervention to be tested in a randomized pilot trial (ClinicalTrials.gov #NCT02432352). PMID

  5. Behavior change interventions to prevent HIV infection among women living in low and middle income countries: a systematic review.

    PubMed

    McCoy, Sandra I; Kangwende, Rugare A; Padian, Nancy S

    2010-06-01

    We conducted a systematic review of behavioral change interventions to prevent the sexual transmission of HIV among women and girls living in low- and middle-income countries. PubMed/MEDLINE, Web of Science, the Cochrane Library, and other databases and bibliographies were systematically searched for trials using randomized or quasi-experimental designs to evaluate behavioral interventions with HIV infection as an outcome. We identified 11 analyses for inclusion reporting on eight unique interventions. Interventions varied widely in intensity, duration, and delivery as well as by target population. Only two analyses showed a significant protective effect on HIV incidence among women and only three of ten analyses that measured behavioral outcomes reduced any measure of HIV-related risk behavior. Ongoing research is needed to determine whether behavior change interventions can be incorporated as independent efficacious components in HIV prevention packages for women or simply as complements to biomedical prevention strategies. PMID:19949847

  6. Evidence-based HIV/STD prevention intervention for black men who have sex with men.

    PubMed

    Herbst, Jeffrey H; Painter, Thomas M; Tomlinson, Hank L; Alvarez, Maria E

    2014-04-18

    This report summarizes published findings of a community-based organization in New York City that evaluated and demonstrated the efficacy of the Many Men, Many Voices (3MV) human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention intervention in reducing sexual risk behaviors and increasing protective behaviors among black men who have sex with men (MSM). The intervention addressed social determinants of health (e.g., stigma, discrimination, and homophobia) that can influence the health and well-being of black MSM at high risk for HIV infection. This report also highlights efforts by CDC to disseminate this evidence-based behavioral intervention throughout the United States. CDC's Office of Minority Health and Health Equity selected the intervention analysis and discussion to provide an example of a program that might be effective for reducing HIV infection- and STD-related disparities in the United States. 3MV uses small group education and interaction to increase knowledge and change attitudes and behaviors related to HIV/STD risk among black MSM. Since its dissemination by CDC in 2004, 3MV has been used in many settings, including health department- and community-based organization programs. The 3MV intervention is an important component of a comprehensive HIV and STD prevention portfolio for at-risk black MSM. As CDC continues to support HIV prevention programming consistent with the National HIV/AIDS Strategy and its high-impact HIV prevention approach, 3MV will remain an important tool for addressing the needs of black MSM at high risk for HIV infection and other STDs. PMID:24743663

  7. Qualitative Analysis of an Educational Intervention with HIV-Discordant Heterosexual Latino Couples

    PubMed Central

    Pérez-Jiménez, David; Orengo-Aguayo, Rosaura E.

    2012-01-01

    Objective This qualitative analysis elucidates the potential elements of the intervention that may be effective in terms of a) increasing knowledge about HIV/AIDS in the members of this population; b) increasing the use of male condoms and the practice of mutual masturbation; and c) changing opinions toward male condom use and mutual masturbation. Methods Five heterosexual HIV-discordant couples participated in the adapted intervention, which consisted of four three-hour-long sessions. One month after the intervention, we conducted a qualitative semi-structured interview with every participant to evaluate issues related to the process and content of the activities comprising the intervention, the impact of the intervention, logistics, and recruitment and retention as well as to make a more general evaluation. The information was submitted to qualitative content analysis. Results After the intervention, participants reported having better attitudes regarding safer sex, particularly in terms of condom use. A reason given by the participants to feel more positive toward condom use and mutual masturbation was that these practices could prevent the infection of the HIV-negative partner. Conclusion This study provides important evidence of an intervention that promises to be efficacious in preventing some high-risk sexual behaviors among Latino HIV-discordant heterosexual couples. The evidence presented seems to suggest that an intervention that includes basic relevant information about HIV/AIDS, that explains the benefits of condom use and other safer sex options, and that provides effective negotiation and communication strategies could significantly reduce HIV transmission among these couples. PMID:22263299

  8. Psychological Interventions with AIDS and HIV: Prevention and Treatment.

    ERIC Educational Resources Information Center

    Kelly, Jeffrey A.; Murphy, Debra A.

    1992-01-01

    Notes that research to date has yielded important findings for primary prevention efforts for Acquired Immune Deficiency Syndrome (AIDS) and has identified psychological dimensions relevant to mental health interventions for persons with human immunodeficiency virus (HIV). Sees pressing need for more systematic intervention outcome research in…

  9. Are couple-based interventions more effective than interventions delivered to individuals in promoting HIV protective behaviors? A meta-analysis.

    PubMed

    Crepaz, Nicole; Tungol-Ashmon, Malu V; Vosburgh, H Waverly; Baack, Brittney N; Mullins, Mary M

    2015-01-01

    Despite several advantages to bringing couples together to learn how to protect themselves and new-born children from the risk of HIV infection, most interventions are designed for individuals or groups, not for dyads. This meta-analysis provides a direct test of whether couple-based interventions are more effective in promoting HIV protective behaviors than interventions delivered to individuals. We conducted systematic searches of five electronic databases and 60 journals. Eligible studies were controlled trials or prospective cohort designs; evaluated a couple-based intervention compared to an individual-level intervention; assessed at least one HIV prevention outcome (e.g., protective sex, drug use, HIV testing, medication adherence, and sexually transmitted infections [STI]); and were published between 1988 and 2014. Fifteen interventions, including 21,882 participants from China, Kenya, Rwanda, Tanzania, Trinidad, Zambia, and the USA, were evaluated. The results of random-effects models showed statistically significant intervention effects for protective sex (OR = 1.60, 95% CI = 1.21, 2.11), HIV testing (OR = 1.79, 95% CI = 1.31, 2.45), and Nevirapine uptake (OR = 1.51, 95% CI = 1.02, 2.24). The evidence demonstrates the usefulness of couple-based interventions in protecting individuals, partners, and new-born children from the risk of HIV transmission and infection. PMID:26608175

  10. Service delivery interventions to improve adolescents' linkage, retention and adherence to antiretroviral therapy and HIV care*

    PubMed Central

    MacPherson, Peter; Munthali, Chigomezgo; Ferguson, Jane; Armstrong, Alice; Kranzer, Katharina; Ferrand, Rashida A; Ross, David A

    2015-01-01

    Objectives Adolescents living with HIV face substantial difficulties in accessing HIV care services and have worse treatment outcomes than other age groups. The objective of this review was to evaluate the effectiveness of service delivery interventions to improve adolescents' linkage from HIV diagnosis to antiretroviral therapy (ART) initiation, retention in HIV care and adherence to ART. Methods We systematically searched the Medline, SCOPUS and Web of Sciences databases and conference abstracts from the International AIDS Conference and International Conference on AIDS and STIs in Africa (ICASA). Studies published in English between 1st January 2001 and 9th June 2014 were included. Two authors independently evaluated reports for eligibility, extracted data and assessed methodological quality using the Cochrane risk of bias tool and Newcastle–Ottawa Scale. Results Eleven studies from nine countries were eligible for review. Three studies were randomised controlled trials. Interventions assessed included individual and group counselling and education; peer support; directly observed therapy; financial incentives; and interventions to improve the adolescent-friendliness of clinics. Most studies were of low to moderate methodological quality. Conclusions This review identified limited evidence on the effectiveness of service delivery interventions to support adolescents' linkage from HIV diagnosis to ART initiation, retention on ART and adherence to ART. Although recommendations are qualified because of the small numbers of studies and limited methodological quality, offering individual and group education and counselling, financial incentives, increasing clinic accessibility and provision of specific adolescent-tailored services appear promising interventions and warrant further investigation. PMID:25877007

  11. A Review of HIV Prevention Interventions for Juvenile Offenders

    PubMed Central

    Stewart, Angela; Fasciano, John; Brown, Larry K.

    2010-01-01

    Objective To conduct a critical review of all HIV prevention intervention studies conducted with adolescents in juvenile justice settings to inform future intervention development. Method PubMed and PsycInfo database searches were conducted for peer-reviewed, published HIV prevention intervention studies with juvenile offenders. Results Sixteen studies were identified (N = 3,700 adolescents). Half of the projects utilized rigorous methodologies to determine intervention effect on behavior change, such as conducting a randomized controlled trial (n = 8). Nine studies reported behaviors at least 3 months post-intervention and five out of nine showed decreases in sexual risk behavior. Conclusions Several HIV prevention programs with juvenile offenders have led to sexual risk reduction, although effect sizes are modest. Most existing programs have neglected to address the impact of family, mental health, and substance use on HIV risk. More work is needed to develop evidence-based interventions that include HIV prevention strategies relevant and appropriate for the juvenile justice setting. PMID:19741021

  12. Mixed-Methods Evaluation of a Novel, Structured, Community-Based Support and Education Intervention for Individuals with HIV/AIDS in KwaZulu-Natal, South Africa.

    PubMed

    Kemp, Christopher; Gerth-Guyette, Emily; Dube, Lungile; Andrasik, Michele; Rao, Deepa

    2016-09-01

    People living with HIV in Sub-Saharan Africa face significant challenges accessing care. Community-based peer support groups can increase linkage to treatment, though the effectiveness of structured, scalable groups has not been demonstrated. This study aimed to measure the impact of the structured Integrated Access to Care and Treatment intervention on clients' knowledge, attitudes, and practice regarding HIV/AIDS, including their experiences of stigma, in KwaZulu-Natal, South Africa. Data collection involved pre-/post-tests and client interviews. Pre-/post-test data from 66 clients were collected. 17 participants were interviewed. Paired t-tests did not detect significant changes in the main outcomes. Qualitative results suggested a psychosocial benefit as participants connected with their peers, expressed themselves openly, and re-engaged with their communities. Unfortunately, this study did not quantitatively measure psychosocial changes, and the results have limited generalizability to men. I ACT may be an effective complement to clinic-based support services, though further study should quantify the psychosocial benefit. PMID:27553008

  13. Using a Mobile Health Intervention to Support HIV Treatment Adherence and Retention Among Patients at Risk for Disengaging with Care.

    PubMed

    Rana, Aadia I; van den Berg, Jacob J; Lamy, Eric; Beckwith, Curt G

    2016-04-01

    Less than half of the 1.2 million HIV-infected individuals in the United States are in consistent medical care, with only a third receiving treatment resulting in viral suppression. Novel interventions to improve engagement are necessary to ensure medical adherence, improve long-term outcomes, and reduce HIV transmission. Mobile health (mHealth) strategies including cell phone and text messaging have shown success in the developing world for medical adherence, yet mHealth interventions have not been developed and evaluated to improve retention in HIV care in the United States. We conducted a 6-month pilot study investigating the use of a clinic-based bi-directional texting intervention to enhance engagement in HIV care among those with higher risk of loss to follow up, including those with a recent HIV diagnosis or those re-engaging in HIV care at a large urban clinic in New England. PMID:27028183

  14. Increasing Antiretroviral Adherence for HIV-Positive African Americans (Project Rise): A Treatment Education Intervention Protocol

    PubMed Central

    Bogart, Laura M; Mutchler, Matt G; McDavitt, Bryce; Mutepfa, Kieta D; Risley, Brian

    2016-01-01

    Background HIV-positive African Americans have been shown to have lower adherence to antiretroviral therapy (ART) than those of other races/ethnicities, yet adherence interventions have rarely been tailored to the needs of this population. Objective We developed and will evaluate a treatment education adherence intervention (called Rise) that was culturally adapted to address the needs of African Americans living with HIV. Methods This randomized controlled trial will examine the effects of the Rise intervention on ART adherence and HIV viral load. African Americans on ART who report adherence problems will be recruited from the community and randomly assigned to receive the intervention or usual care for 6 months. The intervention consists of 6-10 individual counseling sessions, with more sessions provided to those who demonstrate lower adherence. Primary outcomes include adherence as monitored continuously with Medication Event Monitoring Systems (MEMS) caps, and viral load data received from the participant’s medical provider. Survey assessments will be administered at baseline and month 6. Results The trial is ongoing. Conclusions If effective, the Rise intervention will provide community-based organizations with an intervention tailored to address the needs of African Americans for promoting optimal ART adherence and HIV clinical outcomes. Trial Registration Clinicaltrials.gov NCT01350544; https://clinicaltrials.gov/ct2/show/NCT01350544 (Archived by WebCite at http://www.webcitation.org/6fjqqnmn0). PMID:27025399

  15. Impact of community-based interventions on HIV knowledge, attitudes, and transmission

    PubMed Central

    2014-01-01

    In 2012, an estimated 35.3 million people lived with HIV, while approximately two million new HIV infections were reported. Community-based interventions (CBIs) for the prevention and control of HIV allow increased access and ease availability of medical care to population at risk, or already infected with, HIV. This paper evaluates the impact of CBIs on HIV knowledge, attitudes, and transmission. We included 39 studies on educational activities, counseling sessions, home visits, mentoring, women’s groups, peer leadership, and street outreach activities in community settings that aimed to increase awareness on HIV/AIDS risk factors and ensure treatment adherence. Our review findings suggest that CBIs to increase HIV awareness and risk reduction are effective in improving knowledge, attitudes, and practice outcomes as evidenced by the increased knowledge scores for HIV/AIDS (SMD: 0.66, 95% CI: 0.25, 1.07), protected sexual encounters (RR: 1.19, 95% CI: 1.13, 1.25), condom use (SMD: 0.96, 95% CI: 0.03, 1.58), and decreased frequency of sexual intercourse (RR: 0.76, 95% CI: 0.61, 0.96). Analysis shows that CBIs did not have any significant impact on scores for self-efficacy and communication. We found very limited evidence on community-based management for HIV infected population and prevention of mother- to-child transmission (MTCT) for HIV-infected pregnant women. Qualitative synthesis suggests that establishment of community support at the onset of HIV prevention programs leads to community acceptance and engagement. School-based delivery of HIV prevention education and contraceptive distribution have also been advocated as potential strategies to target high-risk youth group. Future studies should focus on evaluating the effectiveness of community delivery platforms for prevention of MTCT, and various emerging models of care to improve morbidity and mortality outcomes. PMID:25126420

  16. A Systematic Review of Interventions for Reducing HIV Risk Behaviors among People Living with HIV in the United States, 1988–2012

    PubMed Central

    Crepaz, Nicole; Tungol, Maria Luisa V.; Higa, Darrel H.; Vosburgh, H. Waverly; Mullins, Mary M.; Barham, Terrika; Adegbite, Adebukola; DeLuca, Julia B.; Sipe, Theresa Ann; White, Christina M.; Baack, Brittney N.; Lyles, Cynthia M.

    2015-01-01

    Objective To conduct a systematic review to examine interventions for reducing HIV risk behaviors among people living with HIV (PLWH) in the United States. Methods Systematic searches included electronic databases from 1988 to 2012, hand searches of journals, reference lists of articles, and HIV/AIDS Internet listservs. Each eligible study was evaluated against the established criteria on study design, implementation, analysis, and strength of findings to assess the risk of bias and intervention effects. Results Forty-eight studies were evaluated. Fourteen studies (29%) with both low risk of bias and significant positive intervention effects in reducing HIV transmission risk behaviors were classified as evidence-based interventions (EBIs). Thirty-four studies were classified as non-EBIs due to high risk of bias or non-significant positive intervention effects. EBIs varied in delivery from brief prevention messages to intensive multi-session interventions. The key components of EBIs included addressing HIV risk reduction behaviors, motivation for behavioral change, misconception about HIV, and issues related to mental health, medication adherence, and HIV transmission risk behavior. Conclusion Moving evidence-based prevention for PLWH into practice is an important step in making a greater impact on the HIV epidemic. Efficacious EBIs can serve as model programs for providers in healthcare and non-healthcare settings looking to implement evidence-based HIV prevention. Clinics and public health agencies at the state, local, and federal levels can use the results of this review as a resource when making decisions that meet the needs of PLWH to achieve the greatest impact on the HIV epidemic. PMID:24983541

  17. Sexual Risk Reduction Interventions for HIV Prevention among South African Youth: A Meta-Analytic Review

    PubMed Central

    Scott-Sheldon, Lori A. J.; Walstrom, Paige; Harrison, Abigail; Kalichman, Seth C.; Carey, Michael P.

    2014-01-01

    Objectives To examine the efficacy of sexual risk reduction interventions among South African youth. Methods Electronic databases were searched to identify studies published between 2007 and early 2013. Studies were eligible if they (1) targeted youth age 9–26, (2) evaluated sexual risk reduction interventions and (3) reported at least one behavioral outcome. Independent raters coded study characteristics, and intervention content. Weighted mean effect sizes were calculated; positive effect sizes indicated less sexual risk behavior and incident STIs. Results Ten studies (k = 11, N = 22,788; 54% female; 79% Black-African) were included. Compared to controls, interventions were successful at delaying sexual intercourse and, among sexually active youth, at increasing condom use. A single study found reductions in the incidence of herpes simplex virus-2, but not HIV. Conclusions Implementing behavioral interventions to delay sexual debut and improve condom use can help to reduce the transmission of HIV among South African youth. PMID:24476351

  18. High mortality in tuberculosis patients despite HIV interventions in Swaziland

    PubMed Central

    van Griensven, J.; Hinderaker, S. G.; Kizito, W.; Sikhondze, W.; Manzi, M.; Dlamini, T.; Harries, A. D.

    2016-01-01

    Setting: All health facilities providing tuberculosis (TB) care in Swaziland. Objective: To describe the impact of human immunodeficiency virus (HIV) interventions on the trend of TB treatment outcomes during 2010–2013 in Swaziland; and to describe the evolution in TB case notification, the uptake of HIV testing, antiretroviral therapy (ART) and cotrimoxazole preventive therapy (CPT), and the proportion of TB-HIV co-infected patients with adverse treatment outcomes, including mortality, loss to follow-up and treatment failure. Design: A retrospective descriptive study using aggregated national TB programme data. Results: Between 2010 and 2013, TB case notifications in Swaziland decreased by 40%, HIV testing increased from 86% to 96%, CPT uptake increased from 93% to 99% and ART uptake among TB patients increased from 35% to 75%. The TB-HIV co-infection rate remained around 70% and the proportion of TB-HIV cases with adverse outcomes decreased from 36% to 30%. Mortality remained high, at 14–16%, over the study period, and anti-tuberculosis treatment failure rates were stable over time (<5%). Conclusion: Despite high CPT and ART uptake in TB-HIV patients, mortality remained high. Further studies are required to better define high-risk patient groups, understand the reasons for death and design appropriate interventions. PMID:27358803

  19. Effects of a Community-Based HIV Risk Reduction Intervention Among HIV-Positive Individuals: Results of a Quasi-Experimental Study in Nepal.

    PubMed

    Poudel, Krishna C; Buchanan, David R; Poudel-Tandukar, Kalpana

    2015-06-01

    We evaluated the efficacy of a sexual risk reduction intervention utilizing protection motivation and social cognitive theories to address knowledge, threat and coping appraisals, and condom use intentions among HIV-positive individuals in Nepal. Using a quasi-experimental research design, we assigned 277 participants to intervention (n=146) and control (n=131) groups. The intervention group received six sessions on sexual risk reduction strategies and the control group six sessions on medication adherence, smoking, and mental health. Data were collected at baseline and immediately after the intervention. Results indicate that the sexual risk reduction intervention produced a significant increase in HIV transmission knowledge, perceived threat and coping appraisals, and intentions to use condoms with regular, HIV-positive, and HIV-negative partners. The positive effects of the intervention remained significant after adjusting for baseline scores and other potential confounders. In conclusion, our theory-based sexual risk reduction intervention was effective in improving HIV transmission knowledge, perceived threat and coping appraisals, and condom use intentions. Further studies are needed to evaluate the long-term efficacy of the intervention in increasing protection motivation and maintaining preventive behaviors. PMID:26010315

  20. Formative Assessment of ARM-U: A Modular Intervention for Decreasing Risk Behaviors Among HIV-Positive and HIV-Negative Methamphetamine-Using MSM

    PubMed Central

    Garfein, Richard S; Metzner, Mitcheal; Cuevas, Jazmine; Bousman, Chad A; Patterson, Thomas

    2010-01-01

    Background: Methamphetamine is a major contributor to HIV transmission among men who have sex with men (MSM). Recent studies show that up to one-third of methamphetamine-using MSM (MUMSM) inject the drug. We developed a behavioral intervention for MUMSM to decrease unprotected anal intercourse and increase awareness of parenteral HIV transmission risk. This 6-session (3 in-person, 3 by telephone) modular intervention was designed to be tailored to participants’ HIV (+/-) and injection drug user ([IDU] yes/no) status. We present results of formative research used to evaluate the content and to assess feasibility and acceptability of this individual-level HIV risk-reduction intervention. Setting: HIV research clinic in a high MSM and methamphetamine prevalence neighborhood. Project: Avoiding Risks from Methamphetamine-Use (ARM-U) is a brief toolbox intervention that allows counselors to select modules that suit a client’s individual risk profile and intervention needs employing motivational interviewing and cognitive behavioral theory. We evaluated the format and content of the intervention through focus groups and pre-testing of the entire intervention using volunteers from the target population stratified into four groups (HIV+/IDU, HIV-/IDU, HIV+/non-IDU, HIV-/non-IDU). Four individuals in each stratum were recruited to undergo the intervention and complete a satisfaction survey at the end of each in-person session. Results: In total, 25 MUMSM attended one of five focus groups. Participants thought all proposed intervention topics were important and could aid in reducing sexual risk behaviors among MUMSM. However, the neurocognitive effects of methamphetamine were reported to be a barrier to practicing safer sex, condom use negotiation or HIV status disclosure. Fifteen (94%) of 16 participants completed all 6 sessions and the satisfaction survey. On average, participants felt the intervention was useful for MUMSM, made them contemplate and move toward behavior

  1. 78 FR 25458 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-01

    ... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA), HHS. ACTION: Notice of Ryan White HIV/AIDS Program Part C Early Intervention Services...

  2. Circle of Life HIV/AIDS-Prevention Intervention for American Indian and Alaska Native Youth

    ERIC Educational Resources Information Center

    Kaufman, Carol E.; Litchfield, Anne; Schupman, Edwin; Mitchell, Christina M.

    2012-01-01

    This article describes the objectives, theoretical bases, development process, and evaluation efforts to-date for the Circle of Life (COL) curricula, HIV/AIDS prevention interventions designed for American Indian and Alaska Native (AI/AN) youth. The curricula are based on Indigenous models of learning and behavior encompassing concepts of Western…

  3. The 'third wave' of HIV prevention: filling gaps in integrated interventions, knowledge, and funding.

    PubMed

    Sepúlveda, Jaime

    2012-07-01

    There is growing optimism in the global health community that the HIV epidemic can be halted. After decades of relying primarily on behavior change to prevent HIV transmission, a second generation of prevention efforts based on medical or biological interventions such as male circumcision and preexposure prophylaxis--the use of antiretroviral drugs to protect uninfected, at-risk individuals--has shown promising results. This article calls for a third generation of HIV prevention efforts that would integrate behavioral, biological, and structural interventions focused on the social, political, and environmental underpinnings of the epidemic, making use of local epidemiological evidence to target affected populations. In this third wave, global programs should deliver HIV prevention services together with cost-effective interventions for reproductive health and for tuberculosis, malaria, and other diseases. Additionally, new efforts are needed to address gaps in HIV prevention research, evaluation, and implementation. Increased and sustained funding, along with evidence-based allocation of funds, will be necessary to accelerate the decline in new HIV infections. PMID:22778344

  4. A quarter-century of HIV prevention intervention efforts among children and adolescents across the globe

    PubMed Central

    Stanton, Bonita; Li, Xiaoming

    2014-01-01

    In 1988 a group of pediatricians, developmental, clinical, child and social psychologists, anthropologists and health educators began researching in Baltimore, Maryland, on an Human Immunodefiency Virus (HIV) prevention intervention, Focus on Youth (FOY). Over the next 25 years, the questions being addressed by FOY reflected those of the global HIV research experience. During the first phase, the questions being addressed by the broader research community included: Can HIV risk behaviors be purposefully impacted by behavioral interventions? If so, how do successful interventions differ from those that are not effective? Are theory-based interventions more likely to be effective than information-only-based interventions? Can theories be translated into culturally and developmentally appropriate interventions including those that are appropriate for children and adolescents? Should parents be involved – and if so, how? During its next phase, the FOY team increasingly became concerned with a disturbing reality. A large number of interventions had been developed and some had been shown to have evidence of impact. But virtually all of these interventions had been conducted in the USA or Europe. The questions facing researchers included: With the global burden of HIV disproportionately impacting low- and middle-income countries (LMIC), especially those in southern Africa, the Caribbean and parts of Asia, what is known about the effectiveness of western-based interventions in these culturally, racially and economically disparate settings? With the exciting proliferation of interventions, federal agencies in the USA and international agencies including Joint United Nations Programme on HIV/AIDS realized the importance of assessing the research portfolio and developing metrics of effectiveness. The questions during this phase included: What is an “effective” intervention? How are effective interventions implemented in a new setting? This phase merged with the next

  5. A controlled study of an HIV/AIDS/STI/TB intervention with faith healers in Vhembe District, South Africa.

    PubMed

    Mashamba, Tshilidzi; Peltzer, Karl; Maluleke, Thelma X; Sodi, Tholene

    2011-01-01

    The aim of the study was to develop an HIV and AIDS training manual, and to evaluate the knowledge, attitudes and management of faith healers of Apostolic churches regarding HIV and AIDS, before and after they attended an HIV and AIDS training programme. A quasi-experimental intervention design was used with faith healers affiliated with the United African Apostolic Church (UAAC) in the Thulamela and Musina municipalities of Vhembe District, Limpopo Province, South Africa. A total of 103 faith healers were included in this study, 58 were systematically assigned to an intervention and 45 to a control group. The intervention group received training for 2 days. At follow-up after 2 months, intervention effects were significant for HIV knowledge and to a lesser extent TB knowledge. No significant improvement was found in HIV/STI (sexually transmitted infection) management strategies such as HIV/STI risk behaviour counselling, referral of clients for HIV testing, keeping condoms at stock in church, and church community HIV/AIDS/STI education. It is important to note that faith healers address some of the major known behavioural risk and protective factors such as partner reduction and condom use. Therefore, faith healers could be more widely utilized in HIV prevention programmes as risk reduction counsellors, in particular on matters of community-level education. PMID:22754060

  6. Randomized Controlled Trial to Test the RHANI Wives HIV Intervention for Women in India at Risk for HIV from Husbands

    PubMed Central

    Saggurti, Niranjan; Battala, Madhusudana; Nair, Saritha; Dasgupta, Anindita; Naik, D. D.; Abramovitz, Daniela; Silverman, Jay G.; Balaiah, Donta

    2013-01-01

    This study involved evaluation of the shortterm impact of the RHANI Wives HIV intervention among wives at risk for HIV from husbands in Mumbai, India. A two-armed cluster RCT was conducted with 220 women surveyed on marital sex at baseline and 4–5 month followup. RHANI Wives was a multisession intervention focused on safer sex, marital communication, gender inequities and violence; control participants received basic HIV prevention education. Generalized linear mixed models were conducted to assess program impact, with cluster as a random effect and with time, treatment group, and the time by treatment interaction as fixed effects. A significant time by treatment effect on proportion of unprotected sex with husband (p = 0.01) was observed, and the rate of unprotected sex for intervention participants was lower than that of control participants at follow-up (RR = 0.83, 95 % CI = 0.75, 0.93). RHANI Wives is a promising model for women at risk for HIV from husbands. PMID:23921584

  7. Randomized controlled trial to test the RHANI Wives HIV intervention for women in India at risk for HIV from husbands.

    PubMed

    Raj, Anita; Saggurti, Niranjan; Battala, Madhusudana; Nair, Saritha; Dasgupta, Anindita; Naik, D D; Abramovitz, Daniela; Silverman, Jay G; Balaiah, Donta

    2013-11-01

    This study involved evaluation of the short-term impact of the RHANI Wives HIV intervention among wives at risk for HIV from husbands in Mumbai, India. A two-armed cluster RCT was conducted with 220 women surveyed on marital sex at baseline and 4-5 month follow-up. RHANI Wives was a multisession intervention focused on safer sex, marital communication, gender inequities and violence; control participants received basic HIV prevention education. Generalized linear mixed models were conducted to assess program impact, with cluster as a random effect and with time, treatment group, and the time by treatment interaction as fixed effects. A significant time by treatment effect on proportion of unprotected sex with husband (p = 0.01) was observed, and the rate of unprotected sex for intervention participants was lower than that of control participants at follow-up (RR = 0.83, 95 % CI = 0.75, 0.93). RHANI Wives is a promising model for women at risk for HIV from husbands. PMID:23921584

  8. Project Accept (HPTN 043): A Community-Based Intervention to Reduce HIV Incidence in Populations at Risk for HIV in Sub-Saharan Africa and Thailand

    PubMed Central

    Khumalo-Sakutukwa, Gertrude; Morin, Stephen F.; Fritz, Katherine; Charlebois, Edwin D.; van Rooyen, Heidi; Chingono, Alfred; Modiba, Precious; Mrumbi, Khalifa; Visrutaratna, Surasing; Singh, Basant; Sweat, Michael; Celentano, David D.; Coates, Thomas J

    2009-01-01

    Background Changing community norms to increase awareness of HIV status and reduce HIV-related stigma has the potential to reduce the incidence of HIV-1 infection in the developing world. Methods We developed and implemented a multi-level intervention providing community-based HIV mobile voluntary counseling and testing (CBVCT), community mobilization (CM), and post-test support services (PTSS). Forty-eight communities in Tanzania, Zimbabwe, South Africa and Thailand were randomized to receive the intervention or standard clinic-based VCT (SVCT), the comparison condition. We monitored utilization of CBVCT and SVCT by community of residence at 3 sites, which was used to assess differential uptake. We also developed Quality Assurance procedures to evaluate staff fidelity to the intervention. Findings In the first year of the study a four-fold increase in testing was observed in the intervention versus comparison communities. We also found an overall 95% adherence to intervention components. Study outcomes, including prevalence of recent HIV infection and community-level HIV stigma, will be assessed after three years of intervention. Conclusion The provision of mobile services, combined with appropriate support activities, may have significant effects on utilization of VCT. These findings also provide early support for community mobilization as a strategy for increasing testing rates. PMID:18931624

  9. Identification of Evidence-Based Interventions for Promoting HIV Medication Adherence: Findings from a Systematic Review of U.S.-Based Studies, 1996–2011

    PubMed Central

    Charania, Mahnaz R.; Marshall, Khiya J.; Crepaz, Nicole; Kay, Linda S.; Koenig, Linda J.; Weidle, Paul J.; Purcell, David W.

    2015-01-01

    A systematic review was conducted to identify evidence-based interventions (EBIs) for increasing HIV medication adherence behavior or decreasing HIV viral load among persons living with HIV (PLWH). We conducted automated searches of electronic databases (i.e., MEDLINE, EMBASE, PsycINFO, CINAHL) and manual searches of journals, reference lists, and listservs. Interventions were eligible for the review if they were U.S.-based, published between 1996 and 2011, intended to improve HIV medication adherence behaviors of PLWH, evaluated the intervention using a comparison group, and reported outcome data on adherence behaviors or HIV viral load. Each intervention was evaluated on the quality of study design, implementation, analysis, and strength of findings. Of the 65 eligible interventions, 10 are EBIs. The remaining 55 interventions failed to meet the efficacy criteria primarily due to null findings, small sample sizes, or low retention rates. Research gaps and future directions for development of adherence EBIs are discussed. PMID:24043269

  10. HIV Infection: Transmission, Effects on Early Development, and Interventions.

    ERIC Educational Resources Information Center

    Lowenthal, Barbara

    1997-01-01

    Describes the modes of transmission of HIV and the course of the disease in infants and toddlers. Information is provided on its effects on early development, medical screening and treatments, therapies, psychosocial assistance, and interventions, including nutritional therapy, occupational and physical therapies, and speech and language therapy.…

  11. Funding of community-based interventions for HIV prevention.

    PubMed

    Poku, Nana K; Bonnel, René

    2016-07-01

    Since the start of the HIV epidemic, community responses have been at the forefront of the response. Following the extraordinary expansion of global resources, the funding of community responses rose to reach at least US$690 million per year in the period 2005-2009. Since then, many civil society organisations (CSOs) have reported a drop in funding. Yet, the need for strong community responses is even more urgent, as shown by their role in reaching the Joint United Nations Programme on HIV/AIDS (UNAIDS) Fast-Track targets. In the case of antiretroviral treatment, interventions need to be adopted by most people at risk of HIV in order to have a substantial effect on the prevention of HIV at the population level. This paper reviews the published literature on community responses, funding and effectiveness. Additional funding is certainly needed to increase the coverage of community-based interventions (CBIs), but current evidence on their effectiveness is extremely mixed, which does not provide clear guidance to policy makers. This is especially an issue for adolescent girls and young women in Eastern and Southern Africa, who face extremely high infection risk, but the biomedical prevention tools that have been proven effective for the general population still remain pilot projects for this group. Research is especially needed to isolate the factors affecting the likelihood that interventions targeting this group are consistently successful. Such work could be focused on the community organisations that are currently involved in delivering gender-sensitive interventions. PMID:27399046

  12. Interventions to Prevent Sexually Transmitted Infections, Including HIV Infection

    PubMed Central

    Cates, Willard

    2011-01-01

    The Centers for Disease Control and Prevention (CDC) Sexually Transmitted Disease (STD) Treatment Guidelines were last updated in 2006. To update the “Clinical Guide to Prevention Services” section of the 2010 CDC STD Treatment Guidelines, we reviewed the recent science with reference to interventions designed to prevent acquisition of STDs, including human immunodeficiency virus (HIV) infection. Major interval developments include (1) licensure and uptake of immunization against genital human papillomavirus, (2) validation of male circumcision as a potent prevention tool against acquisition of HIV and some other sexually transmitted infections (STIs), (3) failure of a promising HIV vaccine candidate to afford protection against HIV acquisition, (4) encouragement about the use of antiretroviral agents as preexposure prophylaxis to reduce risk of HIV and herpes simplex virus acquisition, (5) enhanced emphasis on expedited partner management and rescreening for persons infected with Chlamydia trachomatis and Neisseria gonorrhoeae, (6) recognition that behavioral interventions will be needed to address a new trend of sexually transmitted hepatitis C among men who have sex with men, and (7) the availability of a modified female condom. A range of preventive interventions is needed to reduce the risks of acquiring STI, including HIV infection, among sexually active people, and a flexible approach targeted to specific populations should integrate combinations of biomedical, behavioral, and structural interventions. These would ideally involve an array of prevention contexts, including (1) communications and practices among sexual partners, (2) transactions between individual clients and their healthcare providers, and (3) comprehensive population-level strategies for prioritizing prevention research, ensuring accurate outcome assessment, and formulating health policy. PMID:22080271

  13. A systematic review of income generation interventions, including microfinance and vocational skills training, for HIV prevention

    PubMed Central

    Kennedy, Caitlin E.; Fonner, Virginia A.; O'Reilly, Kevin R.; Sweat, Michael D.

    2013-01-01

    Income generation interventions, such as microfinance or vocational skills training, address structural factors associated with HIV risk. However, the effectiveness of these interventions on HIV-related outcomes in low- and middle-income countries has not been synthesized. We conducted a systematic review by searching electronic databases from 1990-2012, examining secondary references, and hand searching key journals. Peer-reviewed studies were included in the analysis if they evaluated income generation interventions in low- or middle-income countries and provided pre-post or multi-arm measures on behavioral, psychological, social, care or biological outcomes related to HIV prevention. Standardized forms were used to abstract study data in duplicate and study rigor was assessed. Of 5,218 unique citations identified, 12 studies met criteria for inclusion. Studies were geographically diverse, with 6 conducted in sub-Saharan Africa, 3 in South or Southeast Asia, and 3 in Latin America and the Caribbean. Target populations included adult women (N=6), female sex workers/bar workers (N=3), and youth/orphans (N=3). All studies targeted females except 2 among youth/orphans. Study rigor was moderate, with 2 group-randomized trials and 2 individual-randomized trials. All interventions except 3 included some form of microfinance. Only a minority of studies found significant intervention effects on condom use, number of sexual partners or other HIV-related behavioral outcomes; most studies showed no significant change, although some may have had inadequate statistical power. One trial showed a 55% reduction in intimate partner violence (adjusted risk ratio 0.45, 95% confidence interval 0.23-0.91). No studies measured incidence/prevalence of HIV or sexually transmitted infections among intervention recipients. The evidence that income generation interventions influence HIV-related behaviors and outcomes is inconclusive. However, these interventions may have important effects

  14. A systematic review of income generation interventions, including microfinance and vocational skills training, for HIV prevention.

    PubMed

    Kennedy, Caitlin E; Fonner, Virginia A; O'Reilly, Kevin R; Sweat, Michael D

    2014-01-01

    Income generation interventions, such as microfinance or vocational skills training, address structural factors associated with HIV risk. However, the effectiveness of these interventions on HIV-related outcomes in low- and middle-income countries has not been synthesized. The authors conducted a systematic review by searching electronic databases from 1990 to 2012, examining secondary references, and hand-searching key journals. Peer-reviewed studies were included in the analysis if they evaluated income generation interventions in low- or middle-income countries and provided pre-post or multi-arm measures on behavioral, psychological, social, care, or biological outcomes related to HIV prevention. Standardized forms were used to abstract study data in duplicate and study rigor was assessed. Of the 5218 unique citations identified, 12 studies met criteria for inclusion. Studies were geographically diverse, with six conducted in sub-Saharan Africa, three in South or Southeast Asia, and three in Latin America and the Caribbean. Target populations included adult women (N = 6), female sex workers/bar workers (N = 3), and youth/orphans (N = 3). All studies targeted females except two among youth/orphans. Study rigor was moderate, with two group-randomized trials and two individual-randomized trials. All interventions except three included some form of microfinance. Only a minority of studies found significant intervention effects on condom use, number of sexual partners, or other HIV-related behavioral outcomes; most studies showed no significant change, although some may have had inadequate statistical power. One trial showed a 55% reduction in intimate partner violence (adjusted risk ratio 0.45, 95% confidence interval 0.23-0.91). No studies measured incidence/prevalence of HIV or sexually transmitted infections among intervention recipients. The evidence that income generation interventions influence HIV-related behaviors and outcomes is inconclusive. However, these

  15. MSM in HIV-prevention trials are sexual partners with each other: An ancillary study to the EXPLORE intervention.

    PubMed

    Mimiaga, Matthew J; Safren, Steven A; Benet, Dana Jones; Manseau, Marc W; DeSousa, Nancy; Mayer, Kenneth H

    2006-01-01

    The EXPLORE study evaluated a behavioral intervention to prevent HIV seroconversion among men who have sex with men (MSM). The present ancillary study enrolled 345 EXPLORE participants at one study site (Boston) and assessed high-risk sexual behavior with other EXPLORE participants. It also assessed sexual intentions across other EXPLORE participants, HIV-negative individuals, and unknown HIV serostatus partners. Thirty-one percent reported having sex with another EXPLORE participant: 27% unprotected receptive oral sex with ejaculation (UO), 30% unprotected insertive anal sex (UIA), and 34% reported unprotected receptive anal sex (URA). Significant relationships between intentions to engage in UO, UIA, and URA, and type of partner emerged with intentions to engage in UO, UIA, and URA higher in HIV-negative partners, other EXPLORE participants, and unknown-HIV serostatus partners. Future HIV-prevention studies recruiting MSM at increased sexual risk of HIV infection should address participants potentially becoming sexual partners with each other. PMID:16331532

  16. A Critical Review of the Characteristics of Theater-Based HIV Prevention Interventions for Adolescents in School Settings.

    PubMed

    Taboada, Arianna; Taggart, Tamara; Holloway, Ian; Houpt, Amanda; Gordon, Robert; Gere, David; Milburn, Norweeta; Lightfoot, Alexandra F

    2016-07-01

    Theater-based interventions are a viable prevention strategy for changing sexual health knowledge, attitudes, and behaviors related to HIV prevention. However, few studies have explored interventions in English-speaking, high-income countries such as the United States, Canada, or the United Kingdom. This article critically reviews the literature to identify key characteristics of theater-based HIV prevention strategies used for adolescents in school-settings in the United States, Canada, and the United Kingdom. Specifically, we identify the theatrical approach used in HIV prevention interventions, the behavioral theories that inform such interventions, and the study design and results of existing evaluation studies conducted in school settings. In the 10 articles reviewed, we found limited grounding in theory and the use of nonrigorous study design. To strengthen the evidence and practical application of theater-based HIV prevention interventions, we highlight three specific recommendations for practitioners and researchers: (1) define and operationalize the theater approach and techniques used, (2) ensure theater-based interventions are grounded in theory, and (3) conduct rigorous evaluation of theater-based interventions. These recommendations are key to strengthening future research on and implementation of theater-based interventions for HIV prevention. PMID:27095037

  17. Exploring Implementation and Fidelity of Evidence-Based Behavioral Interventions for HIV Prevention: Lessons Learned from the Focus on Kids Diffusion Case Study

    ERIC Educational Resources Information Center

    Galbraith, Jennifer S.; Stanton, Bonita; Boekeloo, Bradley; King, Winifred; Desmond, Sharon; Howard, Donna; Black, Maureen M.; Carey, James W.

    2009-01-01

    Evidence-based interventions (EBIs) are used in public health to prevent HIV infection among youth and other groups. EBIs include core elements, features that are thought to be responsible for the efficacy of interventions. The authors evaluate experiences of organizations that adopted an HIV-prevention EBI, Focus on Kids (FOK), and their fidelity…

  18. HIV behavioural interventions targeted towards older adults: a systematic review

    PubMed Central

    2014-01-01

    Background The increasing number of people living with HIV aged 50 years and older has been recognised around the world yet non-pharmacologic HIV behavioural and cognitive interventions specifically targeted to older adults are limited. Evidence is needed to guide the response to this affected group. Methods We conducted a systematic review of the available published literature in MEDLINE, Embase and the Education Resources Information Center. A search strategy was defined with high sensitivity but low specificity to identify behavioural interventions with outcomes in the areas of treatment adherence, HIV testing uptake, increased HIV knowledge and uptake of prevention measures. Data from relevant articles were extracted into excel. Results Twelve articles were identified all of which originated from the Americas. Eight of the interventions were conducted among older adults living with HIV and four for HIV-negative older adults. Five studies included control groups. Of the included studies, four focused on general knowledge of HIV, three emphasised mental health and coping, two focused on reduced sexual risk behaviour, two on physical status and one on referral for care. Only four of the studies were randomised controlled trials and seven – including all of the studies among HIV-negative older adults – did not include controls at all. A few of the studies conducted statistical testing on small samples of 16 or 11 older adults making inference based on the results difficult. The most relevant study demonstrated that using telephone-based interventions can reduce risky sexual behaviour among older adults with control reporting 3.24 times (95% CI 1.79-5.85) as many occasions of unprotected sex at follow-up as participants. Overall however, few of the articles are sufficiently rigorous to suggest broad replication or to be considered representative and applicable in other settings. Conclusions More evidence is needed on what interventions work among older adults to

  19. A quarter century of HIV prevention intervention efforts among children and adolescents across the globe.

    PubMed

    Stanton, Bonita; Li, Xiaoming

    2014-01-01

    In 1988 a group of pediatricians, developmental, clinical, child and social psychologists, anthropologists and health educators began researching in Baltimore, Maryland on an HIV prevention intervention, Focus on Youth. Over the next 25 years the questions being addressed by Focus on Youth, reflected those of the global HIV research experience. During the first phase, the questions being addressed by the broader research community included: Can HIV risk behaviors be purposefully impacted by behavioral interventions? If so, how do successful interventions differ from those that are not effective? Are theory-based interventions more likely to be effective than information-only based interventions? Can theories be translated into culturally and developmentally appropriate interventions including those that are appropriate for children and adolescents? Should parents be involved--and if so, how? During its next phase, the Focus on Youth team increasingly became concerned with a disturbing reality. A large number of interventions had been developed and some had been shown to have evidence of impact. But virtually all of these interventions had been conducted in the USA or Europe. The questions facing researchers included: With the global burden of HIV disproportionately impacting Low and Middle Income Countries (LMIC), especially those in southern Africa, the Caribbean and parts of Asia, what is known about the effectiveness of western-based interventions in these culturally, racially and economically disparate settings? With the exciting proliferation of interventions, federal agencies in the USA and international agencies including UNAIDS realized the importance of assessing the research portfolio and developing metrics of effectiveness. The questions during this phase included: What is an "effective" intervention? How are effective interventions implemented in a new setting? This phase merged with the next phase as researchers and public health workers realized that

  20. Overcoming Barriers to HIV Treatment Adherence: A Brief Cognitive Behavioral Intervention for HIV-Positive Adults on Antiretroviral Treatment

    PubMed Central

    Olem, David; Sharp, Kelly M.; Taylor, Jonelle M.; Johnson, Mallory O.

    2014-01-01

    Maximizing HIV treatment adherence is critical in efforts to optimize health outcomes and to prevent further HIV transmission. The Balance Project intervention uses cognitive behavioral approaches to improve antiretroviral medication adherence through promoting adaptive coping with medication side effect and distress related to HIV. This 5-session intervention has been documented to prevent nonadherence among persons living with HIV who experience high levels of distress associated with their antiretroviral medication side effects. We describe the theoretical underpinnings of the intervention, provide details of the training and session protocols with a case example, and discuss implications for future applications of the intervention in both research and clinical settings. PMID:24855332

  1. Effects of behavioral stress reduction Transcendental Meditation intervention in Persons with HIV

    PubMed Central

    Chhatre, Sumedha; Metzger, David S.; Frank, Ian; Boyer, Jean; Thompson, Edward; Nidich, Sanford; Montaner, Luis J.; Jayadevappa, Ravishankar

    2013-01-01

    Stress is implicated in the pathogenesis and progression of HIV. The Transcendental Meditation is a behavioral stress reduction program that incorporates mind-body approach, and has demonstrated effectiveness in improving outcomes via stress reduction. We evaluated the feasibility of implementing Transcendental Meditation and its effects on outcomes in persons with HIV. In this community based single blinded Phase-I, randomized controlled trial, outcomes (psychological and physiological stress, immune activation, generic and HIV-specific health related quality of life, depression and quality of well-being) were assessed at baseline and at six months, and were compared using parametric and non-parametric tests. Twenty two persons with HIV were equally randomized to Transcendental Meditation intervention or healthy eating (HE) education control group. Retention was 100% in Transcendental Meditation group and 91% in healthy eating control group. The Transcendental Meditation group exhibited significant improvement in vitality. Significant between group differences were observed for generic and HIV-specific health related quality of life.. Small sample size may possibly limit the ability to observe significant differences in some outcomes. Transcendental Meditation stress reduction intervention in community dwelling adults with HIV is viable and can enhance health related quality of life. Further research with large sample and longer follow-up is needed to validate our results. PMID:23394825

  2. What Works Well in HIV Prevention Among Spanish Young People? An Analysis of Differential Effectiveness Among Six Intervention Techniques.

    PubMed

    Ballester-Arnal, Rafael; Gil-Llario, María Dolores; Giménez-García, Cristina; Kalichman, Setch C

    2015-07-01

    The AIDS epidemic remains a concern of public health among young people and adolescents. Prevention programs have revealed diverse deficiencies to attain their main goal: preventing risky behaviors. This experimental study evaluates the differential effectiveness of six intervention techniques for preventing HIV/AIDS based on informational-motivational-behavioral Model (talk, website, attitudinal discussion, participation of a seropositive person, fear induction and role play). 239 Spanish young people took part in an experimental design to evaluate six intervention techniques and a non-intervention condition, through changes in their knowledge, attitudes and protective sex behavior. Our findings support a general effectiveness of preventive intervention techniques comparing non-intervention. In particular, the motivational techniques reveal more effectiveness for these Spanish young people. Therefore, it is required identifying a differential impact of the intervention techniques when implementing HIV behavioral interventions. PMID:25085080

  3. Effectiveness of Peer Education Interventions for HIV Prevention in Developing Countries: A Systematic Review and Meta-Analysis

    ERIC Educational Resources Information Center

    Medley, Amy; Kennedy, Caitlin; O'Reilly, Kevin; Sweat, Michael

    2009-01-01

    Peer education for HIV prevention has been widely implemented in developing countries, yet the effectiveness of this intervention has not been systematically evaluated. We conducted a systematic review and meta-analysis of peer education interventions in developing countries published between January 1990 and November 2006. Standardized methods of…

  4. Cost effectiveness of a computer-delivered intervention to improve HIV medication adherence

    PubMed Central

    2013-01-01

    Background High levels of adherence to medications for HIV infection are essential for optimal clinical outcomes and to reduce viral transmission, but many patients do not achieve required levels. Clinician-delivered interventions can improve patients’ adherence, but usually require substantial effort by trained individuals and may not be widely available. Computer-delivered interventions can address this problem by reducing required staff time for delivery and by making the interventions widely available via the Internet. We previously developed a computer-delivered intervention designed to improve patients’ level of health literacy as a strategy to improve their HIV medication adherence. The intervention was shown to increase patients’ adherence, but it was not clear that the benefits resulting from the increase in adherence could justify the costs of developing and deploying the intervention. The purpose of this study was to evaluate the relation of development and deployment costs to the effectiveness of the intervention. Methods Costs of intervention development were drawn from accounting reports for the grant under which its development was supported, adjusted for costs primarily resulting from the project’s research purpose. Effectiveness of the intervention was drawn from results of the parent study. The relation of the intervention’s effects to changes in health status, expressed as utilities, was also evaluated in order to assess the net cost of the intervention in terms of quality adjusted life years (QALYs). Sensitivity analyses evaluated ranges of possible intervention effectiveness and durations of its effects, and costs were evaluated over several deployment scenarios. Results The intervention’s cost effectiveness depends largely on the number of persons using it and the duration of its effectiveness. Even with modest effects for a small number of patients the intervention was associated with net cost savings in some scenarios and for

  5. Efficacy of an Intervention for Families Living with HIV in Thailand: A Randomized Controlled Trial

    PubMed Central

    LI, Li; LIANG, Li-Jung; LEE, Sung-Jae; IAMSIRITHAWORN, Sopon; WAN, Dai; ROTHERAM-BORUS, Mary Jane

    2011-01-01

    This study evaluates the efficacy of an intervention for persons living with HIV (PLH) and their family members in Thailand. A randomized controlled trial of 813 PLH and family members was carried out at four district hospitals in Thailand. Participants completed Computer Assisted Personal Interview (CAPI) assessments at baseline, 6, 12, 18, and 24 months. The primary outcome was quality of life (QoL); other measures included depressive symptoms and family functioning. Relative to the standard care condition, the intervention group reported significantly improved QoL at 6 months (P = 0.0014). When the intervention efficacy was stratified by baseline depressive symptoms (low vs. high), intervention efficacy was observed only among those with low depressive symptoms. Study findings suggest that the intervention was more efficacious for participants with less depressive symptoms and better family functioning. Extensive interventions may be optimal for those who have the capacity to learn the tools and skills. PMID:22038079

  6. Efficacy of HIV Prevention Interventions in Latin American and Caribbean Nations, 1995–2008: A Meta-Analysis

    PubMed Central

    Huedo-Medina, Tania B.; Boynton, Marcella H.; Warren, Michelle R.; LaCroix, Jessica M.; Carey, Michael P.; Johnson, Blair T.

    2014-01-01

    This meta-analysis synthesized 34 HIV prevention interventions (from 27 studies) that were evaluated in Latin American and Caribbean nations. These studies were obtained through systematic searches of English, Spanish, and Portuguese-language databases available as of January 2009. Overall, interventions significantly increased knowledge (d = 0.51) and condom use (d = 0.28) but the effects varied widely. Interventions produced more condom use when they focused on high-risk individuals, distributed condoms, and explicitly addressed socio-cultural components. The best-fitting models utilized factors related to geography, especially indices of a nations’ human development index (HDI) and income inequality (i.e., Gini index). Interventions that provided at least three hours of content succeeded better when HDI and income inequality were lower, suggesting that intensive HIV prevention activities succeed best where the need is greatest. Implications for HIV intervention development in Latin America and the Caribbean are discussed. PMID:20661768

  7. Evaluation of Natural Resource Interventions

    ERIC Educational Resources Information Center

    Rowe, Andy

    2012-01-01

    This article provides a frame for evaluation of natural resource interventions, which necessarily involves both human and natural systems. Two-system evaluands require us to adapt evaluation methods for comparison and attribution and to address differences in time and space occurring across the systems as well as potentially very different values…

  8. 78 FR 10183 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-13

    ... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services... prevent a lapse in comprehensive primary care services for persons living with HIV/AIDS, HRSA will...

  9. 78 FR 18989 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA), Department of Health and Human Services. ACTION: Notice of Ryan White HIV/AIDS...

  10. 78 FR 31568 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-24

    ... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA), Department of Health and Human Services. ACTION: Notice of Ryan White HIV/AIDS...

  11. 78 FR 10183 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-13

    ... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services... a lapse in comprehensive primary care services for persons living with HIV/AIDS, HRSA will...

  12. 78 FR 10182 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-13

    ... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA), Department of Health and Human Services. ACTION: Notice of Ryan White HIV/AIDS...

  13. 78 FR 78976 - Ryan White HIV/AIDS Program Part C Early Intervention Services Grant Under the Ryan White HIV...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA), Department of Health and Human Services. ACTION: Notice of Ryan White HIV/AIDS...

  14. 78 FR 10183 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-13

    ... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA), Department of Health and Human Services. ACTION: Notice of Ryan White HIV/AIDS...

  15. Barriers and Facilitators to Implementing Access to HIV Care Interventions: A Qualitative Analysis of the Positive Charge Initiative.

    PubMed

    Kinsky, Suzanne; Maulsby, Catherine H; Jain, Kriti M; Charles, Vignetta; Riordan, Maura; Holtgrave, David R

    2015-10-01

    Research indicates that less than half of people living with HIV (PLWH) have undetectable levels of virus, despite recent findings that viral load suppression dramatically reduces the transmissibility of HIV. Linkage to HIV care is a crucial initial step, yet we know relatively little about how to effectively implement linkage interventions to reach PLWH who are not in care. AIDS United's initiative, Positive Charge (PC), funded five U.S. sites to develop and implement comprehensive linkage interventions. Evaluation of the initiative included qualitative interviews with management and service staff from each intervention site. Sites experienced barriers and facilitators to implementation on multiple environmental, organization, and personnel levels. Successful strategies included developing early relationships with collaborating partners, finding ways to share key information among agencies, and using evaluation data to build support among leadership staff. Lessons learned will be useful for organizations that develop and implement future interventions targeting hard-to-reach, out-of-care PLWH. PMID:26485230

  16. Reducing risky relationships: a multisite randomized trial of a prison-based intervention for reducing HIV sexual risk behaviors among women with a history of drug use.

    PubMed

    Knudsen, Hannah K; Staton-Tindall, Michele; Oser, Carrie B; Havens, Jennifer R; Leukefeld, Carl G

    2014-01-01

    Women involved in the criminal justice system, particularly those with a history of drug use, are at elevated risk of HIV infection, yet few HIV prevention interventions have been tailored for delivery to incarcerated women. Drawing on the Relational Model, the Reducing Risky Relationships for HIV (RRR-HIV) intervention was developed and evaluated in a multisite randomized clinical trial. Women with weekly drug use prior to incarceration (n = 444) who were incarcerated within correctional institutions in four states were randomized to (1) the RRR-HIV intervention consisting of an HIV educational video, five group sessions, and one postrelease booster session or (2) a control condition consisting of the HIV educational video. The RRR-HIV intervention combined didactic and interactive content regarding seven "thinking myths" about intimate relationships that may result in decisions to engage in risky sexual behaviors. Data were collected while women were still incarcerated and approximately 90 days following release from prison by trained interviewers. A negative binomial regression (NBR) model of unprotected sexual behaviors at the 90-day follow-up indicated that RRR-HIV participants reported fewer unprotected sexual behaviors than women in the control condition once the analysis was adjusted for study site. Future studies should examine the sustainability of the RRR-HIV intervention's effect on risk reduction. Implementation research is needed to determine whether delivery of this intervention by correctional staff or peers, rather than research staff, yields similar reductions in unprotected sexual behaviors. PMID:24410251

  17. HIV and Dyadic Intervention: An Interdependence and Communal Coping Analysis

    PubMed Central

    Montgomery, Catherine M.; Watts, Charlotte; Pool, Robert

    2012-01-01

    Background The most common form of HIV transmission in sub-Saharan Africa is heterosexual sex between two partners. While most HIV prevention interventions are aimed at the individual, there is mounting evidence of the feasibility, acceptability, and efficacy of dyadic interventions. However, the mechanisms through which dyadic-level interventions achieve success remain little explored. We address this gap by using Lewis et al’s interdependence model of couple communal coping and behaviour change to analyse data from partners participating in an HIV prevention trial in Uganda and Zambia. Methods and Findings We conducted a comparative qualitative study using in-depth interviews. Thirty-three interviews were conducted in total; ten with couples and twenty-three with staff members at the two sites. The Ugandan site recruited a sero-discordant couple cohort and the Zambian site recruited women alone. Spouses’ transformation of motivation is strong where couples are recruited and both partners stand to gain considerably by participating in the research; it is weaker where this is not the case. As such, coping mechanisms differ in the two sites; among sero-discordant couples in Uganda, communal coping is evidenced through joint consent to participate, regular couple counselling and workshops, sharing of HIV test results, and strong spousal support for adherence and retention. By contrast, coping at the Zambian site is predominantly left to the individual woman and occurs against a backdrop of mutual mistrust and male disenfranchisement. We discuss these findings in light of practical and ethical considerations of recruiting couples to HIV research. Conclusions We argue for the need to consider the broader context within which behaviour change occurs and propose that future dyadic research be situated within the framework of the ‘risk environment’. PMID:22808227

  18. Effects of postnatal interventions for the reduction of vertical HIV transmission on infant growth and non-HIV infections: a systematic review

    PubMed Central

    Zunza, Moleen; Mercer, Gareth D; Thabane, Lehana; Esser, Monika; Cotton, Mark F

    2013-01-01

    Introduction Guidelines in resource-poor settings have progressively included interventions to reduce postnatal HIV transmission through breast milk. In addition to HIV-free survival, infant growth and non-HIV infections should be considered. Determining the effect of these interventions on infant growth and non-HIV infections will inform healthcare decisions about feeding HIV-exposed infants. We synthesize findings from studies comparing breast to formula feeding, early weaning to standard-duration breastfeeding, breastfeeding with extended antiretroviral (ARV) to short-course ARV prophylaxis, and alternative preparations of infant formula to standard formula in HIV-exposed infants, focusing on infant growth and non-HIV infectious morbidity outcomes. The review objectives were to collate and appraise evidence of interventions to reduce postnatal vertical HIV transmission, and to estimate their effect on growth and non-HIV infections from birth to two years of age among HIV-exposed infants. Methods We searched PubMed, SCOPUS, and Cochrane CENTRAL Controlled Trials Register. We included randomized trials and prospective cohort studies. Two authors independently extracted data and evaluated risk of bias. Rate ratios and mean differences were used as effect measures for dichotomous and continuous outcomes, respectively. Where pooling was possible, we used fixed-effects meta-analysis to pool results across studies. Quality of evidence was assessed using the GRADE approach. Results and discussion Prospective cohort studies comparing breast- versus formula-fed HIV-exposed infants found breastfeeding to be protective against diarrhoea in early life [risk ratio (RR)=0.31; 95% confidence interval (CI)=0.13 to 0.74]. The effect of breastfeeding against diarrhoea [hazard ratio (HR)=0.74; 95% CI=0.57 to 0.97] and respiratory infections (HR=0.65; 95% CI=0.41 to 1.00) was significant through two years of age. The only randomized controlled trial (RCT) available showed that

  19. The Chinese Life-Steps Program: A Cultural Adaptation of a Cognitive-Behavioral Intervention to Enhance HIV Medication Adherence

    PubMed Central

    Shiu, Cheng-Shi; Chen, Wei-Ti; Simoni, Jane; Fredriksen-Goldsen, Karen; Zhang, Fujie; Zhou, Hongxin

    2013-01-01

    China is considered to be the new frontier of the global AIDS pandemic. Although effective treatment for HIV is becoming widely available in China, adherence to treatment remains a challenge. This study aimed to adapt an intervention promoting HIV-medication adherence—favorably evaluated in the West—for Chinese HIV-positive patients. The adaptation process was theory-driven and covered several key issues of cultural adaptation. We considered the importance of interpersonal relationships and family in China and cultural notions of health. Using an evidence-based treatment protocol originally designed for Western HIV-positive patients, we developed an 11-step Chinese Life-Steps program with an additional culture-specific intervention option. We describe in detail how the cultural elements were incorporated into the intervention and put into practice at each stage. Clinical considerations are also outlined and followed by two case examples that are provided to illustrate our application of the intervention. Finally, we discuss practical and research issues and limitations emerging from our field experiments in a HIV clinic in Beijing. The intervention was tailored to address both universal and culturally specific barriers to adherence and is readily applicable to generalized clinical settings. This evidence-based intervention provides a case example of the process of adapting behavioral interventions to culturally diverse communities with limited resources. PMID:23667305

  20. Increased HIV disclosure three months after an online video intervention for men who have sex with men (MSM).

    PubMed

    Chiasson, Mary Ann; Shaw, Francine Shuchat; Humberstone, Mike; Hirshfield, Sabina; Hartel, Diana

    2009-09-01

    A behavioral intervention for men who have sex with men (MSM) was created for online delivery. The nine-minute video drama "The Morning After" (www.hivbigdeal.org) was designed to promote critical thinking about HIV risk. MSM were recruited for the evaluation through banner ads on a subscription-based gay sexual meeting web site. Participants viewed the intervention online and completed online behavioral questionnaires at enrollment and three month follow-up. Each participant served as his own control. No participant incentives were provided. Follow-up was completed by 522 (54%) of 971 eligible men. Men completing follow-up were similar to those who did not by age and prevalence of unprotected anal intercourse (UAI) but reported more lifetime sex partners. They also differed somewhat by race, education, and HIV testing. In the three months after the intervention, men were significantly more likely to disclose HIV status to partners (odds ratio [OR] = 3.37, p<0.001) and less likely to report a casual partner or UAI in their most recent sexual encounter than at baseline. Of 120 men HIV tested during follow-up, 17 (14%) reported being HIV seropositive. These findings show that MSM at high risk for HIV will participate in a brief online video intervention designed to engage critical thinking and that significant, self-reported increases in HIV disclosure and decreases in risk behavior occurred three months after MSM viewed the video. PMID:20024766

  1. HIV prevention with male prostitutes and patrons of hustler bars: replication of an HIV preventive intervention.

    PubMed

    Miller, R L; Klotz, D; Eckholdt, H M

    1998-02-01

    The core objectives of this study were to document the process by which a community-based organization replicated and adapted an experimentally developed intervention to its own use and to explore the effectiveness of that HIV prevention program for male prostitutes and other patrons in New York City "hustler" bars. The intervention model employed was based on previous research with gay men (Kelly, St. Lawrence, Diaz, et al., 1991; Kelly, St. Lawrence, Stevenson, et al., 1992) and inspired by diffusion of innovation theory (Rogers, 1995). The effects of the current intervention were assessed on a sample of 1,741 male prostitutes and bar patrons. Analyses indicated significant reductions in paid, unprotected sexual intercourse and oral sex following the intervention. Analyses further indicated that the data were partially consistent with the program's model, which specified that norms were the putative mediator of behavior change in the intervention. Also, the intervention's effects varied by bar and by participants' race/ethnicity. Data support the utility of the intervention model for an urban sample of men at high risk for HIV infection. The importance of exploring the mechanisms that underlie the intervention is discussed. PMID:9574500

  2. Improving Parental Stress Levels Among Mothers Living with HIV: A Randomized Control Group Intervention Study

    PubMed Central

    Johnson, Erica R.; Davies, Susan L.; Aban, Inmaculada; Mugavero, Michael J.; Shrestha, Sadeep

    2015-01-01

    Abstract Limited knowledge exists regarding parenting efficacy interventions for mothers living with HIV (MLH). This study evaluated the impact of a supportive group intervention on lowering parenting stress among MLH. Eighty MLH were randomized to a parenting (N=34) or health focused (control) (N=46) group intervention. Pre- and post-intervention stress levels were assessed using the Parental Stress Index-Short Form (PSI/SF). Differences in PSI/SF scores were examined using ANOVA, and predictors of PSI/SF scores were evaluated using multivariable linear regression. Findings indicate that both groups experienced significant decreases in parenting stress from baseline to post-intervention (p=0.0001), with no significant differences between interventions. At baseline, 41% of participants were identified as highly stressed and 30% as clinically stressed, with PSI/SF scores above the 85th and 90th percentile, respectively. Amongst the highly stressed subpopulation, significant improvements in PSI/SF scores for Parental Distress PSI/SF (p=0.039), Difficult Child PSI/SF (p=0.048), and total PSI/SF (p=0.036) were seen, with greater improvements in the parenting intervention. Among the clinically stressed subpopulation, significant improvements in total post-intervention PSI/SF scores were seen (p=0.049), with greater improvements in the parenting intervention. Results indicate that screening for high levels of stress should be considered in clinical practice to effectively implement stress-reducing interventions among MLH. PMID:25734870

  3. Interventions to Address Chronic Disease and HIV: Strategies to Promote Exercise and Nutrition Among HIV-Infected Individuals

    PubMed Central

    Botros, Diana; Somarriba, Gabriel; Neri, Daniela; Miller, Tracie L.

    2012-01-01

    Food insecurity, micronutrient deficits, dyslipidemia, insulin resistance, obesity, cardiovascular disease, and bone disorders complicate the treatment of HIV infection. Nutrition and exercise interventions can be effective in ameliorating these symptoms that are associated with HIV and antiretroviral therapy (ART). In this literature review, we examine the most recent nutrition and exercise interventions for HIV-infected patients. Macronutrient supplementation can be useful in treating malnutrition and wasting. Multivitamin (vitamin B complex, vitamin C, and vitamin E) supplements and vitamin D may improve quality of life and decrease morbidity and mortality. Nutritional counseling and exercise interventions are effective for treating obesity, fat redistribution, and metabolic abnormalities. Physical activity interventions improve body composition, strength, and fitness in HIV-infected individuals. Taken collectively, the evidence suggests that a proactive approach to nutrition and physical activity guidance and interventions can improve outcomes and help abrogate the adverse metabolic, cardiovascular, and psychological consequences of HIV and its treatments. PMID:22933247

  4. Exploring the influence of social determinants on HIV risk behaviors and the potential application of structural interventions to prevent HIV in women

    PubMed Central

    Edwards, Arlene E.; Collins, Charles B.

    2016-01-01

    When seeking to prevent HIV/AIDS in women, attending to aspects of their lived experience provides opportunities to address the presence of social determinants in prevention strategies. According to the CDC, in 2010, the rate of new HIV infections among Black women was 20 times that of White women, while among Hispanic/Latino women it was 4 times the rate of White women. Additionally, 86% of HIV infections in women were attributed to heterosexual contact and 14% to injection drug use. The WHO indicates that worldwide, 49% of individuals infected by HIV are women, with a predominant source of infection tied to heterosexual transmission. This paper presents social determinants as influential factors in terms of women’s sexual behavior decision-making, along with suggested structural interventions to address the social determinants of their HIV risks. Secondary analysis was conducted on data from an earlier study (Abdul-Quader and Collins, 2011) which used concept-mapping to examine the feasibility, evaluability, and sustainability of structural interventions for HIV prevention. The current analysis focused on structural interventions applicable to women and their HIV prevention needs. Three themes emerged: economic interventions, responses to violence against women, and integrated health service delivery strategies. The themes provide a foundation for next steps regarding research, policy planning, and intervention implementation that is inclusive of women’s lived experience. The paper concludes with suggestions such as attention to innovative projects and a paradigm shift regarding policy planning as key next steps towards HIV prevention that reflects the contextual complexity of women’s lived experiences. PMID:27134801

  5. The Community-based Participatory Intervention Effect of “HIV-RAAP”

    PubMed Central

    Yancey, Elleen M.; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H.; Yuan, Keming

    2012-01-01

    Objectives To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. Methods A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. Results The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). Conclusions The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission. PMID:22488405

  6. Development of a Multilevel Intervention to Increase HIV Clinical Trial Participation among Rural Minorities

    ERIC Educational Resources Information Center

    Corbie-Smith, Giselle; Odeneye, Ebun; Banks, Bahby; Shandor Miles, Margaret; Roman Isler, Malika

    2013-01-01

    Minorities are disproportionately affected by HIV/AIDS in the rural Southeast; therefore, it is important to develop targeted, culturally appropriate interventions to support rural minority participation in HIV/AIDS research. Using intervention mapping, we developed a comprehensive multilevel intervention for service providers (SPs) and people…

  7. A systematic review of microfinance-based interventions for HIV/AIDS prevention.

    PubMed

    Arrivillaga, Marcela; Salcedo, Juan Pablo

    2014-02-01

    The aim of this study is to describe the scope of microfinance-based interventions for HIV/AIDS prevention. A systematic review was carried out of literature published between 1986 and 2012 from EBSCO, ProQuest, Science Direct, Emerald, and JSTOR. The search included original research articles that presented evaluated interventions. Books, dissertations, gray literature, and theoretical reviews were excluded. Findings revealed a total of fourteen studies focused on the evaluation of: the IMAGE project, female sex workers, life skills and risk behavior reduction, adherence to treatment, and children and their families. Most of these interventions have shown to have beneficial effects, although results depend on: the type of program, monitoring, sustainability of microcredits, and contextual conditions. The findings of this review should be complemented with interventions carried out by various NGOs and microfinance institutions in different countries that present their results in a dissimilar way. PMID:24450275

  8. The Evaluation of a Latino Community Health Worker HIV Prevention Program

    ERIC Educational Resources Information Center

    Martin, Molly; Camargo, Maria; Ramos, Lori; Lauderdale, Diane; Krueger, Kristin; Lantos, John

    2005-01-01

    This study evaluated the effectiveness of a community health promotion project to increase HIV knowledge in an urban, immigrant Latino community in Chicago. Latino participants (N = 704) answered questions on HIV before and after an education intervention given by community health workers. Outcomes included changes in knowledge and self-perceived…

  9. Identifying HIV most-at-risk groups in Malawi for targeted interventions. A classification tree model

    PubMed Central

    Emina, Jacques B O; Madise, Nyovani; Kuepie, Mathias; Zulu, Eliya M; Ye, Yazoume

    2013-01-01

    Objectives To identify HIV-socioeconomic predictors as well as the most-at-risk groups of women in Malawi. Design A cross-sectional survey. Setting Malawi Participants The study used a sample of 6395 women aged 15–49 years from the 2010 Malawi Health and Demographic Surveys. Interventions N/A Primary and secondary outcome measures Individual HIV status: positive or not. Results Findings from the Pearson χ2 and χ2 Automatic Interaction Detector analyses revealed that marital status is the most significant predictor of HIV. Women who are no longer in union and living in the highest wealth quintiles households constitute the most-at-risk group, whereas the less-at-risk group includes young women (15–24) never married or in union and living in rural areas. Conclusions In the light of these findings, this study recommends: (1) that the design and implementation of targeted interventions should consider the magnitude of HIV prevalence and demographic size of most-at-risk groups. Preventive interventions should prioritise couples and never married people aged 25–49 years and living in rural areas because this group accounts for 49% of the study population and 40% of women living with HIV in Malawi; (2) with reference to treatment and care, higher priority must be given to promoting HIV test, monitoring and evaluation of equity in access to treatment among women in union disruption and never married or women in union aged 30–49 years and living in urban areas; (3) community health workers, households-based campaign, reproductive-health services and reproductive-health courses at school could be used as canons to achieve universal prevention strategy, testing, counselling and treatment. PMID:23793677

  10. Yoga lifestyle intervention reduces blood pressure in HIV-infected adults with cardiovascular disease risk factors

    PubMed Central

    Cade, Todd; Reeds, Dominic N.; Mondy, Kristin E.; Overton, Turner; Grassino, Joseph; Tucker, Shawn; Bopp, Coco; Laciny, Erin; Hubert, Sara; Lassa-Claxton, Sherry; Yarasheski, Kevin E.

    2009-01-01

    People living with human immunodeficiency virus infection (HIV) are at increased risk for developing cardiovascular disease (CVD). Safe and effective interventions for lowering CVD risk in HIV are high priorities. Objective We conducted a prospective, randomized, controlled study to evaluate whether a yoga lifestyle intervention improves CVD risk factors, virologic or immunologic status, or quality of life in HIV-infected adults more than in a matched control group. Methods Sixty HIV-infected adults with mild-moderate CVD risk were assigned to 20 wks of supervised yoga practice or standard of care treatment. Baseline and week 20 measures were; 2hr-oral glucose tolerance test with insulin monitoring, body composition, fasting serum lipid/lipoprotein profile, resting blood pressures, CD4+ T-cell number and plasma HIV RNA, and the Medical Outcomes Study SF-36 health-related quality of life inventory. Results Resting systolic and diastolic blood pressures were reduced more (p=0.04) in the yoga group (−5±2 and −3±1 mmHg) than in the standard of care group (+1±2 and +2±2 mmHg), despite no greater reduction in body weight, fat mass, proatherogenic lipids, or improvements in glucose tolerance or overall quality of life after yoga. Immune and virologic status was not adversely affected. Conclusion Among traditional lifestyle modifications, yoga is a low cost, simple to administer, non-pharmacological, popular behavioral intervention that can lower blood pressure in pre-hypertensive HIV-infected adults with mild-moderate CVD risk factors. PMID:20059570

  11. Using standardized patients to evaluate hospital-based intervention outcomes

    PubMed Central

    Li, Li; Lin, Chunqing; Guan, Jihui

    2014-01-01

    Background The standardized patient approach has proved to be an effective training tool for medical educators. This article explains the process of employing standardized patients in an HIV stigma reduction intervention in healthcare settings in China. Methods The study was conducted in 40 hospitals in two provinces of China. One year after the stigma reduction intervention, standardized patients made unannounced visits to participating hospitals, randomly approached service providers on duty and presented symptoms related to HIV and disclosed HIV-positive test results. After each visit, the standardized patients evaluated their providers’ attitudes and behaviours using a structured checklist. Standardized patients also took open-ended observation notes about their experience and the evaluation process. Results Seven standardized patients conducted a total of 217 assessments (108 from 20 hospitals in the intervention condition; 109 from 20 hospitals in the control condition). Based on a comparative analysis, the intervention hospitals received a better rating than the control hospitals in terms of general impression and universal precaution compliance as well as a lower score on stigmatizing attitudes and behaviours toward the standardized patients. Conclusion Standardized patients are a useful supplement to traditional self-report assessments, particularly for measuring intervention outcomes that are sensitive or prone to social desirability. PMID:24369433

  12. Mano a Mano-Mujer: an effective HIV prevention intervention for Chilean women.

    PubMed

    Cianelli, Rosina; Ferrer, Lilian; Norr, Kathleen F; Miner, Sarah; Irarrazabal, Lisette; Bernales, Margarita; Peragallo, Nilda; Levy, Judith; Norr, James L; McElmurry, Beverly

    2012-01-01

    The impact of a professionally facilitated peer group intervention for HIV prevention among 400 low-income Chilean women was examined using a quasiexperimental design. At 3 months postintervention, the intervention group had higher HIV-related knowledge, more positive attitudes toward people living with HIV, fewer perceived condom use barriers, greater self- efficacy, higher HIV reduction behavioral intentions, more communication with partners about safer sex, and decreased depression symptoms. They did not, however, have increased condom use or self-esteem. More attention to gender barriers is needed. This intervention offers a model for reducing HIV for women in Chile and other Latin American countries. PMID:22420675

  13. Perceptions of Black College Women on Barriers to HIV-Risk Reduction and Their HIV Prevention Intervention Needs.

    PubMed

    Chandler, Rasheeta; Anstey, Erica H; Ross, Henry; Morrison-Beedy, Dianne

    2016-01-01

    HIV prevention interventions can help college students engage in safe sexual behaviors. We used the Information, Motivation, Behavioral Skills model to frame four focus group discussions with Black women (n = 32) attending a historically Black college/university or a traditional university to understand their HIV prevention needs. Participants wanted clear information about sexually transmitted infections/HIV and access to contraception. Motivators for practicing safe sex were related to cultural and religious expectations, desire to avoid pregnancy, and conscious efforts to defy racial stereotypes. Barriers to practicing safe sex included issues of accountability, stigma associated with accessing HIV testing/prevention services, and media influences. We found general consensus about the need to develop skill-building HIV prevention interventions focused on communication skills, condom negotiation, access to services, and empowerment. We offer insight into culture- and age-appropriate HIV prevention for Black college women to guide the development of future interventions. PMID:26875473

  14. Assessing the Effects of a Complementary Parent Intervention and Prior Exposure to a Preadolescent Program of HIV Risk Reduction for Mid-Adolescents

    PubMed Central

    Wang, Bo; Deveaux, Lynette; Lunn, Sonja; Rolle, Glenda; Braithwaite, Nanika; Dinaj-Koci, Veronica; Marshall, Sharon; Gomez, Perry

    2015-01-01

    Objectives. We (1) evaluated the impact of an evidence-based HIV prevention program with and without a parent component among mid-adolescents living in the Caribbean and (2) determined the effect of prior receipt of a related intervention during preadolescence on intervention response. Methods. A randomized, controlled 4-cell trial of a 10-session, theory-based HIV prevention intervention involving 2564 Bahamian grade-10 youths (some of whom had received a comparable intervention in grade 6) was conducted (2008–2011). Randomization occurred at the level of the classroom with follow-up at 6, 12, and 18 months after intervention. The 3 experimental conditions all included the youths’ curriculum and either a youth–parent intervention emphasizing adolescent–parent communication, a parent-only goal-setting intervention, or no parent intervention. Results. An intervention delivered to mid-adolescents in combination with a parent–adolescent sexual-risk communication intervention increased HIV/AIDS knowledge, condom-use skills, and self-efficacy and had a marginal effect on consistent condom use. Regardless of prior exposure to a similar intervention as preadolescents, youths benefited from receipt of the intervention. Conclusions. Preadolescents and mid-adolescents in HIV-affected countries should receive HIV prevention interventions that include parental participation. PMID:25602877

  15. The flawed reliance on randomized controlled trials in studies of HIV behavioral prevention interventions for people who inject drugs and other populations

    PubMed Central

    Friedman, Samuel R.; Perlman, David C.; Ompad, Danielle C.

    2015-01-01

    This article discusses ways in which randomized controlled trials do not accurately measure the impact of HIV behavioral interventions. This is because: 1.Such trials measure the wrong outcomes. Behavior change may have little to do with changes in HIV incidence since behavior change in events between HIV-concordant people have no impact on incidence. Even more important, the comparison of HIV incidence rates between study arms of individual-level RCTs does not measure the true outcome of interest—whether or not the intervention reduces HIV transmission at the community level. This is because this comparison cannot measure the extent to which the intervention stops transmission by HIV-infected people in the study to those outside it. (And this is made even worse if HIV-infected are excluded from the evaluation of the intervention.) 2. There are potential harms implicit in most cognitively-oriented behavioral interventions that are not measured in current practice and may not be measurable using RCTs. Intervention trials often reinforce norms and values of individual self-protection. They rarely if ever measure whether doing this reduces community trust, solidarity, cohesion, organization, or activism in ways that might facilitate HIV transmission. 3. Many interventions are not best conceived of as interventions with individuals but rather with networks, cultures of risks, or communities. As such, randomizing individuals leads to effective interventions that diffuse protection through a community; but these are evaluated as ineffective because the changes diffuse to the control arm, which leads to systematic and erroneous reductions in the evaluated effectiveness as RCTs measure it. The paper ends by discussing research designs that are superior to individual-level RCTs at measuring whether an intervention reduces or increases new HIV transmission. PMID:26222900

  16. HIV testing, staging, and evaluation.

    PubMed

    Rodriguez, Carla V; Horberg, Michael A

    2014-09-01

    HIV testing and incidence are stable, but trends for certain populations are concerning. Primary prevention must be reinvigorated and target vulnerable populations. Science and policy have progressed to improve the accuracy, speed, privacy, and affordability of HIV testing. More potent and much better tolerated HIV treatments and a multidisciplinary approach to care have increased adherence and viral suppression. Changes to health care law in the United States seek to expand the affordability and access of improved HIV diagnostics and treatment. Continued challenges include improving long-term outcomes in people on lifetime regimens, reducing comorbidities associated with those regimens, and preventing further transmission. PMID:25151560

  17. Couple-based HIV counseling and testing: a risk reduction intervention for U.S. drug-involved women and their primary male partners

    PubMed Central

    Pouget, Enrique R.; Tortu, Stephanie; Volpe, Ellen M.; Torres, Leilani; Rodriguez, William

    2014-01-01

    To help reduce the elevated risk of acquiring HIV for African American and Latina women drug users in primary heterosexual relationships, we developed a brief couple-based HIV counseling and testing prevention intervention. The intervention was based on an integrated HIV risk behavior theory that incorporated elements of social exchange theory, the theory of gender and power, the stages-of-change model, and the information-motivation-behavior skills model. In this article we describe the development, content and format of the couple-based HIV testing and counseling intervention, and its delivery to 110 couples (220 individuals) in a randomized effectiveness trial, the Harlem River Couples Project, conducted in New York City from 2005 to 2007. Components of the couple-based intervention included a personalized dyadic action plan based on the couple’s risk profile, and interactive exercises designed to help build interpersonal communication skills, and facilitated discussion of social norms regarding gender roles. The couple-based HIV testing and counseling intervention significantly reduced women’s overall HIV risk compared to a standard-of-care individual HIV testing and counseling intervention. Experiences and perceptions of the intervention were positive among both clients and interventionists. The study was the first to demonstrate the effectiveness and feasibility of delivering a brief couple-based HIV counseling and testing intervention to reduce risk among drug-using heterosexual couples in high HIV prevalent urban communities in the United States. The intervention can be expanded to include new HIV prevention strategies, such as pre-exposure prophylaxis. Further research is needed to evaluate cost-effectiveness and implementation of the intervention in clinical settings. PMID:25512179

  18. Couple-based HIV counseling and testing: a risk reduction intervention for US drug-involved women and their primary male partners.

    PubMed

    McMahon, James M; Pouget, Enrique R; Tortu, Stephanie; Volpe, Ellen M; Torres, Leilani; Rodriguez, William

    2015-02-01

    To help reduce the elevated risk of acquiring HIV for African-American and Latina women drug users in primary heterosexual relationships, we developed a brief couple-based HIV counseling and testing prevention intervention. The intervention was based on an integrated HIV risk behavior theory that incorporated elements of social exchange theory, the theory of gender and power, the stages-of-change model, and the information-motivation-behavior skills model. In this article, we describe the development, content, and format of the couple-based HIV testing and counseling intervention, and its delivery to 110 couples (220 individuals) in a randomized effectiveness trial, the Harlem River Couples Project, conducted in New York City from 2005 to 2007. Components of the couple-based intervention included a personalized dyadic action plan based on the couple's risk profile and interactive exercises designed to help build interpersonal communication skills, and facilitated discussion of social norms regarding gender roles. The couple-based HIV testing and counseling intervention significantly reduced women's overall HIV risk compared to a standard-of-care individual HIV testing and counseling intervention. Experiences and perceptions of the intervention were positive among both clients and interventionists. The study was the first to demonstrate the effectiveness and feasibility of delivering a brief couple-based HIV counseling and testing intervention to reduce risk among drug-using heterosexual couples in high HIV prevalent urban communities in the USA. The intervention can be expanded to include new HIV prevention strategies, such as pre-exposure prophylaxis. Further research is needed to evaluate cost-effectiveness and implementation of the intervention in clinical settings. PMID:25512179

  19. Intervention Mapping as a Participatory Approach to Developing an HIV prevention Intervention in Rural African American Communities

    PubMed Central

    Corbie-Smith, Giselle; Akers, Aletha; Blumenthal, Connie; Council, Barbara; Wynn, Mysha; Muhammad, Melvin; Stith, Doris

    2011-01-01

    Southeastern states are among the hardest hit by the HIV epidemic in this country, and racial disparities in HIV rates are high in this region. This is particularly true in our communities of interest in rural eastern North Carolina. Although most recent efforts to prevent HIV attempt to address multiple contributing factors, we have found few multilevel HIV interventions that have been developed, tailored or tested in rural communities for African Americans. We describe how Project GRACE integrated Intervention Mapping (IM) methodology with community based participatory research (CBPR) principles to develop a multi-level, multi-generational HIV prevention intervention. IM was carried out in a series of steps from review of relevant data through producing program components. Through the IM process, all collaborators agreed that we needed a family-based intervention involving youth and their caregivers. We found that the structured approach of IM can be adapted to incorporate the principles of CBPR. PMID:20528128

  20. The Global HIV Archive: Facilitating the Transition from Science to Practice of Efficacious HIV Prevention Interventions*

    PubMed Central

    Card, Josefina J.; Newman, Emily N.; Golden, Rachel E.; Kuhn, Tamara; Lomonaco, Carmela

    2014-01-01

    This paper describes the development, content, and capabilities of the online Global HIV Archive (GHA). With the goal of facilitating widespread adaptation and appropriate use of efficacious HIV prevention programs throughout the globe, GHA has: first, expanded and updated the search for HIV prevention programs originating in low-resource countries; second, identified those meritorious HIV prevention programs meeting established efficacy criteria of technical merit, replicability, and positive outcomes; third, prepared both implementation and evaluation materials from the efficacious programs for public use; fourth, developed interactive wizards or capacity-building tools to facilitate appropriate program selection, implementation, and adaptation; and, fifth, made the efficacious programs and accompanying wizards available to health practitioners throughout the globe in both printed and online formats. PMID:24563820

  1. A systematic review of interventions to improve prevention of mother-to-child HIV transmission service delivery and promote retention

    PubMed Central

    Ambia, Julie; Mandala, Justin

    2016-01-01

    Introduction The success of prevention of mother-to-child transmission of HIV (PMTCT) is dependent upon high retention of mother-infant pairs within these programmes. This is a systematic review to evaluate the effectiveness of interventions that aim to improve PMTCT service delivery and promote retention throughout the PMTCT steps. Methods Selected databases were searched for studies published in English (up to September 2015). Outcomes of interest included antiretroviral (ARV) drugs or antiretroviral therapy (ART) initiation among HIV-positive pregnant and/or breastfeeding women and their infants, retention into PMTCT programs, the uptake of early infant diagnosis (EID) of HIV and infant HIV status. Risk ratios and random-effect meta-analysis were used in the analysis. Results Interventions assessed in the 34 identified studies included male partner involvement in PMTCT, peer mentoring, the use of community health workers (CHWs), mobile phone-based reminders, conditional cash transfer, training of midwives, integration of PMTCT services and enhanced referral. Five studies (two randomized) that evaluated mobile phone-based interventions showed a statistically significant increase (pooled RR 1.18; 95% CI 1.05 to 1.32, I2=83%) in uptake of EID of HIV at around six weeks postpartum. Male partner involvement in PMTCT was associated with reductions in infant HIV transmission (pooled RR 0.61; 95% CI 0.39 to 0.94, I2=0%) in four studies (one randomized). Four studies (three randomized) that were grounded on psychological interventions reported non-significant results (pooled RR 1.01; 95% CI 0.93 to 1.09, I2=69%) in increasing ARV/ART uptake among HIV-positive pregnant and/or breastfeeding women and infant HIV testing (pooled RR 1.00; 95% CI 0.94 to 1.07, I2=45%). The effect of the other interventions on the effectiveness of improving PMTCT uptake was unclear. Heterogeneity of interventions limits these findings. Conclusions Our findings indicate that mobile phone

  2. Helping the Children: World Bank Directory of HIV/AIDS Interventions in Africa.

    ERIC Educational Resources Information Center

    World Bank, Washington, DC. Human Development Network.

    This directory is intended to provide information on HIV/AIDS interventions funded by the World Bank that include a component for young children. Data were collected from 1986-2001 fiscal year reports from both freestanding HIV/AIDS projects and those projects with HIV/AIDS components. Countries are listed alphabetically and projects are organized…

  3. HIV/AIDS Interventions in an Aging U.S. Population

    ERIC Educational Resources Information Center

    Jacobson, Stephanie A.

    2011-01-01

    According to the Centers for Disease Control and Prevention (CDC), 25 percent of people living with HIV in the United States in 2006 were age 50 and older. HIV prevention for people over 50 is an important health concern, especially as the U.S. population grows older. Scholarly research has identified the need for HIV/AIDS interventions in the…

  4. Improved Prevention Counseling by HIV Care Providers in a Multisite, Clinic-Based Intervention: Positive STEPs

    ERIC Educational Resources Information Center

    Thrun, Mark; Cook, Paul F.; Bradley-Springer, Lucy A.; Gardner, Lytt; Marks, Gary; Wright, Julie; Wilson, Tracey E.; Quinlivan, E. Byrd; O'Daniels, Christine; Raffanti, Stephen; Thompson, Melanie; Golin, Carol

    2009-01-01

    The Centers for Disease Control and Prevention have recommended that HIV care clinics incorporate prevention into clinical practice. This report summarizes HIV care providers' attitudes and counseling practices before and after they received training to deliver a counseling intervention to patients. Providers at seven HIV clinics received training…

  5. HIV-testing among female sex workers on the border between Brazil and French Guiana: the need for targeted interventions.

    PubMed

    Parriault, Marie-Claire; van Melle, Astrid; Basurko, Célia; Gaubert-Marechal, Emilie; Macena, Raimunda Hermelinda Maia; Rogier, Stéphanie; Kerr, Ligia Regina Franco Sansigolo; Nacher, Mathieu

    2015-08-01

    The border between Brazil and French Guiana is a place of economic, cultural, social and sexual exchange. Female sex workers represent a high risk population for HIV in this area where sexual tourism is particularly developed. HIV testing seems to be an important element in the fight against the epidemic. Indeed, early HIV testing gives access to treatments and prevention. An HIV/AIDS knowledge, attitudes, behaviors and practices survey was conducted in 2011 among sex workers along the border between Brazil and French Guiana. A total of 213 female sex workers were interviewed. One third (31.5%) of the interviewed had never tested for HIV. Factors associated with non HIV-testing were the lack of knowledge of places where to do an HIV test, to be 30 or older, feeling at risk of HIV, not evaluating one's own risk towards HIV, and living in Oiapoque. These results clearly suggest that targeted interventions are needed to encourage and assist female sex workers to get tested regularly. PMID:26375641

  6. Intervention to train physicians in rural China on HIV/STI knowledge and risk reduction counseling: preliminary findings.

    PubMed

    Wang, Debin; Operario, Don; Hong, Qian; Zhang, Hongbo; Coates, Thomas J

    2009-04-01

    We evaluated an intervention to train physicians in rural China on knowledge of HIV/STI prevention, diagnosis, treatment options, and HIV/STI behavioral risk reduction counseling. This paper reports preliminary findings related to feasibility and acceptability of the program. Using a pre-post design, 69 physicians were recruited from rural county hospitals and participated in a 10-day group training program, followed by two months of clinical fieldwork and two additional weeks of training. Physicians completed baseline and six-month assessments. Patients' cohorts, recruited from clinic waiting areas of participating physicians, completed baseline and six-month HIV/STI risk assessments. Physicians reported increased knowledge of HIV biology and pathology, epidemiology, host immune response, opportunisitic infection and syndromic management, antiretroviral therapy, risk reduction counseling, and stigma reduction following the training. Patients reported improved knowledge of HIV, reduced HIV stigma, higher rates of HIV testing, and improved condom use at follow-up. The findings suggest that training physicians on HIV/STI-related knowledge and risk reduction counseling is a promising strategy for reducing HIV/STI epidemics in rural China. PMID:19266406

  7. Systematic Review of Couple-Based HIV Intervention and Prevention Studies: Advantages, Gaps, and Future Directions

    PubMed Central

    El-Bassel, Nabila

    2015-01-01

    We conducted a systematic review of couple-based HIV biobehavioral (skills-building, VCT, and adherence) and biomedical (ART, circumcision) prevention and intervention studies designed to reduce sexual-and drug-risk behaviors and HIV transmission and acquisition. Of the 11,162 papers identified in the search, 93 peer-reviewed papers met the inclusion criteria and yielded a total of 33 studies conducted globally. Biobehavioral couple-based prevention and intervention studies have been efficacious in reducing sexual- and drug-risk behaviors, increasing access to HIV testing and care, and improving adherence. Biomedical couple-based studies were found to reduce HIV incidence among HIV-negative sex partners and viral load among HIV-positive partners. Despite much progress, couple-based HIV prevention and intervention studies remain limited; a number of methodological gaps exist and studies focusing on MSM, people who inject drugs, and sex workers are scarce. PMID:24980246

  8. THE DEVELOPMENT AND FEASIBILITY OF A BRIEF RISK REDUCTION INTERVENTION FOR NEWLY HIV-DIAGNOSED MEN WHO HAVE SEX WITH MEN

    PubMed Central

    Sikkema, Kathleen J.; Hansen, Nathan B.; Kochman, Arlene; Santos, Jonathan; Watt, Melissa H.; Wilson, Patrick A.; DeLorenzo, Allyson; Laudato, Jay; Mayer, Gal

    2011-01-01

    Men who have sex with men (MSM) represent more than half of all new HIV infections in the United States. Utilizing a collaborative, community based approach, a brief risk reduction intervention was developed and pilot tested among newly HIV-diagnosed MSM receiving HIV care in a primary care setting. Sixty-five men, within 3 months of diagnosis, were randomly assigned to the experimental condition or control condition and assessed at baseline, 3-month, and 6-month follow-up. Effect sizes were calculated to explore differences between conditions and over time. Results demonstrated the potential effectiveness of the intervention in reducing risk behavior, improving mental health, and increasing use of ancillary services. Process evaluation data demonstrated the acceptability of the intervention to patients, clinic staff, and administration. The results provide evidence that a brief intervention can be successfully integrated into HIV care services for newly diagnosed MSM and should be evaluated for efficacy. PMID:22228917

  9. Positive Choices: Outcomes of a Brief Risk Reduction Intervention for Newly HIV-diagnosed Men who have Sex with Men

    PubMed Central

    Sikkema, Kathleen J.; Abler, Laurie; Hansen, Nathan B.; Wilson, Patrick A.; Drabkin, Anya S.; Kochman, Arlene; MacFarlane, Jessica C.; DeLorenzo, Allyson; Mayer, Gal; Watt, Melissa; Nazareth, William

    2014-01-01

    Positive Choices (PC), a brief sexual risk reduction intervention conducted with newly HIV-diagnosed men who have sex with men (MSM), was evaluated for preliminary efficacy. Participants were enrolled if they reported unprotected anal intercourse (UAI) in the three months prior to HIV diagnosis (n=102). Three months after diagnosis, participants completed baseline assessments and were randomly assigned to receive the 3-session PC intervention or the comprehensive standard of care (C-SoC) at a community health center. Participants completed assessments at 3-(post intervention), 6-, and 9-months after baseline. Compared to C-SoC participants, PC participants significantly reduced the frequency of UAI with HIV serodiscordant (HIV negative or status unknown) partners over the 9-month follow-up period. No differences by condition were found in the frequency of UAI with all partners. The findings from this trial suggest that brief risk reduction approaches for newly-diagnosed MSM integrated into HIV care can benefit secondary HIV prevention efforts. PMID:24771017

  10. Behavioral Interventions to Prevent HIV Transmission and Acquisition for Transgender Women: A Critical Review

    PubMed Central

    Kuhns, Lisa M.; Reisner, Sari L.; Mimiaga, Matthew J.

    2016-01-01

    Abstract: Worldwide, transgender women are at disproportionately higher risk of HIV infection, with the primary mode of infection being condomless anal intercourse. Although very few HIV prevention interventions have been developed and tested specifically for transgender women, growing evidence suggests that behavioral HIV risk reduction interventions for other marginalized groups are efficacious. We outline the current state of knowledge and areas in need of further development in this area. PMID:27429186

  11. Behavioral Interventions to Prevent HIV Transmission and Acquisition for Transgender Women: A Critical Review.

    PubMed

    Garofalo, Robert; Kuhns, Lisa M; Reisner, Sari L; Mimiaga, Matthew J

    2016-08-15

    Worldwide, transgender women are at disproportionately higher risk of HIV infection, with the primary mode of infection being condomless anal intercourse. Although very few HIV prevention interventions have been developed and tested specifically for transgender women, growing evidence suggests that behavioral HIV risk reduction interventions for other marginalized groups are efficacious. We outline the current state of knowledge and areas in need of further development in this area. PMID:27429186

  12. Process Evaluation of HIV Prevention Peer Groups in Malawi: A Look inside the Black Box

    ERIC Educational Resources Information Center

    McCreary, Linda L.; Kaponda, Chrissie P. N.; Kafulafula, Ursula K.; Ngalande, Rebecca C.; Kumbani, Lily C.; Jere, Diana L. N.; Norr, James L.; Norr, Kathleen F.

    2010-01-01

    This paper reports the process evaluation of a peer group intervention for human immunodeficiency virus (HIV) prevention which had positive outcomes for three target groups in Malawi: rural adults, adolescents and urban hospital workers. The six-session intervention was delivered to small groups of 10-12 participants by 85 trained volunteer peer…

  13. Community-based HIV/AIDS interventions to promote psychosocial well-being among people living with HIV/AIDS: a literature review

    PubMed Central

    Wu, Liyun; Li, Xiaoming

    2013-01-01

    Background: This review explores the current community-based psychosocial interventions among people living with HIV/AIDS (PLWHA) across the globe. Methods: Evaluation studies were retrieved and reviewed regarding study location, characteristics of participants, study design, intervention strategies, outcome indicators, and intervention findings. Results: The 28 studies spanned a broad range of intervention strategies, including coping skills, treatment and cure, cultural activities, community involvement, knowledge education, voluntary counseling and testing, peer-group support, three-layered service provision, child-directed group intervention, adult mentoring, and support group interventions. Regardless of study designs, all studies reported positive intervention effects, ranging from a reduction in HIV/AIDS stigma, loneliness, marginalization, distress, depression, anger, and anxiety to an increase in self-esteem, self-efficacy, coping skills, and quality of life. Conclusion: Although the existing studies have limitation with regard to program coverage, intensity, scope, and methodological challenges, they underscore the importance of developing community-based interventions to promote psychosocial well-being among PLWHA. Future studies need to employ more rigorous methodology and integrate contextual and institutional factors when implementing effective interventions. PMID:25264499

  14. A Systematic Review of Interventions to Reduce Maternal Mortality among HIV-Infected Pregnant and Postpartum Women

    PubMed Central

    Holtz, Sara A.; Thetard, Rudi; Konopka, Sarah N.; Albertini, Jennifer; Amzel, Anouk; Fogg, Karen P.

    2015-01-01

    Background: In high-prevalence populations, HIV-related maternal mortality is high with increased mortality found among HIV-infected pregnant and postpartum women compared to their uninfected peers. The scale-up of HIV-related treatment options and broader reach of programming for HIV-infected pregnant and postpartum women is likely to have decreased maternal mortality. This systematic review synthesized evidence on interventions that have directly reduced mortality among this population. Methods: Studies published between January 1, 2003 and November 30, 2014 were searched using PubMed. Of the 1,373 records screened, 19 were included in the analysis. Results: Interventions identified through the review include antiretroviral therapy (ART), micronutrients (multivitamins, vitamin A, and selenium), and antibiotics. ART during pregnancy was shown to reduce mortality. Timing of ART initiation, duration of treatment, HIV disease status, and ART discontinuation after pregnancy influence mortality reduction. Incident pregnancy in women already on ART for their health appears not to have adverse consequences for the mother. Multivitamin use was shown to reduce disease progression while other micronutrients and antibiotics had no beneficial effect on maternal mortality. Conclusions: ART was the only intervention identified that decreased death in HIV-infected pregnant and postpartum women. The findings support global trends in encouraging initiation of lifelong ART for all HIV-infected pregnant and breastfeeding women (Option B+), regardless of their CD4+ count, as an important step in ensuring appropriate care and treatment. Global Health Implications: Maternal mortality is a rare event that highlights challenges in measuring the impact of interventions on mortality. Developing effective patient-centered interventions to reduce maternal morbidity and mortality, as well as corresponding evaluation measures of their impact, requires further attention by policy makers

  15. An HIV Intervention Tailored for Black Young Men Who Have Sex with Men in the House Ball Community

    PubMed Central

    Hosek, Sybil G.; Lemos, Diana; Hotton, Anna L.; Fernandez, M. Isabel; Telander, Kyle; Bell, Margo; Footer, Dana

    2014-01-01

    Black young men who have sex with men (BYMSM) are the group most disproportionately impacted by HIV in the United States and most in need of efficacious interventions to address community-level factors that increase their vulnerability to HIV. The House Ball Community (HBC) is a distinct social network within the larger BYMSM community that may be particularly vulnerable to social norms and stigma around HIV. This study tailored an evidence-based, community-level popular opinion leader (OL) intervention for use within the HBC. The intervention, called POSSE, was then piloted to evaluate feasibility, acceptability and preliminary efficacy. Recruiting opinion leaders from the community and training them to deliver risk reduction messages was found to be feasible and highly acceptable. Community-level surveys (n=406) were completed over 5 waves of data collection. Overall exposure to the intervention increased across waves. Statistically significant (p < .05) declines were observed for multiple sexual partners, condomless anal intercourse with any male partners and with male partners of unknown HIV status. HIV stigma declined as well, but the trend was not statistically significant. PMID:25300319

  16. An HIV intervention tailored for black young men who have sex with men in the House Ball Community.

    PubMed

    Hosek, Sybil G; Lemos, Diana; Hotton, Anna L; Fernandez, M Isabel; Telander, Kyle; Footer, Dana; Bell, Margo

    2015-01-01

    Black young men who have sex with men (BYMSM) are the group most disproportionately impacted by HIV in the USA and most in need of efficacious interventions to address community-level factors that increase their vulnerability to HIV. The House Ball Community (HBC) is a distinct social network within the larger BYMSM community that may be particularly vulnerable to social norms and stigma around HIV. This study tailored an evidence-based, community-level popular opinion leader (OL) intervention for use within the HBC. The intervention, called Promoting Ovahness through Safer Sex Education (POSSE), was then piloted to evaluate feasibility, acceptability, and preliminary efficacy. Recruiting OLs from the community and training them to deliver risk reduction messages were found to be feasible and highly acceptable. Community-level surveys (n = 406) were completed over five waves of data collection. Overall exposure to the intervention increased across waves. Statistically significant (p < .05) declines were observed for multiple sexual partners, condomless anal intercourse with any male partners, and with male partners of unknown HIV status. HIV stigma declined as well, but the trend was not statistically significant. PMID:25300319

  17. A Pilot Trial of a Sexual Health Counseling Intervention for HIV-Positive Gay and Bisexual Men Who Report Anal Sex without Condoms

    PubMed Central

    Hart, Trevor A.; Stratton, Natalie; Coleman, Todd A.; Wilson, Holly A.; Simpson, Scott H.; Julien, Rick E.; Adam, Barry D.

    2016-01-01

    Background Even in the presence of promising biomedical treatment as prevention, HIV incidence among men who have sex with men has not always decreased. Counseling interventions, therefore, continue to play an important role in reducing HIV sexual transmission behaviors among gay and bisexual men and other men who have sex with men. The present study evaluated effects of a small-group counseling intervention on psychosocial outcomes and HIV sexual risk behavior. Method HIV-positive (HIV+) peer counselors administered seven 2-hour counseling sessions to groups of 5 to 8 HIV+ gay and bisexual men. The intervention employed information provision, motivational interviewing, and behavioral skills building to reduce sexual transmission risk behaviors. Results There was a significant reduction in condomless anal sex (CAS) with HIV-negative and unknown HIV-status partners, from 50.0% at baseline to 28.9% of the sample at 3-month follow-up. Findings were robust even when controlling for whether the participant had an undetectable viral load at baseline. Significant reductions were also found in the two secondary psychosocial outcomes, loneliness and sexual compulsivity. Conclusions The findings provide preliminary evidence that this intervention may offer an efficient way of concurrently reducing CAS and mental health problems, such as sexual compulsivity and loneliness, for HIV+ gay and bisexual men. Trial Registration ClinicalTrials.gov NCT02546271 PMID:27054341

  18. Theoretical Foundations of Research Focused on HIV Prevention Among Substance-Involved Women: A Review of Observational and Intervention Studies.

    PubMed

    Auerbach, Judith D; Smith, Laramie R

    2015-06-01

    Although substance use continues to be a significant component of HIV risk among women worldwide, to date, relatively little attention has been paid in research, services, or policy to substance-involved women (SIW). HIV acquisition for SIW stems from transmission risks directly related to substance use and risks associated with sexual activity in which power to negotiate risk and safety are influenced by dynamics of male partnerships, sex work, and criminalization (of both drug use and sex work), among other factors. As such, HIV risk for SIW resides as much in the environment—physical, social, cultural, economic, and political—in which drug use occurs as it does from transmission-related behaviors of individual women. To reduce HIV infections among SIW, it is important to specify the interaction of individual- and environmental-level factors, including, but not limited to those related to women's own substance use, that can and ought to be changed. This involves theorizing about the interplay of gender, substance use, and HIV risk, and incorporating that theoretical understanding into intervention design and evaluation. A review of the published literature focused on HIV prevention among SIW revealed a general lack of theoretical and conceptual foundation specific to the gender-related and environmental drivers of HIV in this population. Greater theoretical linkages to intersectionality and syndemic approaches are recommended to better identify and target relevant mechanisms by which the interplay of gender dynamics and substance use potentiate the likelihood of HIV acquisition and transmission among SIW. PMID:25978481

  19. Multilevel perspectives on community intervention: an example from an Indo-US HIV prevention project in Mumbai, India.

    PubMed

    Schensul, Stephen L; Saggurti, Niranjan; Singh, Rajendra; Verma, Ravi K; Nastasi, Bonnie K; Mazumder, Papiya Guha

    2009-06-01

    This paper explores the meaning and applicability of multilevel interventions and the role of ethnography in identifying intervention opportunities and accounting for research design limitations. It utilizes as a case example the data and experiences from a 6-year, NIMH-funded, intervention to prevent HIV/STI among married men in urban poor communities in Mumbai, India. The experiences generated by this project illustrate the need for multilevel interventions to include: (1) ethnographically driven formative research to delineate appropriate levels, stakeholders and collaborators; (2) identification of ways to link interventions to the local culture and community context; (3) the development of a model of intervention that is sufficiently flexible to be consistently applied to different intervention levels using comparable culturally congruent concepts and approaches; (4) mechanisms to involve community residents, community based organizations and community-based institutions; and (5) approaches to data collection that can evaluate the impact of the project on multiple intersecting levels. PMID:19357946

  20. Determining the Cost-Savings Threshold for HIV Adherence Intervention Studies for Persons with Serious Mental Illness and HIV.

    PubMed

    Wu, Evan S; Rothbard, Aileen; Holtgrave, David R; Blank, Michael B

    2016-05-01

    Persons with serious mental illnesses are at increased risk for contracting and transmitting HIV and often have poor adherence to medication regimens. Determining the economic feasibility of different HIV adherence interventions among individuals with HIV and serious mental illness is important for program planners who must make resource allocation decisions. The goal of this study was to provide a methodology to estimate potential cost savings from an HIV medication adherence intervention program for a new study population, using data from prior published studies. The novelty of this approach is the way CD4 count data was used as a biological marker to estimate costs averted by greater adherence to anti-retroviral treatment. Our approach is meant to be used in other adherence intervention studies requiring cost modeling. PMID:25535041

  1. AFRICAN-AMERICAN AND HISPANIC-AMERICAN ADOLESCENTS, HIV INFECTION, AND PREVENTIVE INTERVENTION

    PubMed Central

    Schinke, Steven P.; Botvin, Gilbert J.; Orlandi, Mario A.; Schilling, Robert F.; Gordon, Adam N.

    2010-01-01

    This paper considers strategies for preventing human immunodeficiency virus (HIV) infection among African-American and Hispanic-American adolescents. We describe culturally sensitive interventions based on social learning theory. The interventions combine elements of cognitive-behavioral skills for problem solving, coping, and interpersonal communication with elements of ethnic pride and HIV facts. The paper discusses the strengths and limitations of skills intervention for AIDS prevention and concludes with directions for research. PMID:2288812

  2. A Community "Hub" Network Intervention for HIV Stigma Reduction: A Case Study.

    PubMed

    Prinsloo, Catharina D; Greeff, Minrie

    2016-01-01

    We describe the implementation of a community "hub" network intervention to reduce HIV stigma in the Tlokwe Municipality, North West Province, South Africa. A holistic case study design was used, focusing on community members with no differentiation by HIV status. Participants were recruited through accessibility sampling. Data analyses used open coding and document analysis. Findings showed that the HIV stigma-reduction community hub network intervention successfully activated mobilizers to initiate change; lessened the stigma experience for people living with HIV; and addressed HIV stigma in a whole community using a combination of strategies including individual and interpersonal levels, social networks, and the public. Further research is recommended to replicate and enhance the intervention. In particular, the hub network system should be extended, the intervention period should be longer, there should be a stronger support system for mobilizers, and the multiple strategy approach should be continued on individual and social levels. PMID:26627447

  3. HIV prevention for South African youth: which interventions work? A systematic review of current evidence

    PubMed Central

    2010-01-01

    Background In South Africa, HIV prevalence among youth aged 15-24 is among the world's highest. Given the urgent need to identify effective HIV prevention approaches, this review assesses the evidence base for youth HIV prevention in South Africa. Methods Systematic, analytical review of HIV prevention interventions targeting youth in South Africa since 2000. Critical assessment of interventions in 4 domains: 1) study design and outcomes, 2) intervention design (content, curriculum, theory, adaptation process), 3) thematic focus and HIV causal pathways, 4) intervention delivery (duration, intensity, who, how, where). Results Eight youth HIV prevention interventions were included; all were similar in HIV prevention content and objectives, but varied in thematic focus, hypothesised causal pathways, theoretical basis, delivery method, intensity and duration. Interventions were school- (5) or group-based (3), involving in- and out-of-school youth. Primary outcomes included HIV incidence (2), reported sexual risk behavior alone (4), or with alcohol use (2). Interventions led to reductions in STI incidence (1), and reported sexual or alcohol risk behaviours (5), although effect size varied. All but one targeted at least one structural factor associated with HIV infection: gender and sexual coercion (3), alcohol/substance use (2), or economic factors (2). Delivery methods and formats varied, and included teachers (5), peer educators (5), and older mentors (1). School-based interventions experienced frequent implementation challenges. Conclusions Key recommendations include: address HIV social risk factors, such as gender, poverty and alcohol; target the structural and institutional context; work to change social norms; and engage schools in new ways, including participatory learning. PMID:20187957

  4. Interventions to modify sexual risk behaviours for preventing HIV in homeless youth

    PubMed Central

    Naranbhai, Vivek; Karim, Quarraisha Abdool; Meyer-Weitz, Anna

    2013-01-01

    Background Homeless youth are at high risk for HIV infection as a consequence of risky sexual behavior. Interventions in homeless youth are challenging. Assessment of the effectiveness of interventions to modify sexual risk behaviours for preventing HIV in homeless youth is needed. Objectives To evaluate and summarize the effectiveness of interventions for modifying sexual risk behaviours and preventing transmission of HIV among homeless youth. Search methods We searched electronic databases (CENTRAL, Medline, EMBASE, AIDSearch, Gateway, PsycInfo, LILACS), reference lists of eligible articles, international health agency publication lists, and clinical trial registries. The search was updated January 2010. We contacted authors of published reports and other key role players. Selection criteria Randomized studies of interventions to modify sexual risk behavior (biological, self-report sexual-risk behavior or health seeking behavior) in homeless youth (12–24 years). Data collection and analysis Data from eligible studies were extracted by two reviewers. We assessed risk of bias per the Cochrane Collaborations tool. None of the eligible studies reported any primary biological outcomes for this review and the reporting of self-report sexual risk behavior outcomes was highly variable across studies precluding calculation of summary measures of effect; we present the outcomes descriptively for each study. We contacted authors for missing or ambiguous data. Results We identified three eligible studies after screening a total of 255 unique records. All three were performed in the United States of America and recruited substance-abusing male and female adolescents (total N=615) through homeless shelters into randomised controlled trials of independent and non-overlapping behavioural interventions. The three trials differed in theoretical background, delivery method, dosage (number of sessions,) content and outcome assessments. Overall, the variability in delivery and

  5. Development of an mHealth Intervention (iSTEP) to Promote Physical Activity among People Living with HIV.

    PubMed

    Montoya, Jessica L; Wing, David; Knight, Adam; Moore, David J; Henry, Brook L

    2015-01-01

    A randomized controlled trial is being conducted in the United States to test the efficacy of a personalized interactive mobile health intervention (iSTEP) designed to increase physical activity (PA) and improve neurocognitive functioning among HIV-positive persons. This article describes an initial qualitative study performed to develop iSTEP for the HIV-positive population, including assessment of PA barriers and facilitators. Two focus groups, with 9 and 12 unique HIV-positive individuals, respectively, were administered to evaluate barriers limiting PA and potential iSTEP content created to encourage greater PA. Group discussions revealed prominent PA barriers, including HIV symptoms (neuropathy, lipoatrophy), antiretroviral medication effects, and fatigue; significant PA facilitators included self-monitoring and family support. Participants provided feedback on strategies to increase PA and expressed positive support for a mobile intervention adapted to personal priorities. These findings will assist the development of novel PA interventions focused on treating the epidemic of HIV-associated neurocognitive disorders. PMID:26307212

  6. Text-Messaging-Enhanced HIV Intervention for African American Adolescents: A Feasibility Study

    PubMed Central

    Cornelius, Judith B.; Dmochowski, Jacek; Boyer, Cherrie; St Lawrence, Janet; Lightfoot, Marguerita; Moore, Michael

    2013-01-01

    We examined the feasibility and acceptability of an HIV prevention intervention for African American adolescents delivered via mobile cell phones and looked at intervention-related changes in beliefs and sexual behaviors. We used a longitudinal one-group comparison design with data collected at three points. Forty adolescents, 13–18 years old, participated in the Becoming a Responsible Teen intervention followed by the delivery of daily multimedia messages for 3 months. The mobile-cell-phone enhanced intervention was feasible and acceptable to the participants. Greater HIV knowledge, improved attitudes toward condoms, and increased perceived HIV risk scores were observed with older adolescents (16–18 years old). Behavior trends showed a decrease in the number of times participants reported engaging in unprotected sexual intercourse over the previous 2 months. Mobile-cell-phone multimedia-text-messaging boosters tested in this study provided preliminary evidence of efficacy of the enhanced HIV prevention intervention for African American youth. PMID:23122907

  7. Effectiveness of an HIV risk reduction counseling intervention for out-of-treatment drug users.

    PubMed

    Kotranski, L; Semaan, S; Collier, K; Lauby, J; Halbert, J; Feighan, K

    1998-02-01

    This study examined and compared the effectiveness of two counseling interventions designed to reduce the HIV drug and sexual risk behaviors of 684 out-of-treatment drug users recruited from South Philadelphia, PA. All study participants received a standard intervention and one half were randomly assigned to also receive the enhanced intervention. The standard intervention provided HIV risk reduction education, HIV testing with pretest and posttest counseling, and training in condom use and needle cleaning. The enhanced intervention provided additional information on STD risk reduction. Both interventions were effective in influencing behavior change between baseline and 6-month follow-up. A higher proportion of persons reduced their drug risk behaviors compared to their sexual risk behaviors. As sexual risk behaviors are more resistant to change, there is a need for tailored interventions that target out-of-treatment drug users. PMID:9505096

  8. Feasibility Analysis of an Evidence-Based Positive Prevention Intervention for Youth Living with HIV/AIDS in Kinshasa, Democratic Republic of the Congo

    ERIC Educational Resources Information Center

    Parker, L.; Maman, S.; Pettifor, A.; Chalachala, J. L.; Edmonds, A.; Golin, C. E.; Moracco, K.; Behets, F.

    2013-01-01

    We evaluated the feasibility of a Positive Prevention intervention adapted for youth living with HIV/AIDS (YLWH) ages 15-24 in Kinshasa, Democratic Republic of the Congo. We conducted in-depth interviews and focus group discussions with intervention facilitators and YLWH participants on the following four areas of a feasibility framework:…

  9. Developing a Culturally Appropriate HIV and Hepatitis C Prevention Intervention for Latino Criminal Justice Clients.

    PubMed

    Ibañez, Gladys E; Whitt, Elaine; Rosa, Mario de la; Martin, Steve; O'Connell, Daniel; Castro, Jose

    2016-07-01

    The population within the criminal justice system suffers from various health disparities including HIV and hepatitis C virus (HCV). African American and Latino offenders represent the majority of the offender population. Evidence-based interventions to prevent HIV and HCV among criminal justice clients are scant and usually do not take cultural differences into account. Toward this end, this study describes the process of culturally adapting an HIV/HCV prevention intervention for Latino criminal justice clients in Miami, Florida, by using the ecological validity model. Recommendations for culturally adapting an intervention for Latinos include an emphasis on language and integrating cultural themes such as familism and machismo. PMID:27302706

  10. Replicating a Teen HIV/STD Preventive Intervention in a Multicultural City

    ERIC Educational Resources Information Center

    Morrison, Diane M.; Hoppe, Marilyn J.; Wells, Elizabeth A.; Beadnell, Blair A.; Wilsdon, Anthony; Higa, Darrel; Gillmore, Mary Rogers; Casey, Erin A.

    2007-01-01

    Although there are now several adolescent HIV and STD preventive interventions of demonstrated efficacy in the literature, little is understood about the portability of these interventions. This study replicated Stanton's Focus on Kids intervention, developed for inner city African American adolescents, in a different population, transferring it…

  11. Evaluation of large-scale combination HIV prevention programs: essential issues.

    PubMed

    Padian, Nancy S; McCoy, Sandra I; Manian, Shanthi; Wilson, David; Schwartländer, Bernhard; Bertozzi, Stefano M

    2011-10-01

    HIV prevention research has shifted to the evaluation of combination prevention programs whereby biomedical, behavioral, and structural interventions are implemented concurrently to maximize synergies among interventions. However, these kinds of combination prevention packages, particularly when implemented at scale, pose significant evaluation challenges, including how best to determine impact and how and whether to measure the effectiveness of component strategies. In addition, methodological challenges unique to HIV infection such as the absence of a reliable incidence assay, the lack of naive control groups, and no suitable surrogates further complicate rigorous evaluation. In this commentary, we discuss the key considerations for planning impact evaluations of combination HIV prevention programs in light of these challenges, including defining the evaluable package, determining which component programs require independent assessment of impact, choosing study designs with valid counterfactuals, selecting appropriate outcomes of interest, and the importance of mid-course program corrections. PMID:21694607

  12. Interventions targeting sexual and reproductive health and rights outcomes of young people living with HIV: a comprehensive review of current interventions from sub-Saharan Africa

    PubMed Central

    Pretorius, Leandri; Gibbs, Andrew; Crankshaw, Tamaryn; Willan, Samantha

    2015-01-01

    Background A growing number of young people (ages 10–24) are living with HIV (YPLWH) in sub-Saharan Africa (SSA). These YPLWH have particular needs and challenges related to their sexual and reproductive health and rights (SRHR). Contextual factors including gender inequalities, violence, stigma, and discrimination and lack of tailored services undermine YPLWH's SRHR. Objective Understand the scope and impact of interventions targeting YPLWH to improve SRH-related outcomes in SSA. Design We undertook a review to synthesise evaluated interventions (qualitative, quantitative, or mixed methods) aimed at improving the SRH outcomes of YPLWH in SSA with outcomes based on a World Health Organization framework of comprehensive SRHR approaches for women living with HIV. Using inclusion criteria, only six interventions were identified. Results Interventions sought to improve a range of direct and indirect SRH outcomes, including sexual behaviour, adherence, disclosure, and mental health. Four overarching issues emerged: 1) all interventions were structured according to cognitive behavioural therapy theories of behaviour change – while showing promise they do not tackle the wider gender, social, and economic contexts that shape YPLWH's SRH; 2) ‘significant others’ were included in two of the interventions, but further work needs to consider how to leverage parental/guardian support appropriately; 3) interventions only accessed young people who were already linked to care, participants were likely to have better SRH outcomes than those potentially more vulnerable YPLWH; and 4) none of the interventions explored the sexuality of young people. Conclusions There have been a limited number of evaluated interventions to strengthen SRH of YPLWH in SSA, and gaps exist in addressing the SRHR needs of YPLWH. Intervention approaches require greater scope and depth, including the need to address structural and contextual challenges. PMID:26534721

  13. An intervention to support HIV pre-exposure prophylaxis (PrEP) adherence in HIV serodiscordant couples in Uganda

    PubMed Central

    Psaros, Christina; Haberer, Jessica E.; Katabira, Elly; Ronald, Allan; Tumwesigye, Elioda; Campbell, James D.; Wangisi, Jonathan; Mugwanya, Kenneth; Kintu, Alex; Enyakoit, Michael; Thomas, Katherine K.; Donnell, Deborah; Krows, Meighan; Kidoguchi, Lara; Ware, Norma; Baeten, Jared M.; Celum, Connie; Bangsberg, David R.; Safren, Steve A.

    2014-01-01

    Background Daily pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy, but adherence is required for maximum benefit. To date, there are no empirically supported PrEP adherence interventions. This manuscript describes the process of developing a PrEP adherence intervention and presents results on its impact on adherence. Methods The Partners PrEP Study was a placebo-controlled efficacy trial of daily oral tenofovir and emtricitabine/tenofovir PrEP among uninfected members of HIV serodiscordant couples. An ancillary adherence study was conducted at three study sites in Uganda. Participants with <80% adherence as measured by unannounced pill count received an additional adherence counseling intervention based on Lifesteps, an evidence-based HIV treatment adherence intervention, based on principles of cognitive-behavioral theory. Findings Of the 1,147 HIV seronegative participants were enrolled in the ancillary adherence study, 168 (14.6%) triggered the adherence intervention. Of participants triggering the intervention, 62% were male; median age was 32.5 years. The median number of adherence counseling sessions was 10. Mean adherence during the month before the intervention was 75.7%, and increased significantly to 84.1% in the month after the first intervention session (p<0.001). The most frequently endorsed adherence barriers at session one were travel and forgetting. Interpretation A PrEP adherence intervention was feasible in a clinical trial of PrEP in Uganda and PrEP adherence increased after the intervention. Future research should identify PrEP users with low adherence for enhanced adherence counseling and determine optimal implementation strategies for interventions to maximize PrEP effectiveness. PMID:24853311

  14. A Model-Based Evaluation of a Cultural Mediator Outreach Program for HIV+ Ethiopian Immigrants in Israel.

    ERIC Educational Resources Information Center

    Kaplan, Edward H.; Soskolne, Varda; Adler, Bella; Leventhal, Alex; Shtarkshall, Ronny A.

    2002-01-01

    Conducted a model-based evaluation of a program designed to reduce HIV transmission from HIV-infected Ethiopian immigrants in Israel. Focused on pregnancy rate reduction as a measure of sexual exposure. Results for 145 female and 176 male clients in the intervention suggest reduction in unprotected sexual exposures among program participants. (SLD)

  15. Formative Work and Community Engagement Approaches for Implementing an HIV Intervention in Botswana Schools.

    PubMed

    Miller, Kim S; Cham, Haddi J; Taylor, Eboni M; Berrier, Faith L; Duffy, Meghan; Vig, Jessica; Chipazi, Lily; Chakalisa, Chawada; Sidibe, Sekou; Swart, Kenau; Tau, Nontobeko Sylvia; Clark, Leslie F

    2016-08-01

    Providing adolescents with evidence-based sexual risk reduction interventions is critical to addressing the HIV/AIDS epidemic among adolescents in sub-Saharan Africa. Project AIM (Adult Identity Mentoring) is an innovative, evidence-based, youth development intervention that is being evaluated for the first time in Botswana through a 3-year (2015-2017), 50-school cluster randomized controlled trial, including testing for herpes simplex virus type 2 as a sexual activity biomarker. Conducting a trial of this magnitude requires the support and collaboration of government and community stakeholders. All school staff, including teachers, must be well informed about the study; dedicated staff placed at each school can help to improve school and community familiarity with the study, improve the information flow, and relieve some of the burden study activities places on schools. PMID:27196663

  16. How Patient Interactions with a Computer-Based Video Intervention Affect Decisions to Test for HIV

    ERIC Educational Resources Information Center

    Aronson, Ian David; Rajan, Sonali; Marsch, Lisa A.; Bania, Theodore C.

    2014-01-01

    The current study examines predictors of HIV test acceptance among emergency department patients who received an educational video intervention designed to increase HIV testing. A total of 202 patients in the main treatment areas of a high-volume, urban hospital emergency department used inexpensive netbook computers to watch brief educational…

  17. Cultural Competence in a Group Intervention Designed for Latino Patients Living with HIV/AIDS

    ERIC Educational Resources Information Center

    Acevedo, Vanessa

    2008-01-01

    Although the trajectory of the HIV/AIDS epidemic has changed dramatically over the past 25 years, addressing the psychosocial needs of patients living with HIV/AIDS remains vital. Ensuring the effective delivery of services demands that interventions be rooted in cultural competence and aimed at vulnerable populations. This article describes a…

  18. A Model Human Sexuality--HIV/AIDS Prevention and Intervention Service-Learning Program

    ERIC Educational Resources Information Center

    Stewart, Clarence, M., Jr.

    2005-01-01

    This article deals with a service-learning program focused on human sexuality and HIV/AIDS prevention and intervention at the Howard University Department of Health, Human Performance and Leisure Studies. Topics discussed include how this program was created, an overview of peer education, HIV/AIDS peer education training, and services provided to…

  19. Straight talk: HIV prevention for African-American heterosexual men: theoretical bases and intervention design.

    PubMed

    Frye, Victoria; Bonner, Sebastian; Williams, Kim; Henny, Kirk; Bond, Keosha; Lucy, Debbie; Cupid, Malik; Smith, Stephen; Koblin, Beryl A

    2012-10-01

    In the United States, racial disparities in HIV/AIDS are stark. Although African Americans comprise an estimated 14% of the U.S. population, they made up 52% of new HIV cases among adults and adolescents diagnosed in 2009. Heterosexual transmission is now the second leading cause of HIV in the United States. African Americans made up a full two-thirds of all heterosexually acquired HIV/AIDS cases between 2005 and 2008. Few demonstrated efficacious HIV prevention interventions designed specifically for adult, African-American heterosexual men exist. Here, we describe the process used to design a theory-based HIV prevention intervention to increase condom use, reduce concurrent partnering, and increase HIV testing among heterosexually active African-American men living in high HIV prevalence areas of New York City. The intervention integrated empowerment, social identity, and rational choices theories and focused on four major content areas: HIV/AIDS testing and education; condom skills training; key relational and behavioral turning points; and masculinity and fatherhood. PMID:23016501

  20. Straight Talk: HIV Prevention for African-American Heterosexual Men: Theoretical Bases and Intervention Design

    PubMed Central

    Frye, Victoria; Bonner, Sebastian; Williams, Kim; Henny, Kirk; Bond, Keosha; Lucy, Debbie; Cupid, Malik; Smith, Stephen; Koblin, Beryl A.

    2016-01-01

    In the United States, racial disparities in HIV/AIDS are stark. Although African Americans comprise an estimated 14% of the U.S. population, they made up 52% of new HIV cases among adults and adolescents diagnosed in 2009. Heterosexual transmission is now the second leading cause of HIV in the United States. African Americans made up a full two-thirds of all heterosexually acquired HIV/AIDS cases between 2005 and 2008. Few demonstrated efficacious HIV prevention interventions designed specifically for adult, African-American heterosexual men exist. Here, we describe the process used to design a theory-based HIV prevention intervention to increase condom use, reduce concurrent partnering, and increase HIV testing among heterosexually active African-American men living in high HIV prevalence areas of New York City. The intervention integrated empowerment, social identity, and rational choices theories and focused on four major content areas: HIV/AIDS testing and education; condom skills training; key relational and behavioral turning points; and masculinity and fatherhood. PMID:23016501

  1. An intervention to decrease intravaginal practices in hiv-infected women in Zambia: a pilot study.

    PubMed

    Alcaide, Maria L; Mumbi, Miriam; Chitalu, Ndashi; Jones, Deborah L

    2013-01-01

    Intravaginal practices (IVP) are those in which women introduce products inside the vagina for hygienic, health, or sexuality reasons. IVP are associated with bacterial vaginosis (BV) and potentially implicated in HIV transmission. This report presents the results of a pilot study of a behavioral intervention to decrease IVP in HIV-infected women in Zambia. At baseline, all of the enrolled women (n =40) engaged in IVP and rates of BV were high. Women receiving the intervention reported a decrease of the insertion of water and cloths inside the vagina. Communication with sexual partners regarding IVP was higher for women receiving the intervention. Results from this study suggest that a behavioral intervention could decrease IVP in HIV-infected women in Zambia and this may have an impact in decreasing HIV transmission from women to sexual partners and newborns. PMID:23340240

  2. The cost and cost-effectiveness of gender-responsive interventions for HIV: a systematic review

    PubMed Central

    Remme, Michelle; Siapka, Mariana; Vassall, Anna; Heise, Lori; Jacobi, Jantine; Ahumada, Claudia; Gay, Jill; Watts, Charlotte

    2014-01-01

    Introduction Harmful gender norms and inequalities, including gender-based violence, are important structural barriers to effective HIV programming. We assess current evidence on what forms of gender-responsive intervention may enhance the effectiveness of basic HIV programmes and be cost-effective. Methods Effective intervention models were identified from an existing evidence review (“what works for women”). Based on this, we conducted a systematic review of published and grey literature on the costs and cost-effectiveness of each intervention identified. Where possible, we compared incremental costs and effects. Results Our effectiveness search identified 36 publications, reporting on the effectiveness of 22 HIV interventions with a gender focus. Of these, 11 types of interventions had a corresponding/comparable costing or cost-effectiveness study. The findings suggest that couple counselling for the prevention of vertical transmission; gender empowerment, community mobilization, and female condom promotion for female sex workers; expanded female condom distribution for the general population; and post-exposure HIV prophylaxis for rape survivors are cost-effective HIV interventions. Cash transfers for schoolgirls and school support for orphan girls may also be cost-effective in generalized epidemic settings. Conclusions There has been limited research to assess the cost-effectiveness of interventions that seek to address women's needs and transform harmful gender norms. Our review identified several promising, cost-effective interventions that merit consideration as critical enablers in HIV investment approaches, as well as highlight that broader gender and development interventions can have positive HIV impacts. By no means an exhaustive package, these represent a first set of interventions to be included in the investment framework. PMID:25373519

  3. Impact of ASUMA Intervention on HIV Risk Behaviors among Puerto Rican Adolescents

    PubMed Central

    Fernandez-Santos, Diana M.; Miranda-Diaz, Christine; Figueroa-Cosme, Wanda I.; Ramon, Raul O.; Mayor, Angel M.; Rios-Olivares, Eddy; Hunter-Mellado, Robert F.

    2015-01-01

    The purpose of this manuscript is to assess and compare HIV risk behaviors among early adolescents after a three-year pilot study. A total of 135 public and private junior high schools students completed the intervention protocol. A self-administered questionnaire was given at baseline and at the end of the third year (fourth measure). Descriptive and inferential analyses were performed using SPSS 20.0. About 60% of the students were 14 years old at the fourth measure. The proportion of students that did not report at least one HIV risk behavior at baseline and those that reported any risk behavior at the fourth measure was lower in the intervention group (45.0%) than in the control group (54.5%). The proportion of students that reported at least one HIV risk behavior at baseline and those that did not report any HIV risk behavior at the fourth measure was higher in the intervention group than in the control group (33.3% vs. 8.3%). The proportion of students engaging in HIV risk behaviors was higher in the control group than in the intervention group at the fourth measure, suggesting that A Supportive Model for HIV Risk Reduction in Early Adolescence (ASUMA) intervention might be a promising initiative to reduce adolescents’ engagement in HIV risk behaviors. PMID:26703684

  4. Impact of ASUMA Intervention on HIV Risk Behaviors among Puerto Rican Adolescents.

    PubMed

    Fernandez-Santos, Diana M; Miranda-Diaz, Christine; Figueroa-Cosme, Wanda I; Ramon, Raul O; Mayor, Angel M; Rios-Olivares, Eddy; Hunter-Mellado, Robert F

    2016-01-01

    The purpose of this manuscript is to assess and compare HIV risk behaviors among early adolescents after a three-year pilot study. A total of 135 public and private junior high schools students completed the intervention protocol. A self-administered questionnaire was given at baseline and at the end of the third year (fourth measure). Descriptive and inferential analyses were performed using SPSS 20.0. About 60% of the students were 14 years old at the fourth measure. The proportion of students that did not report at least one HIV risk behavior at baseline and those that reported any risk behavior at the fourth measure was lower in the intervention group (45.0%) than in the control group (54.5%). The proportion of students that reported at least one HIV risk behavior at baseline and those that did not report any HIV risk behavior at the fourth measure was higher in the intervention group than in the control group (33.3% vs. 8.3%). The proportion of students engaging in HIV risk behaviors was higher in the control group than in the intervention group at the fourth measure, suggesting that A Supportive Model for HIV Risk Reduction in Early Adolescence (ASUMA) intervention might be a promising initiative to reduce adolescents' engagement in HIV risk behaviors. PMID:26703684

  5. The START Study to evaluate the effectiveness of a combination intervention package to enhance antiretroviral therapy uptake and retention during TB treatment among TB/HIV patients in Lesotho: rationale and design of a mixed-methods, cluster-randomized trial

    PubMed Central

    Howard, Andrea A.; Hirsch-Moverman, Yael; Frederix, Koen; Daftary, Amrita; Saito, Suzue; Gross, Tal; Wu, Yingfeng; Maama, Llang Bridget

    2016-01-01

    Background Initiating antiretroviral therapy (ART) early during tuberculosis (TB) treatment increases survival; however, implementation is suboptimal. Implementation science studies are needed to identify interventions to address this evidence-to-program gap. Objective The Start TB Patients on ART and Retain on Treatment (START) Study is a mixed-methods, cluster-randomized trial aimed at evaluating the effectiveness, cost-effectiveness, and acceptability of a combination intervention package (CIP) to improve early ART initiation, retention, and TB treatment success among TB/HIV patients in Berea District, Lesotho. Design Twelve health facilities were randomized to receive the CIP or standard of care after stratification by facility type (hospital or health center). The CIP includes nurse training and mentorship, using a clinical algorithm; transport reimbursement and health education by village health workers (VHW) for patients and treatment supporters; and adherence support using text messaging and VHW. Routine data were abstracted for all newly registered TB/HIV patients; anticipated sample size was 1,200 individuals. A measurement cohort of TB/HIV patients initiating ART was recruited; the target enrollment was 384 individuals, each to be followed for the duration of TB treatment (6–9 months). Inclusion criteria were HIV-infected; on TB treatment; initiated ART within 2 months of TB treatment initiation; age ≥18; English- or Sesotho-speaking; and capable of informed consent. The exclusion criterion was multidrug-resistant TB. Three groups of key informants were recruited from intervention clinics: early ART initiators; non/late ART initiators; and health care workers. Primary outcomes include ART initiation, retention, and TB treatment success. Secondary outcomes include time to ART initiation, adherence, change in CD4+ count, sputum smear conversion, cost-effectiveness, and acceptability. Follow-up and data abstraction are complete. Discussion The START

  6. Pilot Testing an Internet-Based STI and HIV Prevention Intervention With Chilean Women

    PubMed Central

    Villegas, Natalia; Santisteban, Daniel; Cianelli, Rosina; Ferrer, Lilian; Ambrosia, Todd; Peragallo, Nilda; Lara, Loreto

    2015-01-01

    Purpose The incidence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is high among young Chilean women, and there are no STI or HIV prevention interventions available to them that incorporate technology. The purpose of this study was to investigate the preliminary efficacy of an Internet-based STI and HIV prevention intervention (I-STIPI) for Chilean young women on measures of STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors. Design This is a pretest-posttest study. Forty young Chilean women between 18 and 24 years of age participated in an investigation of the I-STIPI’s preliminary efficacy on STI and HIV prevention-related outcomes between baseline and a postintervention assessment. The intervention consisted of four online modules. Data collection was conducted in Santiago, Chile. Paired-samples t test analysis was used to determine whether there were significant differences in each of the outcome variables. Findings After receiving I-STIPI, women reported a significant increase in levels of STI- and HIV-related knowledge, attitudes toward the use of condoms and perceived self-efficacy, and a reduction of risky sexual behaviors with uncommitted partners. Conclusions The I-STIPI showed promise as an Internet-based intervention that can reduce barriers to accessing preventive interventions and increase STI and HIV preventive behaviors in young Chilean women. Clinical Relevance The study provided important information about the ability of an Internet-based intervention to reduce young women’s risk factors and to provide positive preliminary efficacy on STI- and HIV-related outcomes. Internet-based interventions can eliminate many barriers to receiving prevention interventions and may prove to be cost effective. PMID:25410132

  7. Empowering patients to link to care and treatment: qualitative findings about the role of a home-based HIV counselling, testing and linkage intervention in South Africa.

    PubMed

    Knight, Lucia C; Van Rooyen, Heidi; Humphries, Hilton; Barnabas, Ruanne V; Celum, Connie

    2015-01-01

    To explore the barriers and facilitators of linkage to and retention in care amongst persons who tested positive for HIV, qualitative research was conducted in a home-based HIV counselling and testing (HBCT) project with interventions to facilitate linkages to HIV care in rural KwaZulu-Natal, South Africa. The intervention tested 1272 adults for HIV in Vulindlela of whom 32% were HIV positive, received point-of-care (POC) CD4 testing and referral to local HIV clinics. Those testing positive also received follow-up visits from a counsellor to evaluate linkages to care. The study employed a qualitative methodology collecting data through in-depth semi-structured interviews. Respondents included 25 HIV-positive persons who had tested as part of HBCT project, 4 intervention research counsellors who delivered the HBCT intervention and 9 government clinic staff who received referrals for care. The results show that HBCT helped to facilitate linkage to care through providing education and support to help overcome fears of stigma and discrimination. The results show the perceived value of receiving a POC CD4 result during post-test counselling, both for those newly diagnosed and those previously diagnosed as HIV positive. The results also demonstrate that in-depth counselling creates an "educated consumer" facilitating engagement with clinical services. The study provides qualitative insights into the acceptability of confidential HBCT with same day POC CD4 testing and counselling as factors that influenced HIV-positive persons' decisions to link to care. This model warrants further evaluation in non-research settings to determine impact and cost-effectiveness relative to other HIV testing and referral strategies. PMID:25923366

  8. Interventions to Address HIV and Intimate Partner Violence in Sub-Saharan Africa: A Review of the Literature

    PubMed Central

    Anderson, Jocelyn C.; Campbell, Jacquelyn C.; Farley, Jason E.

    2013-01-01

    HIV and intimate partner violence (IPV) are commonly co-occurring epidemics affecting the health of women globally and especially in sub-Saharan Africa. There is a need for interventions that address both HIV and IPV in health care settings. Our review examined recent literature for intervention studies that explored both HIV and IPV. Of the 9 interventions identified, only 2 were set in health care settings; the remainder were community based. Large multifaceted community-based interventions showed promise in the areas of addressing social norms in order to empower women. Educational interventions have shown short-term improvements in HIV-related knowledge and behavioral intention. Further research is needed to examine brief screening, intervention, and referral for HIV and IPV services within health care settings. Health care-specific interventions such as use of pre-exposure and post-exposure prophylaxis to prevent HIV transmission must also be studied in the context of IPV. PMID:23790280

  9. Effects of a Pilot Church-Based Intervention to Reduce HIV Stigma and Promote HIV Testing Among African Americans and Latinos.

    PubMed

    Derose, Kathryn P; Griffin, Beth Ann; Kanouse, David E; Bogart, Laura M; Williams, Malcolm V; Haas, Ann C; Flórez, Karen R; Collins, Deborah Owens; Hawes-Dawson, Jennifer; Mata, Michael A; Oden, Clyde W; Stucky, Brian D

    2016-08-01

    HIV-related stigma and mistrust contribute to HIV disparities. Addressing stigma with faith partners may be effective, but few church-based stigma reduction interventions have been tested. We implemented a pilot intervention with 3 Latino and 2 African American churches (4 in matched pairs) in high HIV prevalence areas of Los Angeles County to reduce HIV stigma and mistrust and increase HIV testing. The intervention included HIV education and peer leader workshops, pastor-delivered sermons on HIV with imagined contact scenarios, and HIV testing events. We surveyed congregants at baseline and 6 month follow-up (n = 1235) and found statistically significant (p < 0.05) reductions in HIV stigma and mistrust in the Latino intervention churches but not in the African American intervention church nor overall across matched African American and Latino pairs. However, within matched pairs, intervention churches had much higher rates of HIV testing (p < 0.001). Stigma reduction and HIV testing may have synergistic effects in community settings. PMID:27000144

  10. Impact of Mano a Mano Mujer, an HIV Prevention Intervention, on Depressive Symptoms among Chilean Women

    PubMed Central

    Cianelli, Rosina; Lara, Loreto; Villegas, Natalia; Bernales, Margarita; Ferrer, Lilian; Kaelber, Lorena; Peragallo, Nilda

    2012-01-01

    Background Worldwide, an in Chile, the number of women living with HIV is increasing. Depression is considered a factor that interferes with HIV prevention. Depression may reach 41% among low income Chilean women. Depressed people are less willing to participate in behaviors that protect them against HIV. Objectives To analyze the impact of Mano a Mano-Mujer (MM-M) on depressive symptoms among Chilean women. Methods A quasi-experimental design was used to test the impact of MM-M, an HIV prevention intervention. The research was conducted in Santiago- Chile, a total of 400 women participated in the study (intervention group, n = 182; control group, n = 218). The intervention was guided by the social-cognitive model and the primary health model. The intervention consists of six two-hour sessions delivered in small groups. Sessions covered: HIV prevention, depression, partner's communication, and substance abuse. Face to face interviews were conducted at baseline and at 3 months follow-up Results At 3 months post-intervention, Chilean women who participated in MM-M significantly decreased their reported depressive symptoms. Conclusions MM-M provided significant benefits for women's depression symptoms. This study offers a model that address depression, a risk factor for HIV. It uses nurses as leaders for the screening of depressive symptoms and as facilitators of community interventions. PMID:22452388

  11. Effect of home based HIV counselling and testing intervention in rural South Africa: cluster randomised trial

    PubMed Central

    Tabana, Hanani; Jackson, Debra; Naik, Reshma; Zembe, Wanga; Lombard, Carl; Swanevelder, Sonja; Fox, Matthew P; Thorson, Anna; Ekström, Anna Mia; Chopra, Mickey

    2013-01-01

    Objective To assess the effect of home based HIV counselling and testing on the prevalence of HIV testing and reported behavioural changes in a rural subdistrict of South Africa. Design Cluster randomised controlled trial. Setting 16 communities (clusters) in uMzimkhulu subdistrict, KwaZulu-Natal province, South Africa. Participants 4154 people aged 14 years or more who participated in a community survey. Intervention Lay counsellors conducted door to door outreach and offered home based HIV counselling and testing to all consenting adults and adolescents aged 14-17 years with guardian consent. Control clusters received standard care, which consisted of HIV counselling and testing services at local clinics. Main outcome measures Primary outcome measure was prevalence of testing for HIV. Other outcomes were HIV awareness, stigma, sexual behaviour, vulnerability to violence, and access to care. Results Overall, 69% of participants in the home based HIV counselling and testing arm versus 47% in the control arm were tested for HIV during the study period (prevalence ratio 1.54, 95% confidence interval 1.32 to 1.81). More couples in the intervention arm had counselling and testing together than in the control arm (2.24, 1.49 to 3.03). The intervention had broader effects beyond HIV testing, with a 55% reduction in multiple partners (0.45, 0.33 to 0.62) and a stronger effect among those who had an HIV test (0.37, 0.24 to 0.58) and a 45% reduction in casual sexual partners (0.55, 0.42 to 0.73). Conclusions Home based HIV counselling and testing increased the prevalence of HIV testing in a rural setting with high levels of stigma. Benefits also included higher uptake of couple counselling and testing and reduced sexual risk behaviour. Trial registration Current Controlled Trials ISRCTN31271935. PMID:23766483

  12. HIV Prevention Counseling Intervention Delivered During Routine Clinical Care Reduces HIV Risk Behavior in HIV-Infected South Africans Receiving Antiretroviral Therapy: The Izindlela Zokuphila/Options for Health Randomized Trial

    PubMed Central

    Fisher, Jeffrey D.; Cornman, Deborah H.; Shuper, Paul A.; Christie, Sarah; Pillay, Sandy; Macdonald, Susan; Ngcobo, Ntombenhle; Amico, K. Rivet; Lalloo, Umesh; Friedland, Gerald; Fisher, William A.

    2014-01-01

    Context Sustainable interventions are needed to minimize HIV risk behavior among people living with HIV (PLWH) in South Africa on antiretroviral therapy (ART), a significant proportion of whom do not achieve viral suppression. Objective To determine whether a brief lay counselor delivered intervention implemented during routine care can reduce risky sex among PLWH on ART. Design Cluster randomized 16 HIV clinical care sites in KwaZulu Natal, South Africa, to intervention or standard-of-care. Setting Publicly funded HIV clinical care sites. Patients 1891 PLWH on ART received the HIV prevention counseling intervention (n = 967) or standard-of-care counseling (n = 924). Intervention Lay counselors delivered a brief intervention using motivational interviewing strategies based on the Information—Motivation—Behavioral Skills (IMB) model during routine clinical care. Main Outcome Measures Number of sexual events without a condom in the past four weeks with partners of any HIV status, and with partners perceived to be HIV-negative or HIV-status unknown, assessed at baseline, 6, 12, and 18 months. Results Intervention participants reported significantly greater reductions in HIV risk behavior on both primary outcomes, compared to standard-of-care participants. Differences in STI incidence between arms were not observed. Conclusion Effective behavioral interventions, delivered by lay counselors within the clinical care setting, are consistent with the strategy of linking HIV care and HIV prevention and integrating biomedical and behavioral approaches to stemming the HIV epidemic. PMID:25230288

  13. Patterns of HIV Prevalence and HIV Risk Behaviors among Injection Drug Users Prior to and 24 Months following Implementation of Cross-Border HIV Prevention Interventions in Northern Vietnam and Southern China

    ERIC Educational Resources Information Center

    Hammett, Theodore M.; Kling, Ryan; Johnston, Patrick; Liu, Wei; Ngu, Doan; Friedmann, Patricia; Binh, Kieu Thanh; Dong, Ha Viet; Van, Ly Kieu; Donghua, Meng; Chen, Yi; Des Jarlais, Don C.

    2006-01-01

    In 2002, we implemented a 4-year HIV prevention intervention for injection drug users (IDUs) in Lang Son Province, Vietnam, and Ning Ming County, Guangxi Province, China, a cross-border region seriously affected by inter-twined epidemics of heroin injection and HIV infection. The interventions involve peer education on HIV risk reduction and…

  14. Coping Mediates Outcome Following a Randomized Group Intervention for HIV-Positive Bereaved Individuals

    PubMed Central

    Smith, Nathan Grant; Tarakeshwar, Nalini; Hansen, Nathan B.; Kochman, Arlene; Sikkema, Kathleen J.

    2013-01-01

    The purpose of this study was to examine the mechanisms responsible for the beneficial psychological effects of a coping-focused group intervention for HIV-positive individuals who had lost loved ones to AIDS. Data from 235 HIV-positive men and women enrolled in a randomized controlled clinical trial testing a coping-focused group intervention were analyzed using a multiple-indicator-multiple-cause (MIMIC) structural equation model. Results revealed that the effects of the intervention on decreases in depression and grief were mediated by decreases in avoidant coping. Specifically, participants in the intervention condition decreased their use of avoidant coping. Decreases in avoidant coping, in turn, were related to decreased depression and grief. The results of this study help to validate the use of coping-focused interventions for HIV-positive bereaved individuals. PMID:19152338

  15. Body image in women with HIV: a cross-sectional evaluation

    PubMed Central

    Huang, Jeannie S; Harrity, Shawn; Lee, Daniel; Becerra, Karen; Santos, Rosanne; Mathews, W Christopher

    2006-01-01

    Background HIV lipodystrophy syndrome is a recognized complication of potent antiretroviral therapy and is characterized by often dramatic changes in various body fat stores, both central and peripheral. Given prior findings of heightened body image dysphoria among HIV-infected men with lipodystrophy as compared to HIV-infected men without lipodystrophy, we sought to determine body image among HIV-infected and HIV-negative women and to determine the relationship of HIV and lipodystrophy with body image. Our a priori hypothesis was that women with HIV and lipodystrophy would have significantly poorer body image as compared to women without HIV and to women with HIV without lipodystrophy. Results 116 women responded to two previously validated self-report instruments (Body Image Quality of Life Index (BIQLI) and the Situational Inventory of Body-Image Dysphoria – Short Form (SIBID-S)) on body image. 62 (53% subjects) HIV-infected women were recruited at the university-based HIV clinic. 54 (47% subjects) HIV-negative female controls were recruited from another study evaluating bone density in otherwise healthy controls. 96% identified their sexual orientation as women having sex with men. Among the HIV-infected group, 36 reported the presence of lipodystrophic characteristics and 26 reported no lipodystrophic changes. Agreement regarding the presence of lipodystrophy between physician and subject was 0.67 as measured by the kappa coefficient of agreement. Compared to HIV-negative women, HIV-positive women demonstrated poor body image as measured by BIQLI (p = 0.0009). Compared with HIV-infected women who denied lipodystrophy, HIV-infected women with self-reported lipodystrophy demonstrated poor body image as measured by BIQLI (p = 0.02) and SIBID-S scales (p = 0.001). Conclusion We demonstrate that HIV and lipodystrophy status among women is associated with poor body image. Universal efforts should be made in the HIV medical community to recognize body image issues

  16. Substance Use Disorders and HIV/AIDS Prevention and Treatment Intervention: Research and Practice Considerations

    PubMed Central

    CAMPBELL, AIMEE N. C.; TROSS, SUSAN; CALSYN, DONALD A.

    2013-01-01

    Social workers are often on the front lines of the HIV/AIDS epidemic – delivering prevention education and interventions, offering or linking individuals to HIV testing, and working to improve treatment access, retention, and adherence, especially among vulnerable populations. Individuals with substance use disorders face additional challenges to reducing sexual and drug risk behaviors, as well as barriers to testing, treatment, and antiretroviral therapy adherence. This paper presents current data on HIV transmission and research evidence on prevention and intervention with substance abusers and highlights how individual social workers can take advantage of this knowledge in practice and through adoption and implementation within organizations. PMID:23731423

  17. Sustainability of Intervention Effects of an Evidence-based HIV Prevention Intervention for African American Women who Smoke Crack Cocaine*

    PubMed Central

    Wechsberg, Wendee M.; Novak, Scott P.; Zule, William A.; Browne, Felicia A.; Kral, Alex H.; Ellerson, Rachel Middlesteadt; Kline, Tracy

    2010-01-01

    Background HIV prevention intervention efficacy is often assessed in the short term. Thus, we conducted a long-term (mean 4.4 years) follow-up of a Woman-Focused HIV intervention for African American crack smokers, for which we had previously observed beneficial short-term gains. Methods 455 out-of-treatment African American women in central North Carolina participated in a randomized field experiment and were followed up to determine sustainability of intervention effects across three conditions: the Woman-Focused intervention, a modified NIDA intervention, and a delayed treatment control condition. We compared these groups in terms of HIV risk behavior at short-term follow-up (STFU; 3–6 months) and long-term follow-up (LTFU; average 4 years). Results The analyses revealed two distinct groups at STFU: women who either eliminated or greatly reduced their risk behaviors (low-risk class) and women who retained high levels of risk across multiple risk domains (high-risk class). At STFU, women in the Woman-Focused intervention were more likely to be in the low HIV-risk group than the women in control conditions, but this effect was not statistically significant at LTFU. However, low-risk participants at STFU were less likely to be retained at LTFU, and this retention rate was lowest among women in the Woman-Focused intervention. Conclusions Short-term intervention effects were not observed over four years later, possibly due to differential retention across conditions. The retention of the highest risk women presents an opportunity for extending intervention effects through the booster sessions for those who need it the most. PMID:20219294

  18. Measuring HIV Self-Management in Women Living with HIV/AIDS: A Psychometric Evaluation Study of the HIV Self-Management Scale

    PubMed Central

    Webel, Allison R.; Asher, Alice; Cuca, Yvette; Okonsky, Jennifer G.; Kaihura, Alphoncina; Rose, Carol Dawson; Hanson, Jan E.; Salata, Robert A.

    2012-01-01

    Objective To develop and validate the HIV Self-Management Scale for women, a new measure of HIV self-management, defined as the day-to-day decisions that individuals make to manage their illness. Methods The development and validation of the scale was undertaken in three phases: focus groups, expert review and psychometric evaluation. Focus groups identified items describing the process and context of self-management in women living with HIV/AIDS (WLHA). Items were refined using expert review and were then administered to WLHA in two sites in the U.S. (n=260). Validity of the scale was assessed through factor analyses, model fit statistics, reliability testing, and convergent and discriminate validity. Results The final scale consists of 3-domains with 20 items describing the construct of HIV self-management. Daily self-management health practices, Social support and HIV self-management, and Chronicity of HIV self-management comprise the three domains. These domains explained 48.6% of the total variance in the scale. The item mean scores ranged from 1.7-2.77, and each domain demonstrated acceptable reliability (0.72-0.86) and stability (0.61-0.85). Conclusions Self-management is critical for WLHA, who constitute over 50% of PLWHA and have poorer health outcomes than their male counterparts. Methods to assess the self-management behavior of WLHA are needed to enhance their health and well-being. Presently no scales exist to measure HIV self-management. Our new 20-item HIV Self-Management Scale is a valid and reliable measure of HIV self-management in this population. Differences in aspects of self-management may be related to social roles and community resources and interventions targeting these factors may decrease morbidity in WLHA. PMID:22569267

  19. Mediators of a smoking cessation intervention for persons living with HIV/AIDS

    PubMed Central

    Vidrine, Damon J.; Kypriotakis, George; Li, Liang; Arduino, Roberto C.; Fletcher, Faith E.; Tamí-Maury, Irene; Gritz, Ellen R.

    2015-01-01

    Background Cigarette smoking among persons living with HIV (PLWH) is a pressing public health concern, and efforts to evaluate cessation treatments are needed. The purpose of the present study was to assess potential mechanisms of a cell phone-delivered intervention for HIV-positive smokers. Methods Data from 350 PLWH enrolled in a randomized smoking cessation treatment trial were utilized. Participants were randomized to either usual care (UC) or a cell phone intervention (CPI) group. The independent variable of interest was treatment group membership, while the dependent variable of interest was smoking abstinence at a 3-month follow-up. The hypothesized treatment mechanisms were depression, anxiety, social support, quit motivation and self-efficacy change scores. Results Abstinence rates in the UC and CPI groups were 4.7% (8 of 172) and 15.7% (28 of 178), respectively. The CPI group (vs. UC) experienced a larger decline in depression between baseline and the 3-month follow-up, and a decline in anxiety. Self-efficacy increased for the CPI group and declined for the UC group. Quit motivation and social support change scores did not differ by treatment group. Only self-efficacy met the predefined criteria for mediation. The effect of the cell phone intervention on smoking abstinence through change in self-efficacy was statistically significant (p<.001) and accounted for 17% of the total effect of the intervention on abstinence. Conclusions The findings further emphasize the important mechanistic function of self-efficacy in promoting smoking cessation for PLWH. Additional efforts are required to disentangle the relationships between emotional, distress motivation, and efficacious smoking cessation treatment. PMID:25542824

  20. Evaluating HIV prevention strategies for populations in key affected groups: The example of Cabo Verde

    PubMed Central

    Monteiro, João Filipe G.; Galea, Sandro; Flanigan, Timothy; Monteiro, Maria de Lourdes; Friedman, Samuel R.; Marshall, Brandon DL

    2015-01-01

    Objectives We used an individual-based model to evaluate the effects of hypothetical prevention interventions on HIV incidence trajectories in a concentrated, mixed epidemic setting from 2011 to 2021, and using Cabo Verde as an example. Methods Simulations were conducted to evaluate the extent to which early HIV treatment and optimization of care, HIV testing, condom distribution, and substance abuse treatment could eliminate new infections (i.e., reduce incidence to less than 10 cases per 10,000 person-years) among non-drug users, female sex workers (FSW), and people who use drugs (PWUD). Results Scaling up all four interventions resulted in the largest decreases in HIV, with estimates ranging from 1.4 (95%CI:1.36–1.44) per 10,000 person-years among non-drug users to 8.2 (95%CI:7.8–8.6) per 10,000 person-years among PWUD in 2021. Intervention scenarios targeting FWS and PWUD also resulted in HIV incidence estimates at or below 10 per 10,000 person-years by 2021 for all population sub-groups. Conclusions Our results suggest that scaling up multiple interventions among entire population is necessary to achieve elimination. However, prioritizing key populations with this combination prevention strategy may also result in a substantial decrease in total incidence. PMID:25838121

  1. Living with HIV: Responses to a Mantram Intervention Using the Critical Incident Research Method

    PubMed Central

    Bormann, Jill E.; Shively, Martha; Kelly, Ann; Becker, Sheryl; Bone, Patricia; Belding, Wendy; Gifford, Allen L.

    2012-01-01

    Abstract Objectives The objective of this study was to identify and describe ways that a spiritually based intervention of silently repeating a mantram—sacred word or phrase—was used as a coping strategy for managing human immunodeficiency virus (HIV) disease. Design The design was a qualitative research method, the critical incident technique. Settings/location The study was conducted at an academically affiliated Veterans Affairs Hospital in southern California. Subjects The subjects were outpatient adults living with HIV (n=32) who were receiving care through HIV clinics, community agencies, and HIV providers. Interventions Subjects who participated in the intervention arm of a randomized controlled trial that tested the efficacy of a 5-weekly group mantram intervention were interviewed 2 months postintervention. Follow-up telephone interviews were specifically aimed at identifying instances of mantram use, and also participant perceptions of intervention usefulness or nonusefulness. Outcome measures The outcome measures comprised categorization and comparison of the types and frequency of incidents reported, describing ways that the intervention was “helpful” or “not helpful” in managing stressors of HIV disease. Results Participants reported a total of 185 incidents. Analysis and classification of the incidents resulted in eight mutually exclusive categories, including Increasing calm and/or peace, Mastering the technique, Changing my viewpoint, Increasing personal awareness, Adjusting behaviors, Managing physical symptoms, Increasing spirituality, and Enhancing relationships. Conclusions This study shows support for the benefits of the mantram intervention for adults with HIV. Additionally, the spiritually based mantram repetition intervention was found to be more helpful in providing a convenient, portable tool for managing a wide range of situations related to living with HIV disease. PMID:22268972

  2. HIV Sexual Risk-Reduction Interventions for Youth: A Review and Methodological Critique of Randomized Controlled Trials

    PubMed Central

    Pedlow, C. Teal; Carey, Michael P.

    2008-01-01

    We review and provide a methodological critique of randomized controlled studies of HIV risk reduction interventions that measured sexual risk behavior outcomes with adolescents. Studies conducted in school, community, and health care settings were reviewed. Overall, 13 of 23 interventions (57%) were effective in reducing sexual risk behavior. Methodological strengths of extant studies included an emphasis on a theoretical framework, evaluation of both group- and individualized intervention formats, use of multiple assessments of risk behavior including biological outcomes, and inclusion of efficacy and effectiveness trials. Methodological limitations included limited evaluation of theoretical mediators of risk reduction, failure to report effect sizes, and lack of sustained findings. Inconsistencies were found in data analytic procedures and reporting, including how nested designs, skewed data, and attrition were addressed. Recommendations for designing methodologically-rigorous interventions are provided. PMID:12705104

  3. Advancing Behavioral HIV Prevention: Adapting an Evidence-Based Intervention for People Living with HIV and Alcohol Use Disorders

    PubMed Central

    Armstrong, M. L.; LaPlante, A. M.; Altice, F. L.; Copenhaver, M.; Molina, P. E.

    2015-01-01

    Alcohol use disorders (AUDs) are highly prevalent among people living with HIV/AIDS (PLWHA) and are associated with increased HIV risk behaviors, suboptimal treatment adherence, and greater risk for disease progression. We used the ADAPT-ITT strategy to adapt an evidence-based intervention (EBI), the Holistic Health Recovery Program (HHRP+), that focuses on secondary HIV prevention and antiretroviral therapy (ART) adherence and apply it to PLWHA with problematic drinking. Focus groups (FGs) were conducted with PLWHA who consume alcohol and with treatment providers at the largest HIV primary care clinic in New Orleans, LA. Overall themes that emerged from the FGs included the following: (1) negative mood states contribute to heavy alcohol consumption in PLWHA; (2) high levels of psychosocial stress, paired with few adaptive coping strategies, perpetuate the use of harmful alcohol consumption in PLWHA; (3) local cultural norms are related to the permissiveness and pervasiveness of drinking and contribute to heavy alcohol use; (4) healthcare providers unanimously stated that outpatient options for AUD intervention are scarce, (5) misperceptions about the relationships between alcohol and HIV are common; (6) PLWHA are interested in learning about alcohol's impact on ART and HIV disease progression. These data were used to design the adapted EBI. PMID:26697216

  4. HIV-infected People in Sudan Moving Toward Chronic Poverty: Possible Interventions.

    PubMed

    Ismail, Salwa Muddthir; Eisa, Ammar Abobakre; Ibrahim, Faisal

    2016-01-01

    We sought to identify the socioeconomic impact on people living with HIV (PLWH) in Sudan. Focus group discussions were used to collect data and identify the most outstanding domains of HIV impact on PLWH and the survival mechanisms that may be common to a group of diverse HIV-infected persons (n = 30). The findings indicated that the most striking financial and social impacts were due to stigma associated with HIV in the conservative Sudanese society, which led to loss of work with all its consequences (e.g., children's education and health care expenses were affected). The socioeconomic impacts of HIV on infected populations are discussed, and suggestions for possible interventions to mitigate harmful impacts and stigma within the society, the workplace, and health care settings are highlighted. We concluded that HIV has intensified the existing problems of infected people, contributing to their vulnerability to poverty. PMID:26190419

  5. HIV-negative Men-who-Have-Sex-with-Men who Bareback are Concerned about HIV Infection: Implications for HIV Risk Reduction Interventions

    PubMed Central

    Balán, Iván C.; Carballo-Diéguez, Alex; Ventuneac, Ana; Remien, Robert H.; Dolezal, Curtis; Ford, Jordan

    2012-01-01

    The emergence of barebacking (intentional unprotected anal intercourse in situations where there is risk of HIV infection) among men who have sex with men (MSM) has been partially attributed to a decrease in HIV-related concerns due to improved anti-retroviral treatment. It is important to understand the level of concern these men have regarding HIV infection because it can affect their interest in risk reduction behaviors as well as their possible engagement in risk reduction interventions. As part of a study on MSM who use the Internet to seek sexual partners, 89 ethnic and racially diverse men who reported never having an HIV-positive test result completed an in-depth qualitative interview and a computer-based quantitative assessment. Of the 82 men who were asked about concerns of HIV infection during the qualitative interviews, 30 expressed “significant concern” about acquiring HIV, while 42 expressed “moderate concern,” and 10 expressed “minimal concern. Themes that emerged across the different levels of concern were their perceptions of the severity of HIV infection, having friends who are HIV positive, and their own vulnerability to HIV infection. However, these themes differed depending on the level of concern. Among the most frequently mentioned approaches to decrease risk of HIV infection, participants mentioned avoiding HIV-positive sex partners, limiting the number of partners with whom they barebacked, and not allowing partners to ejaculate inside their rectum. Findings suggest that many MSM who bareback would be amenable to HIV prevention efforts that do not depend solely on condom use. PMID:22218787

  6. FEASIBILITY ANALYSIS OF AN EVIDENCE-BASED POSITIVE PREVENTION INTERVENTION FOR YOUTH LIVING WITH HIV/AIDS IN KINSHASA, DEMOCRATIC REPUBLIC OF THE CONGO

    PubMed Central

    Parker, L.; Maman, S.; Pettifor, A.; Chalachala, J. L.; Edmonds, A.; Golin, C. E.; Moracco, K.; Behets, F.

    2013-01-01

    We evaluated the feasibility of a Positive Prevention intervention adapted for youth living with HIV/AIDS (YLWH) ages 15–24 in Kinshasa, Democratic Republic of the Congo. We conducted in-depth interviews and focus group discussions with intervention facilitators and YLWH participants on the following four areas of a feasibility framework: acceptability, implementation, adaptation, and limited-efficacy. The adapted intervention was suitable, satisfying, and attractive to program facilitators and participants and able to be implemented effectively. It performed well with a new population and showed preliminary efficacy. However, we identified certain aspects of the intervention that must be addressed prior to wider implementation such as: (1) including more content on navigating marriage while living with HIV and disclosure; (2) adjusting intervention timing and session length; and (3) simplifying the more complicated content. An adapted evidence-based intervention was found to be feasible and lessons learned can be applied to YLWH in other low-resource settings. PMID:23514081

  7. Preventing perinatal transmission of HIV--costs and effectiveness of a recommended intervention.

    PubMed Central

    Gorsky, R D; Farnham, P G; Straus, W L; Caldwell, B; Holtgrave, D R; Simonds, R J; Rogers, M F; Guinan, M E

    1996-01-01

    OBJECTIVE. To calculate the national costs of reducing perinatal transmission of human immunodeficiency virus through counseling and voluntary testing of pregnant women and zidovudine treatment of infected women and their infants, as recommended by the Public Health Service, and to compare these costs with the savings from reducing the number of pediatric infections. METHOD. The authors analyzed the estimated costs of the intervention and the estimated cost savings from reducing the number of pediatric infections. The outcome measures are the number of infections prevented by the intervention and the net cost (cost of intervention minus the savings from a reduced number of pediatric HIV infections). The base model assumed that intervention participation and outcomes would resemble those found in the AIDS Clinical Trials Group Protocol 076. Assumptions were varied regarding maternal seroprevalence, participation by HIV-infected women, the proportion of infected women who accepted and completed the treatment, and the efficacy of zidovudine to illustrate the effect of these assumptions on infections prevented and net cost. RESULTS. Without the intervention, a perinatal HIV transmission rate of 25% would result in 1750 HIV-infected infants born annually in the United States, with lifetime medical-care costs estimated at $282 million. The cost of the intervention (counseling, testing, and zidovudine treatment) was estimated to be $ 67.6 million. In the base model, the intervention would prevent 656 pediatric HIV infections with a medical care cost saving of $105.6 million. The net cost saving of the intervention was $38.1 million. CONCLUSION. Voluntary HIV screening of pregnant women and ziovudine treatment for infected women and their infants resulted in cost savings under most of the assumptions used in this analysis. These results strongly support implementation of the Public Health Service recommendations for this intervention. PMID:8711101

  8. Pilot Trial of a Disclosure Intervention for HIV+ Mothers: The TRACK Program

    ERIC Educational Resources Information Center

    Murphy, Debra A.; Armistead, Lisa; Marelich, William D.; Payne, Diana L.; Herbeck, Diane M.

    2011-01-01

    Objective: The "T"eaching, "R"aising, "A"nd "C"ommunicating with "K"ids (TRACK) program was a longitudinal pilot-trial intervention designed to assist mothers living with HIV (MLHs) to disclose their serostatus to their young children (age 6-12 years). Method: MLH and child dyads (N = 80 dyads) were recruited and randomized to intervention or…

  9. How Psychological States Affect the Immune System: Implications for Interventions in the Context of HIV.

    ERIC Educational Resources Information Center

    Littrell, Jill

    1996-01-01

    Discusses the psychological states associated with enhanced immune system functioning and those associated with suppressed immune functioning. Reviews studies of psychological and behavioral interventions to boost the immune systems of people who are HIV positive. Suggests that group interventions can enhance psychological states associated with…

  10. Recruiting and Retaining High-Risk Adolescents into Family-Based HIV Prevention Intervention Research

    ERIC Educational Resources Information Center

    Kapungu, Chisina T.; Nappi, Carla N.; Thakral, Charu; Miller, Steven A.; Devlin, Catharine; McBride, Cami; Hasselquist, Emily; Coleman, Gloria; Drozd, Derek; Barve, Chinmayee; Donenberg, Geri; DiClemente, Ralph; Brown, Larry

    2012-01-01

    The purpose of this study was to examine the effectiveness of evidence-based recruitment and retention strategies for a longitudinal, family-based HIV prevention intervention study targeting adolescents in psychiatric care by (1) determining consent rate (recruitment), rate of participation at the first intervention session (retention), and…

  11. Psychosocial Interventions for Women with HIV/AIDS: A Critical Review

    ERIC Educational Resources Information Center

    Hernandez, Julieta P.; Macgowan, Mark J.

    2015-01-01

    Objective: Recent research on psychosocial interventions addressing the well-being of women with HIV/AIDS has brought new options for practitioners. This study critically reviews the treatment features, methodological quality, and efficacy of these interventions. Methods: A comprehensive search between 2000 and 2011 identified 19 studies employing…

  12. The Healthy Living Project: An Individually Tailored, Multidimensional Intervention for HIV-Infected Persons

    ERIC Educational Resources Information Center

    Gore-Felton, Cheryl; Rotheram-Borus, Mary Jane; Weinhardt, Lance S.; Kelly, Jeffrey A.; Lightfoot, Marguerita; Kirshenbaum, Sheri B.; Johnson, Mallory O.; Chesney, Margaret A.; Catz, Sheryl L.; Ehrhardt, Anke A.; Remien, Robert H.; Morin, Stephen F.

    2005-01-01

    The NIMH Healthy Living Project (HLP), a randomized behavioral intervention trial for people living with HIV, enrolled 943 individuals, including women, heterosexual men, injection drug users, and men who have sex with men from Los Angeles, Milwaukee, New York, and San Francisco. The intervention, which is based on qualitative formative research…

  13. Improving Ascertainment of Risk Factors for HIV Infection: Results of a Group-Randomized Evaluation

    ERIC Educational Resources Information Center

    Harrison, Kathleen McDavid; Pals, Sherri L.; Sajak, Tammy; Chase, Jennifer; Kajese, Tebitha

    2010-01-01

    To allow appropriate allocation of prevention and care funding, HIV/AIDS surveillance data must include risk factor information, currently available for less than 70% of cases reported in the United States. The authors evaluated an intervention consisting of provider training and materials to improve risk factor reporting. Facilities were matched…

  14. Implementation of Evidence-Based HIV Interventions for Young Adult African American Women in Church Settings

    PubMed Central

    Stewart, Jennifer M.

    2015-01-01

    Objective To assess the barriers and facilitators to using African American churches as sites for implementation of evidence-based HIV interventions among young African American women. Design Mixed methods cross-sectional design. Setting African American churches in Philadelphia, PA. Participants 142 African American pastors, church leaders, and young adult women ages 18 to 25. Methods Mixed methods convergent parallel design. Results The majority of young adult women reported engaging in high-risk HIV-related behaviors. Although church leaders reported willingness to implement HIV risk-reduction interventions, they were unsure of how to initiate this process. Key facilitators to the implementation of evidence-based interventions included the perception of the leadership and church members that HIV interventions were needed and that the church was a promising venue for them. A primary barrier to implementation in this setting is the perception that discussions of sexuality should be private. Conclusion Implementation of evidence-based HIV interventions for young adult African American women in church settings is feasible and needed. Building a level of comfort in discussing matters of sexuality and adapting existing evidence-based interventions to meet the needs of young women in church settings is a viable approach for successful implementation. PMID:25139612

  15. Future directions for interventions targeting PTSD in HIV-infected adults

    PubMed Central

    Applebaum, Allison J.; Bedoya, C. Andres; Hendriksen, Ellen S.; Wilkinson, Jesse L.; Safren, Steven A.; O’Cleirigh, Conall

    2015-01-01

    Although studies consistently report high rates of comorbid Post Traumatic Stress Disorder (PTSD) and HIV infection, development and testing of PTSD treatment interventions in HIV-infected adults is limited. As such, the purpose of this review was twofold. First, this review augments the 3 existing reviews of research for PTSD in HIV-infected adults conducted within the past 10 years. We found 2 empirically supported cognitive-behavioral therapy (CBT)-based interventions for the treatment of trauma-related symptoms in HIV-infected adults. Due to the continued limited number of effective interventions for this population, a second aim of our review was to draw from the expansive field of effective PTSD interventions for the general population to propose ways that future clinical intervention research may be tailored for HIV-infected adults. Therefore, in addition to a review, we conceptualized this paper as an opportunity to generate an ideal preview of the field of intervention research in this population. PMID:25665885

  16. Women, Reproductive Rights, and HIV/AIDS: Issues on Which Research and Interventions are Still Needed

    PubMed Central

    2006-01-01

    From 2002 to 2005, two literature reviews identified a number of reproductive-health issues that appeared to be relatively neglected in relation to HIV/AIDS: contraceptive information tailored to the needs of HIV-positive people; voluntary HIV counselling and testing during antenatal care, labour, and delivery; parenting options for HIV-positive people besides pregnancy through unprotected intercourse (i.e. assisted conception and legal adoption or foster care); unwanted pregnancy; and abortion-related care. An additional finding was that stigma and discrimination were frequently cited as barriers to enjoyment of reproductive rights by HIV-positive women. Subsequently, a pilot project was initiated in which non-governmental organizations (NGOs) in developing countries used benchmarks to ascertain whether these neglected issues were addressed in local programmes and interventions serving women affected by HIV and AIDS. The benchmarks also assessed whether policies and programmes paid attention to the human and reproductive rights of HIV-positive women. This paper describes the main findings from the two exercises in relation to contraception for women living with HIV or AIDS, abortion-related care, legal adoption by HIV-positive parents, and reproductive rights. It concludes with a number of recommendations on topics to be incorporated into the international research agenda, policies, and programmes in the field of HIV/AIDS. PMID:17591338

  17. Urban Farming: A Non-Traditional Intervention for HIV-Related Distress

    PubMed Central

    Shacham, Enbal; Donovan, Michael F.; Connolly, Shannon; Mayrose, Andrea; Scheuermann, Mary; Overton, E. Turner

    2013-01-01

    As individuals with HIV are living longer with less morbidity, developing interventions that address co-morbidities are essential. Psychological distress symptoms fluctuate throughout HIV infection and interrupt self-care practices. This pilot study was conducted to test the implementation of a clinic-recruited sample to participate in a community-based urban farming intervention, and assess the efficacy of reducing psychological distress symptoms. While the changes were not statistically significant, participants reported less distress symptoms, improved overall general health, and reduced frequency of illicit drug use. These findings support the development of a larger scale study to examine the impact of this nontraditional intervention. PMID:21986870

  18. Urban farming: a non-traditional intervention for HIV-related distress.

    PubMed

    Shacham, Enbal; Donovan, Michael F; Connolly, Shannon; Mayrose, Andrea; Scheuermann, Mary; Overton, E Turner

    2012-07-01

    As individuals with HIV are living longer with less morbidity, developing interventions that address co-morbidities are essential. Psychological distress symptoms fluctuate throughout HIV infection and interrupt self-care practices. This pilot study was conducted to test the implementation of a clinic-recruited sample to participate in a community-based urban farming intervention, and assess the efficacy of reducing psychological distress symptoms. While the changes were not statistically significant, participants reported less distress symptoms, improved overall general health, and reduced frequency of illicit drug use. These findings support the development of a larger scale study to examine the impact of this nontraditional intervention. PMID:21986870

  19. Tailored Treatment for HIV+ Persons with Mental Illness: The Intervention Cascade

    PubMed Central

    Blank, Michael; Eisenberg, Marlene

    2013-01-01

    The public health literature demonstrates disturbingly high HIV risk for persons with a serious mental illness (SMI), who are concurrently co-morbid for substance abuse (SA). Many HIV positives have not been tested, and therefore do not know their status, but for individuals who are triply diagnosed, adherence to HIV treatment results in meaningful reductions in viral loads and CD4 counts. Barriers to treatment compliance are reviewed, low threshold/low intensity community based interventions are discussed, and preliminary evidence is presented for the efficacy of the Intervention Cascade, defined as an integrated intervention delivered by specially trained nurses who individualize a treatment compliance intervention in real time as an adaptive response to demand characteristics of the individual. PMID:23673886

  20. A Group Intervention for HIV/STI Risk Reduction among Indian Couples

    PubMed Central

    Nehra, Ritu; Bagga, Rashmi; Jones, Deborah; Deepika, Deepika; Sethi, Sunil; Sharma, Sunil; Weiss, Stephen M.

    2013-01-01

    Background: HIV in India is transmitted primarily by heterosexual contact. The present study sought to test the feasibility of a group HIV/STI risk re­duction intervention among heterosexual couples in India. Methods: Focus groups and key informant interviews were used in 2008 to cul­turally tailor the intervention. Thirty sexually active and HIV/STI negative cou­ples were enrolled and assessed regarding risk behavior and sexual barrier accept­ability. Gender-concordant group sessions used cognitive behavioral strategies for HIV/STI prevention. Results: At baseline, male condom use was low (36%); no participants re­ported use of female condoms or vaginal gels. HIV knowledge was low; women had more HIV knowledge and more positive attitudes towards con­dom use than men. Post-intervention, willingness to use all barrier products (t = 10.0, P< .001) and intentions to avoid risk behavior increased (t = 5.62, P< .001). Conclusion: This study illustrates the feasibility of utilizing a group interven­tion to enhance HIV/STI risk reduction among Indian couples. PMID:24688963

  1. Development and evaluation of a psychometric instrument designed to assess HIV risk behaviors of prison inmates.

    PubMed

    Balogun, Joseph A; Abiona, Titilayo C; Lukobo-Durrell, Mainza; Adefuye, Adedeji S; Sloan, Patricia E

    2010-01-01

    Clinicians and researchers interested in HIV interventions for prisoners lack an appropriate psychometric instrument to assess HIV risk behaviors. This study evaluated the readability and internal consistency of a questionnaire designed to assess such behaviors. The questionnaire was administered to 277 inmates. The Flesch Reading Ease score was 78.3 with a Flesch-Kincaid grade level of 3.7, suggesting limited comprehension difficulties. Internal consistency was evaluated by determining Cronbach's alpha (Calpha) for total items and for each subscale. Following factor analyses, 25 items converged into five subscales and combined they account for 72% of the variance. The overall Calpha was .86 and the subscales Calpha ranged from .82 to .98. Findings reveal that the questionnaire is internally consistent and suitable for use with prisoners with low literacy skills. The use of this instrument for intervention studies in prisons has the potential to reduce inmates' HIV risk behaviors. PMID:19861320

  2. AN INTERVENTION TO REDUCE HIV-RELATED STIGMA IN PARTNERSHIP WITH AFRICAN AMERICAN AND LATINO CHURCHES

    PubMed Central

    Derose, Kathryn Pitkin; Bogart, Laura M.; Kanouse, David E.; Felton, Alexandria; Collins, Deborah Owens; Mata, Michael A.; Oden, Clyde W.; Domínguez, Blanca X.; Flórez, Karen R.; Hawes-Dawson, Jennifer; Williams, Malcolm V.

    2014-01-01

    HIV-related stigma negatively affects prevention and care, and community-based interventions are needed. Here we describe the development of a multi-ethnic, faith-based intervention to reduce HIV stigma that included: educational workshops on HIV, testing, and stigma; peer leader workshops using role plays and drawing on principles of motivational interviewing; a pastor-delivered sermon on HIV that incorporated theological reflection and an imagined contact scenario; and congregation-based HIV testing events. Lessons learned include: partnership development is essential and requires substantial investment; tailoring intervention components to single race-ethnic groups may not be preferable in diverse community settings; and adapting testing processes to be able to serve larger numbers of people in shorter time frames is needed for congregational settings. This development process successfully combined the rigorous application of social science theory and community engagement to yield a multifaceted HIV stigma reduction intervention appropriate for Protestant and Catholic churches in African American and Latino communities. PMID:24450276

  3. Identifying Key Drivers of the Impact of an HIV Cure Intervention in Sub-Saharan Africa

    PubMed Central

    Phillips, Andrew N.; Cambiano, Valentina; Revill, Paul; Nakagawa, Fumiyo; Lundgren, Jens D.; Bansi-Matharu, Loveleen; Mabugu, Travor; Sculpher, Mark; Garnett, Geoff; Staprans, Silvija; Becker, Stephen; Murungu, Joseph; Lewin, Sharon R.; Deeks, Steven G.; Hallett, Timothy B.

    2016-01-01

    Background. It is unknown what properties would be required to make an intervention in low income countries that can eradicate or control human immunodeficiency virus (HIV) without antiretroviral therapy (ART) cost-effective. Methods. We used a model of HIV and ART to investigate the effect of introducing an ART-free viral suppression intervention in 2022 using Zimbabwe as an example country. We assumed that the intervention (cost: $500) would be accessible for 90% of the population, be given to those receiving effective ART, have sufficient efficacy to allow ART interruption in 95%, with a rate of viral rebound of 5% per year in the first 3 months, and a 50% decline in rate with each successive year. Results. An ART-free viral suppression intervention with these properties would result in >0.53 million disability-adjusted-life-years averted over 2022–2042, with a reduction in HIV program costs of $300 million (8.7% saving). An intervention of this efficacy costing anything up to $1400 is likely to be cost-effective in this setting. Conclusions. Interventions aimed at curing HIV infection have the potential to improve overall disease burden and to reduce costs. Given the effectiveness and cost of ART, such interventions would have to be inexpensive and highly effective. PMID:27034345

  4. Provider Perspectives on Evidence-Based HIV Prevention Interventions: Barriers and Facilitators to Implementation

    PubMed Central

    Dickson-Gomez, Julia

    2011-01-01

    Abstract Since the beginning of the HIV/AIDS epidemic, community-based organizations (CBOs) have been key players in combating this disease through grassroots prevention programs and close ties to at-risk populations. Increasingly, both funding agencies and public health institutions require that CBOs implement evidence-based HIV prevention interventions, most of which are researcher developed. However, after completing training for these evidence-based interventions (EBIs), agencies may either abandon plans to implement them or significantly modify the intervention. Based on 22 semistructured interviews with HIV prevention service providers, this article explores the barriers and facilitators to dissemination and implementation of EBIs included in the Centers for Disease Control and Prevention's (CDC) Diffusion of Effective Behavioral Interventions (DEBI) program. Results suggest that there is a tension between the need to implement interventions with fidelity and the lack of guidance on how to adapt the interventions for their constituencies and organizational contexts. Findings suggest the need for HIV prevention intervention development and dissemination that integrate community partners in all phases of research and dissemination. PMID:21323564

  5. A synthesis of meta-analytic evidence of behavioral interventions to reduce HIV/STIs.

    PubMed

    Covey, Judith; Rosenthal-Stott, Harriet E S; Howell, Stephanie J

    2016-06-01

    To identify the mode of delivery, communicator, and content dimensions that make STI/HIV prevention interventions most successful at increasing condom use/protected sex or reducing STI/HIV incidence. A literature search for published meta-analyses of STI/HIV prevention interventions yielded 37 meta-analyses that had statistically tested the moderating effects of the dimensions. Significant and non-significant moderators from the coded dimensions were extracted from each meta-analysis. The most consistently significant moderators included matching the gender or ethnicity of the communicator to the intervention recipients, group targeting or tailoring of the intervention, use of a theory to underpin intervention design, providing factual information, presenting arguments designed to change attitudes, and providing condom skills and intrapersonal skills training. The absence of significant effects for intervention duration and expert delivery are also notable. The success of HIV/STI prevention interventions may be enhanced not only by providing skills training and information designed to change attitudes, but also by ensuring that the content is tailored to the target group and delivered by individuals of the same gender and ethnicity as the recipients. PMID:26831053

  6. Acceptability of Mobile Phone Technology for Medication Adherence Interventions among HIV-Positive Patients at an Urban Clinic

    PubMed Central

    Miller, Christopher W. T.; Himelhoch, Seth

    2013-01-01

    Mobile phone technology is increasingly used to overcome traditional barriers limiting access to care. The goal of this study was to evaluate access and willingness to use smart and mobile phone technology for promoting adherence among people attending an urban HIV clinic. One hundred consecutive HIV-positive patients attending an urban HIV outpatient clinic were surveyed. The questionnaire evaluated access to and utilization of mobile phones and willingness to use them to enhance adherence to HIV medication. The survey also included the CASE adherence index as a measure of adherence. The average age was 46.4 (SD = 9.2). The majority of participants were males (63%), black (93%), and Hispanic (11.4%) and reported earning less than $10,000 per year (67.3%). Most identified themselves as being current smokers (57%). The vast majority reported currently taking HAART (83.5%). Approximately half of the participants reported some difficulty with adherence (CASE < 10). Ninety-six percent reported owning a mobile phone. Among owners of mobile phones 47.4% reported currently owning more than one device. Over a quarter reported owning a smartphone. About 60% used their phones for texting and 1/3 used their phone to search the Internet. Nearly 70% reported that they would use a mobile device to help with HIV adherence. Those who reported being very likely or likely to use a mobile device to improve adherence were significantly more likely to use their phone daily (P = 0.03) and use their phone for text messages (P = 0.002). The vast majority of patients in an urban HIV clinic own mobile phones and would use them to enhance adherence interventions to HIV medication. PMID:23997948

  7. Acceptability of a Community-Based Outreach HIV-Testing Intervention Using Oral Fluid Collection Devices and Web-Based HIV Test Result Collection Among Sub-Saharan African Migrants: A Mixed-Method Study

    PubMed Central

    Manirankunda, Lazare; Platteau, Tom; Albers, Laura; Fransen, Katrien; Vermoesen, Tine; Namanya, Fiona; Nöstlinger, Christiana

    2016-01-01

    Background Late human immunodeficiency virus (HIV) diagnosis is common among sub-Saharan African migrants. To address their barriers to HIV testing uptake and improve timely HIV diagnoses and linkage to care, the outreach HIV testing intervention, “swab2know,” was developed. It combined a community-based approach with innovative testing methods: oral fluid self-sampling and the choice between Web-based HIV test result collections using a secured website or post-test counseling at a sexual health clinic. The sessions included an informational speech delivered by a physician of sub-Saharan African origin and testimonies by community members living with HIV. Objectives The objectives of this study were to evaluate the intervention’s acceptability among sub-Saharan African migrants and its potential to reach subgroups at higher risk for HIV infection and to identify facilitators and barriers for HIV testing uptake. Methods This mixed-method study combined qualitative (participant observations and informal interviews with testers and nontesters) and quantitative data (paper–pencil survey, laboratory data, and result collection files). Data were analyzed using a content analytical approach for qualitative and univariate analysis for quantitative data. Results A total of 10 testing sessions were organized in sub-Saharan African migrant community venues in the city of Antwerp, Belgium, between December 2012 and June 2013. Overall, 18.2% of all people present (N=780) underwent HIV testing; 29.8% of them tested for HIV for the first time, 22.3% did not have a general practitioner, and 21.5% reported 2 or more sexual partners (last 3 months). Overall, 56.3% of participants chose to collect their HIV test results via the protected website. In total, 78.9% collected their results. The qualitative analysis of 137 participant observation field notes showed that personal needs and Internet literacy determined the choice of result collection method. Generally, the oral

  8. Reducing HIV risk among Hispanic/Latino men who have sex with men: Qualitative analysis of behavior change intentions by participants in a small-group intervention

    PubMed Central

    Alonzo, Jorge; Mann, Lilli; Tanner, Amanda E.; Sun, Christina J.; Painter, Thomas M.; Freeman, Arin; Reboussin, Beth A.; Song, Eunyoung; Rhodes, Scott D.

    2016-01-01

    Objective The southeastern United States has the fastest-growing Hispanic/Latino population in the country and carries a disproportionate HIV burden. Among Hispanics/Latinos, men, and men who have sex with men (MSM) in particular, are at elevated risk of HIV infection; however, very few efficacious behavioral HIV prevention interventions are available for use with this vulnerable population. To address this shortage of prevention resources, our community-based participatory research (CBPR) partnership developed and is currently evaluating the efficacy of the HOLA en Grupos intervention to increase condom use and HIV testing among Hispanic/Latino MSM. Methods We recruited 304 Hispanic/Latino MSM who were randomized to receive the small group HOLA en Grupos intervention that was implemented during four 4-hour long sessions over four consecutive Sundays, or a 4-session small group general health education comparison intervention. At the end of the fourth session of the HOLA en Grupos intervention, the intervention facilitators asked participants to write down the sexual health-related behaviors they intended to change as a result of their participation. Results Qualitative analysis of the participants’ responses identified six types of intended behavior changes: increasing and maintaining condom use; identifying strategies to support correct and consistent condom use; increasing communication and negotiation with sexual partners about condom use; getting tested for HIV and other sexually transmitted infections; applying other sexual health promotion strategies; and sharing newly learned sexual health information with their peers. Conclusion Most risk-reduction intentions aligned with the intervention’s key messages of using condoms consistently and getting tested for HIV. However, participants’ stated intentions may have also depended on which behavior changes they perceived as most salient after participating in the intervention. Participants’ intentions to

  9. Efficacy of an HIV Intervention in Reducing High-Risk HPV, Non-viral STIs, and Concurrency among African-American Women: A Randomized Controlled Trial

    PubMed Central

    Wingood, Gina M.; DiClemente, Ralph J.; Robinson-Simpson, LaShun; Lang, Delia L.; Caliendo, Angela; Hardin, James W.

    2013-01-01

    Objective This trial evaluated the efficacy of an HIV intervention condition, relative to a health promotion condition, in reducing incidence of non-viral STIs (Chlamydia, gonorrhea, trichomoniasis), oncogenic HPV subtypes 16 and 18, sexual concurrency, and other HIV-associated behaviors over a 12-month period. Design Randomized controlled trial. Data analysts blinded to treatment allocation. Setting Kaiser Permanente Georgia Subjects A random sample of 848 African American women Intervention The two 4-hour HIV intervention sessions were based on Social Cognitive Theory and the Theory of Gender and Power. The intervention was designed to enhance participants’ self sufficiency and attitudes and skills associated with condom use. The HIV intervention also encouraged STI testing and treatment of male sex partners, and reducing vaginal douching and individual and male partner concurrency. Main Outcome Measure Incident non-viral STIs. Results In GEE analyses, over the 12-month follow-up, participants in the HIV intervention, relative to the comparison, were less likely to have non-viral incident STIs (OR=0.62; 95% CI, 0.40-0.96; P =.033); and incident high-risk HPV infection (OR=0.37; 95% CI, 0.18-0.77; P = .008), or concurrent male sex partners (OR=0.55; 95% CI, 0.37-0.83; P = .005). Additionally, intervention participants were less likely to report multiple male sex partners, more likely to use condoms during oral sex, more likely to inform their main partner of their STI test results, encourage their main partner to seek STI testing, report that their main partner was treated for STIs, and report not douching. Conclusion This is the first trial to demonstrate that an HIV intervention can achieve reductions in non-viral STIs, high-risk HPV, and individual concurrency. PMID:23673884

  10. Effectiveness of interventions promoting HIV serostatus disclosure to sexual partners: a systematic review.

    PubMed

    Conserve, Donaldson F; Groves, Allison K; Maman, Suzanne

    2015-10-01

    Disclosure of HIV serostatus to sexual partners is mandated within certain states in the United States and other countries. Despite these laws implemented and public health efforts to increase disclosure, rates of disclosure to sexual partners among people living with HIV (PLWH) remain low, suggesting the need for interventions to assist PLWH with the disclosure process. We conducted a systematic review of studies testing whether HIV serostatus disclosure interventions increase disclosure to sexual partners. We searched six electronic databases and screened 484 records. Five studies published between 2005 and 2012 met inclusion criteria and were included in this review. Results showed that three of the HIV serostatus disclosure-related intervention studies were efficacious in promoting disclosure to sexual partners. Although all three studies were conducted in the United States the intervention content and measurements of disclosure across the studies varied, so broad conclusions are not possible. The findings suggest that more rigorous HIV serostatus disclosure-related intervention trials targeting different populations in the United States and abroad are needed to facilitate disclosure to sexual partners. PMID:25645328

  11. The HOPE Social Media Intervention for Global HIV Prevention: A Cluster Randomized Controlled Trial in Peru

    PubMed Central

    Young, Sean D.; Cumberland, William G.; Nianogo, Roch; Menacho, Luis A.; Galea, Jerome T.; Coates, Thomas

    2015-01-01

    Background Social media technologies are newly emerging tools that can be used for HIV prevention and testing in low- and middle-income countries, such as Peru. This study examined the efficacy of using the Harnessing Online Peer Education (HOPE) social media intervention to increase HIV testing among men who have sex with men (MSM) in Peru. Methods In a cluster randomized controlled trial with concealed allocation, Peruvian MSM from Greater Lima/Callao (N = 556) were randomly assigned to join private intervention or control groups on Facebook for 12 weeks. In the intervention condition, forty-nine Peruvian MSM were trained and randomly assigned to be HIV prevention mentors to participants via Facebook groups over 12 weeks. Control participants received an enhanced standard of care, including standard offline HIV prevention available in Peru as well as participation in Facebook groups (without peer leaders) that provided study updates and HIV testing information. After accepting a request to join the groups, continued participation was voluntary. Participants could request a free HIV test at a local community clinic, and completed questionnaires on HIV risk behaviors and social media use at baseline and 12-week follow-up. Findings Between March 19, 2012, and June 11, 2012, and Sept 26, 2012, and Dec 19, 2012, 556 participants were randomly assigned to intervention groups (N=278) or control groups (N=278); we analyse data for 252 and 246. 43 participants (17%) in the intervention group and 16 (7%) in the control groups got tested for HIV (adjusted odds ratio 2.61, 95% CI 1.55–4.38). No adverse events were reported. Retention at 12-week follow-up was 90%. Across conditions, 7 (87.5%) of the 8 participants who tested positive were linked to care at a local clinic. Interpretation Development of peer-mentored social media communities seemed to be an effective method to increase HIV testing among high-risk populations in Peru.: Results suggest that the HOPE social

  12. Putting Prevention in Their Pockets: Developing Mobile Phone-Based HIV Interventions for Black Men Who Have Sex with Men

    PubMed Central

    Pike, Emily C.; Fowler, Beth; LeGrand, Sara; Parsons, Jeffrey T.; Bull, Sheana S.; Wilson, Patrick A.; Wohl, David A.; Hightow-Weidman, Lisa B.

    2013-01-01

    Abstract Young black men who have sex with men (MSM) bear a disproportionate burden of HIV. Rapid expansion of mobile technologies, including smartphone applications (apps), provides a unique opportunity for outreach and tailored health messaging. We collected electronic daily journals and conducted surveys and focus groups with 22 black MSM (age 18–30) at three sites in North Carolina to inform the development of a mobile phone-based intervention. Qualitative data was analyzed thematically using NVivo. Half of the sample earned under $11,000 annually. All participants owned smartphones and had unlimited texting and many had unlimited data plans. Phones were integral to participants' lives and were a primary means of Internet access. Communication was primarily through text messaging and Internet (on-line chatting, social networking sites) rather than calls. Apps were used daily for entertainment, information, productivity, and social networking. Half of participants used their phones to find sex partners; over half used phones to find health information. For an HIV-related app, participants requested user-friendly content about test site locators, sexually transmitted diseases, symptom evaluation, drug and alcohol risk, safe sex, sexuality and relationships, gay-friendly health providers, and connection to other gay/HIV-positive men. For young black MSM in this qualitative study, mobile technologies were a widely used, acceptable means for HIV intervention. Future research is needed to measure patterns and preferences of mobile technology use among broader samples. PMID:23565925

  13. Putting prevention in their pockets: developing mobile phone-based HIV interventions for black men who have sex with men.

    PubMed

    Muessig, Kathryn E; Pike, Emily C; Fowler, Beth; LeGrand, Sara; Parsons, Jeffrey T; Bull, Sheana S; Wilson, Patrick A; Wohl, David A; Hightow-Weidman, Lisa B

    2013-04-01

    Young black men who have sex with men (MSM) bear a disproportionate burden of HIV. Rapid expansion of mobile technologies, including smartphone applications (apps), provides a unique opportunity for outreach and tailored health messaging. We collected electronic daily journals and conducted surveys and focus groups with 22 black MSM (age 18-30) at three sites in North Carolina to inform the development of a mobile phone-based intervention. Qualitative data was analyzed thematically using NVivo. Half of the sample earned under $11,000 annually. All participants owned smartphones and had unlimited texting and many had unlimited data plans. Phones were integral to participants' lives and were a primary means of Internet access. Communication was primarily through text messaging and Internet (on-line chatting, social networking sites) rather than calls. Apps were used daily for entertainment, information, productivity, and social networking. Half of participants used their phones to find sex partners; over half used phones to find health information. For an HIV-related app, participants requested user-friendly content about test site locators, sexually transmitted diseases, symptom evaluation, drug and alcohol risk, safe sex, sexuality and relationships, gay-friendly health providers, and connection to other gay/HIV-positive men. For young black MSM in this qualitative study, mobile technologies were a widely used, acceptable means for HIV intervention. Future research is needed to measure patterns and preferences of mobile technology use among broader samples. PMID:23565925

  14. Family-centred HIV interventions: lessons from the field of parental depression

    PubMed Central

    2010-01-01

    Traditionally, HIV prevention focuses on individual behaviours that place one at risk for HIV infection. Less widely regarded as a fundamental public health issue is parental depression and the detrimental effects it exerts on infant and child development, as well as its key contribution to non-fatal burden. Much like many HIV prevention and treatment interventions, programmes for depression focus almost exclusively on individuals and individual behaviour. This paper will use the extensive evidence base from research into parental depression as a model to argue for a family based approach to HIV prevention and treatment. The aim of this will be to make a case for targeting a broader set of behaviours that occur within families when developing and implementing interventions. PMID:20573291

  15. Development and piloting of a mother and child intervention to promote resilience in young children of HIV-infected mothers in South Africa.

    PubMed

    Visser, Maretha; Finestone, Michelle; Sikkema, Kathleen; Boeving-Allen, Alex; Ferreira, Ronel; Eloff, Irma; Forsyth, Brian

    2012-11-01

    This paper describes the process of developing a parallel intervention for HIV-positive mothers and their young children (6-10 years) with a view to strengthening the relationship between them. Strong mother-child relationships can contribute to enhanced psychological resilience in children. The intervention was developed through action research, involving a situation analysis based on focus group discussions; intervention planning, piloting the intervention and a formative evaluation of the intervention. Participants supplied feedback regarding the value of the intervention in mother-child relationships. The findings obtained from the formative evaluation were used to refine the intervention. Two parallel programmes for mothers and children (15 sessions each) were followed by 10 joint sessions. The intervention for mothers focused on maternal mental health and the strengthening of their capacity to protect and care for their young children. The intervention for children addressed the development of their self-esteem, interpersonal relationships and survival skills. The formative evaluation provided evidence of good participation, support and group cohesion. Qualitative feedback indicated that the activities stimulated mother-child interaction. A similar intervention can easily be applied elsewhere using the detailed manual. The insights gained and lessons learnt related to mother and child interaction within an HIV-context that emerged from this research, can be valuable in other settings, both in Sub-Saharan Africa and elsewhere. PMID:22542951

  16. Design of a comic book intervention for gay male youth at risk for HIV.

    PubMed

    Harvey, J

    1997-01-01

    The prototype of a safer-sex comic book was designed in response to the need for HIV intervention material targetting gay male youth in Toronto. This prototype depicted three separate stories, each based on recorded interviews, and each revolving around the negotiation of condom use between a different pair of characters. The characters were based on observations of respondents. The prototype's plausibility, relevance and attractiveness were assessed through focus groups and an evaluation questionnaire. Results indicated that most readers found the depicted stories pleasing, realistic and personally relevant. Readers found fault with the transitions between the stories and with certain character elements. Suggested solutions and comments about condom use served as directions for further development of the prototype into a finished product. PMID:9316792

  17. A Developing Framework for the Development, Implementation and Maintenance of HIV Interventions in the African American Church

    PubMed Central

    Stewart, Jennifer M.

    2016-01-01

    The African American church has promoted the health of African Americans through supporting interventions that target a wide variety of diseases, and it is a crucial community partner in the development of HIV prevention interventions. Although research has described the development of church-based HIV interventions, there is a significant lack of frameworks and approaches available to guide the implementation and maintenance of HIV interventions within church-based settings. A developing framework of a comprehensive church-based intervention, derived from an ethnographic study about the development, implementation, and maintenance of an HIV/AIDS Ministry within an African American church is presented. This approach can provide guidance to support the development, implementation, and maintenance of HIV interventions in faith settings. PMID:25702738

  18. Project Roadmap: Reeducating Older Adults in Maintaining AIDS Prevention--A Secondary Intervention for Older HIV-Positive Adults

    ERIC Educational Resources Information Center

    Illa, Lourdes; Echenique, Marisa; Saint Jean, Gilbert; Bustamante-Avellaneda, Victoria; Metsch, Lisa; Mendez-Mulet, Luis; Eisdorfer, Carl; Sanchez-Martinez, Mario

    2010-01-01

    The number of older adults living with HIV/AIDS is larger than ever. Little is known about their sexual behaviors, although contrary to stereotypes, older adults desire and engage in sexual activity. Despite increased recognition of the need for prevention interventions targeting HIV-positive individuals, no secondary HIV prevention interventions…

  19. The Impact of Perceived Group Support on the Effectiveness of an HIV Prevention Intervention for African American Women

    ERIC Educational Resources Information Center

    Belgrave, Faye Z.; Corneille, Maya; Hood, Kristina; Foster-Woodson, Julia; Fitzgerald, Angela

    2010-01-01

    The enormous HIV/AIDS disparity among African American women and women in other ethnic groups dictates the need to implement the most effective HIV prevention interventions. This study examined the impact of perceived group support on HIV protective behaviors (i.e., attitudes and behaviors related to condom use, alcohol, and drugs) of African…

  20. Project ORE: A Friendship-Based Intervention to Prevent HIV/STI in Urban African American Adolescent Females

    ERIC Educational Resources Information Center

    Dolcini, M. Margaret; Harper, Gary W.; Boyer, Cherrie B.; Pollack, Lance M.

    2010-01-01

    There is an urgent need for continued innovation in the design of HIV/STI prevention interventions for African American females, a group at high risk for STIs and HIV. In particular, attention to social development and to culture is needed. The present study reports on a group randomized controlled trial of a friendship-based HIV/STI prevention…

  1. HIV Treatment in the Criminal Justice System: Critical Knowledge and Intervention Gaps

    PubMed Central

    Meyer, Jaimie P.; Chen, Nadine E.; Springer, Sandra A.

    2011-01-01

    The criminal justice system bears a disproportionate burden of the HIV epidemic. Continuity of care is critical for HAART-based prevention of HIV-related morbidity and mortality. This paper describes four major challenges to successful management of HIV in the criminal justice system: relapse to substance use, homelessness, mental illness, and loss of medical and social benefits. Each of these areas constitutes a competing priority upon release that demands immediate attention and diverts time, energy, and valuable resources away from engagement in care and adherence to HAART. Numerous gaps exist in scientific knowledge about these issues and potential solutions. In illuminating these knowledge deficits, we present a contemporary research agenda for the management of HIV in correctional systems. Future empirical research should focus on these critical issues in HIV-infected prisoners and releasees while interventional research should incorporate evidence-based solutions into the criminal justice setting. PMID:21776379

  2. Sex isn't that simple: culture and context in HIV prevention interventions for gay and bisexual male adolescents.

    PubMed

    Harper, Gary W

    2007-11-01

    Gay and bisexual male adolescents and young adults in the United States have been disproportionately impacted by the HIV pandemic. Despite the steadily increasing rise in their HIV infection rates, there has not been a commensurate increase in HIV prevention programs targeted to the unique social and sexual lives of these youths. Programs that address cultural and contextual factors that influence sexual risk and protective behaviors need to be developed, implemented, and rigorously evaluated. These interventions should address the potential influences of sexual and gay culture on the HIV risk/protective behaviors of gay and bisexual adolescents, as well as the influence of more traditional cultural factors related to ethnicity. The influence of contextual developmental factors should also be addressed. This may include an incorporation into prevention programs of the societal-level influences of heterosexism and masculinity ideology and the individual-level influences of sexual identity and ethnic identity development. Researchers and interventionists need to be creative and innovative in their HIV prevention approaches and ensure that programs are grounded in the lives and realities of gay and bisexual adolescents and young adults. PMID:18020756

  3. WiLLOW: Reaching HIV-Positive African-American Women Through a Computer-Delivered Intervention

    PubMed Central

    Klein, Charles H.; Lomonaco, Carmela G.; Pavlescak, Rik; Card, Josefina J.

    2013-01-01

    WiLLOW is an evidence-based, group level HIV prevention program for African-American women living with HIV. This study evaluated the efficacy of a multimedia adaptation of WiLLOW in enhancing protective sexual behaviors and psychosocial mediators associated with HIV risk reduction. Using a randomized controlled design, 168 participants completed baseline, satisfaction, and three-month follow-up assessments. At follow-up intervention participants reported higher proportions of condom protected sex acts (p = .002) with both HIV-negative (p = .040) and HIV-positive (p = .003) partners. They were also more likely to report 100 % condom use (OR = 9.67; p = .03); fewer unprotected vaginal and anal sex acts (p = .002); significantly greater sexual communication self-efficacy (p = .004); and less stress (p = .012). Participants rated Multimedia WiLLOW favorably in four satisfaction categories—enjoyment (p < .001); information utility (p = .018); information clarity (p = .015) and held attention (p = .01). PMID:23625384

  4. An individualized intervention to foster optimal antiretroviral treatment-taking behavior among persons living with HIV: a pilot randomized controlled trial.

    PubMed

    Ramirez-Garcia, Pilar; Côté, José

    2012-01-01

    The key to the success of antiretroviral (ARV) treatment is optimal treatment taking. However, people living with HIV (PLWH) have problems sustaining this behavior. An intervention to facilitate optimal ARV treatment taking was developed using the intervention mapping approach. A pilot randomized controlled trial was conducted to evaluate the feasibility, acceptability, and effects of this intervention on optimal ARV treatment taking and on viral and immunologic outcomes. Over the 9 months of recruitment, 76 PLWH were referred. A total of 51 participants were enrolled in the study. All but three experimental participants attended at least one of the four intervention sessions. At 12 and 24 weeks respectively, the HIV RNA level was undetectable for 34.8% and 56.5% of controls and 78.6% and 89.3% of experimental participants (p = .056). The results are compelling and suggest that this intervention is acceptable to PLWH and that further formal testing is worth considering. PMID:21737312

  5. Evaluation of a health setting-based stigma intervention in five African countries.

    PubMed

    Uys, Leana; Chirwa, Maureen; Kohi, Thecla; Greeff, Minrie; Naidoo, Joanne; Makoae, Lucia; Dlamini, Priscilla; Durrheim, Kevin; Cuca, Yvette; Holzemer, William L

    2009-12-01

    The study aim is to explore the results of an HIV stigma intervention in five African health care settings. A case study approach was used. The intervention consisted of bringing together a team of approximately 10 nurses and 10 people living with HIV or AIDS (PLHA) in each setting and facilitating a process in which they planned and implemented a stigma reduction intervention, involving both information giving and empowerment. Nurses (n = 134) completed a demographic questionnaire, the HIV/AIDS Stigma Instrument-Nurses (HASI-N), a self-efficacy scale, and a self-esteem scale, both before and after the intervention, and the team completed a similar set of instruments before and after the intervention, with the PLHA completing the HIV/AIDS Stigma Instrument for PLHA (HASI-P). The intervention as implemented in all five countries was inclusive, action-oriented, and well received. It led to understanding and mutual support between nurses and PLHA and created some momentum in all the settings for continued activity. PLHA involved in the intervention teams reported less stigma and increased self-esteem. Nurses in the intervention teams and those in the settings reported no reduction in stigma or increases in self- esteem and self-efficacy, but their HIV testing behavior increased significantly. This pilot study indicates that the stigma experience of PLHA can be decreased, but that the stigma experiences of nurses are less easy to change. Further evaluation research with control groups and larger samples and measuring change over longer periods of time is indicated. PMID:20025515

  6. Evaluation of a Health Setting-Based Stigma Intervention in Five African Countries

    PubMed Central

    Uys, Leana; Chirwa, Maureen; Kohi, Thecla; Greeff, Minrie; Makoae, Lucia; Dlamini, Priscilla; Durrheim, Kevin; Cuca, Yvette; Holzemer, William L.

    2009-01-01

    Abstract The study aim is to explore the results of an HIV stigma intervention in five African health care settings. A case study approach was used. The intervention consisted of bringing together a team of approximately 10 nurses and 10 people living with HIV or AIDS (PLHA) in each setting and facilitating a process in which they planned and implemented a stigma reduction intervention, involving both information giving and empowerment. Nurses (n = 134) completed a demographic questionnaire, the HIV/AIDS Stigma Instrument-Nurses (HASI-N), a self-efficacy scale, and a self-esteem scale, both before and after the intervention, and the team completed a similar set of instruments before and after the intervention, with the PLHA completing the HIV/AIDS Stigma Instrument for PLHA (HASI-P). The intervention as implemented in all five countries was inclusive, action-oriented, and well received. It led to understanding and mutual support between nurses and PLHA and created some momentum in all the settings for continued activity. PLHA involved in the intervention teams reported less stigma and increased self-esteem. Nurses in the intervention teams and those in the settings reported no reduction in stigma or increases in self- esteem and self-efficacy, but their HIV testing behavior increased significantly. This pilot study indicates that the stigma experience of PLHA can be decreased, but that the stigma experiences of nurses are less easy to change. Further evaluation research with control groups and larger samples and measuring change over longer periods of time is indicated. PMID:20025515

  7. Stakeholder Engagement in HIV Cure Research: Lessons Learned from Other HIV Interventions and the Way Forward.

    PubMed

    Lo, Ying-Ru; Chu, Carissa; Ananworanich, Jintanat; Excler, Jean-Louis; Tucker, Joseph D

    2015-07-01

    Clinical and basic science advances have raised considerable hope for achieving an HIV cure by accelerating research. This research is dominated primarily by issues about the nature and design of current and future clinical trials. Stakeholder engagement for HIV cure remains in its early stages. Our analysis examines timing and mechanisms of historical stakeholder engagement in other HIV research areas for HIV-uninfected individuals [vaccine development and pre-exposure prophylaxis (PrEP)], and HIV-infected individuals (treatment as prevention, prevention of mother-to-child transmission, and treatment of acute HIV infection) and articulate a plan for HIV cure stakeholder engagement. The experience from HIV vaccine development shows that early engagement of stakeholders helped manage expectations, mitigating the failure of several vaccine trials, while paving the way for subsequent trials. The relatively late engagement of HIV stakeholders in PrEP research may partly explain some of the implementation challenges. The treatment-related stakeholder engagement was strong and community-led from the onset and helped translation from research to implementation. We outline five steps to initiate and sustain stakeholder engagement in HIV cure research and conclude that stakeholder engagement represents a key investment in which stakeholders mutually agree to share knowledge, benefits, and risk of failure. Effective stakeholder engagement prevents misconceptions. As HIV cure research advances from early trials involving subjects with generally favorable prognosis to studies involving greater risk and uncertainty, success may depend on early and deliberate engagement of stakeholders. PMID:26061668

  8. Stakeholder Engagement in HIV Cure Research: Lessons Learned from Other HIV Interventions and the Way Forward

    PubMed Central

    Chu, Carissa; Ananworanich, Jintanat; Excler, Jean-Louis; Tucker, Joseph D.

    2015-01-01

    Abstract Clinical and basic science advances have raised considerable hope for achieving an HIV cure by accelerating research. This research is dominated primarily by issues about the nature and design of current and future clinical trials. Stakeholder engagement for HIV cure remains in its early stages. Our analysis examines timing and mechanisms of historical stakeholder engagement in other HIV research areas for HIV-uninfected individuals [vaccine development and pre-exposure prophylaxis (PrEP)], and HIV-infected individuals (treatment as prevention, prevention of mother-to-child transmission, and treatment of acute HIV infection) and articulate a plan for HIV cure stakeholder engagement. The experience from HIV vaccine development shows that early engagement of stakeholders helped manage expectations, mitigating the failure of several vaccine trials, while paving the way for subsequent trials. The relatively late engagement of HIV stakeholders in PrEP research may partly explain some of the implementation challenges. The treatment-related stakeholder engagement was strong and community-led from the onset and helped translation from research to implementation. We outline five steps to initiate and sustain stakeholder engagement in HIV cure research and conclude that stakeholder engagement represents a key investment in which stakeholders mutually agree to share knowledge, benefits, and risk of failure. Effective stakeholder engagement prevents misconceptions. As HIV cure research advances from early trials involving subjects with generally favorable prognosis to studies involving greater risk and uncertainty, success may depend on early and deliberate engagement of stakeholders. PMID:26061668

  9. Biomedical interventions to prevent HIV infection: evidence, challenges, and way forward.

    PubMed

    Padian, Nancy S; Buvé, Anne; Balkus, Jennifer; Serwadda, David; Cates, Ward

    2008-08-16

    Intensive research efforts for more than two decades have not yet resulted in an HIV vaccine of even moderate effectiveness. However, some progress has been made with other biomedical interventions, albeit on the basis of inconsistent levels of evidence. The male condom, if used correctly and consistently, has been proven in observational studies to be very effective in blocking HIV transmission during sexual intercourse; and, in three randomised trials, male circumcision was protective against HIV acquisition among men. Treatment of sexually transmitted infections, a public health intervention in its own right, has had mixed results, depending in part on the epidemic context in which the approach was assessed. Finally, oral and topical antiretroviral compounds are being assessed for their role in reduction of HIV transmission during sexual intercourse. Research on biomedical interventions poses formidable challenges. Difficulties with product adherence and the possibility of sexual disinhibition are important concerns. Biomedical interventions will need to be part of an integrative package that includes biomedical, behavioural, and structural interventions. Assessment of such multicomponent approaches with moderate effects is difficult. Issues to be considered include the nature of control groups and the effect of adherence on the true effectiveness of the intervention. PMID:18687456

  10. Continuous evaluation of evolving behavioral intervention technologies.

    PubMed

    Mohr, David C; Cheung, Ken; Schueller, Stephen M; Hendricks Brown, C; Duan, Naihua

    2013-10-01

    Behavioral intervention technologies (BITs) are web-based and mobile interventions intended to support patients and consumers in changing behaviors related to health, mental health, and well-being. BITs are provided to patients and consumers in clinical care settings and commercial marketplaces, frequently with little or no evaluation. Current evaluation methods, including RCTs and implementation studies, can require years to validate an intervention. This timeline is fundamentally incompatible with the BIT environment, where technology advancement and changes in consumer expectations occur quickly, necessitating rapidly evolving interventions. However, BITs can routinely and iteratively collect data in a planned and strategic manner and generate evidence through systematic prospective analyses, thereby creating a system that can "learn." A methodologic framework, Continuous Evaluation of Evolving Behavioral Intervention Technologies (CEEBIT), is proposed that can support the evaluation of multiple BITs or evolving versions, eliminating those that demonstrate poorer outcomes, while allowing new BITs to be entered at any time. CEEBIT could be used to ensure the effectiveness of BITs provided through deployment platforms in clinical care organizations or BIT marketplaces. The features of CEEBIT are described, including criteria for the determination of inferiority, determination of BIT inclusion, methods of assigning consumers to BITs, definition of outcomes, and evaluation of the usefulness of the system. CEEBIT offers the potential to collapse initial evaluation and postmarketing surveillance, providing ongoing assurance of safety and efficacy to patients and consumers, payers, and policymakers. PMID:24050429

  11. Continuous Evaluation of Evolving Behavioral Intervention Technologies

    PubMed Central

    Mohr, David C.; Cheung, Ken; Schueller, Stephen M.; Brown, C. Hendricks; Duan, Naihua

    2013-01-01

    Behavioral intervention technologies (BITs) are web-based and mobile interventions intended to support patients and consumers in changing behaviors related to health, mental health, and well-being. BITs are provided to patients and consumers in clinical care settings and commercial marketplaces, frequently with little or no evaluation. Current evaluation methods, including RCTs and implementation studies, can require years to validate an intervention. This timeline is fundamentally incompatible with the BIT environment, where technology advancement and changes in consumer expectations occur quickly, necessitating rapidly evolving interventions. However, BITs can routinely and iteratively collect data in a planned and strategic manner and generate evidence through systematic prospective analyses, thereby creating a system that can “learn.” A methodologic framework, Continuous Evaluation of Evolving Behavioral Intervention Technologies (CEEBIT), is proposed that can support the evaluation of multiple BITs or evolving versions, eliminating those that demonstrate poorer outcomes, while allowing new BITs to be entered at any time. CEEBIT could be used to ensure the effectiveness of BITs provided through deployment platforms in clinical care organizations or BIT marketplaces. The features of CEEBIT are described, including criteria for the determination of inferiority, determination of BIT inclusion, methods of assigning consumers to BITs, definition of outcomes, and evaluation of the usefulness of the system. CEEBIT offers the potential to collapse initial evaluation and postmarketing surveillance, providing ongoing assurance of safety and efficacy to patients and consumers, payers, and policymakers. PMID:24050429

  12. PROJECT SALUD: EFFICACY OF A COMMUNITY-BASED HIV PREVENTION INTERVENTION FOR HISPANIC MIGRANT WORKERS IN SOUTH FLORIDA

    PubMed Central

    Sánchez, Jesús; De La Rosa, Mario; Serna, Claudia A.

    2014-01-01

    Project Salud evaluates the efficacy of a community-based intervention to reduce risk behaviors and enhance factors for HIV-preventative behaviors. A randomized controlled trial of 278 high risk Latino migrant workers was conducted between 2008 and 2010. Participants completed an audio computer-assisted self-interview questionnaire at baseline and 3- and 9-month post-intervention follow-ups. Participants were randomly assigned to the community-based intervention (A-SEMI) or the health promotion condition (HPC). Both interventions consisted of four 2.5–hour interactive sessions and were structurally equivalent in administration and format. Relative to the comparison condition, A-SEMI participants reported more consistent condom use, were less likely to report never having used condoms, and were more likely to have used condoms at last sexual encounter during the past 90 and 30 days. A-SEMI participants also experienced a positive change in regard to factors for HIV-preventive behaviors over the entire 9-month period. Our results support the implementation of community-based, culturally tailored interventions among Latino migrant workers. PMID:24059875

  13. A new approach to prevent HIV transmission: Project Protect intervention for recently infected individuals

    PubMed Central

    Vasylyeva, T.I.; Friedman, S.R.; Smyrnov, P.; Bondarenko, K.

    2015-01-01

    Past research suggests that as many as 50% of onward human immunodeficiency virus (HIV) transmissions occur during acute and recent HIV infection. It is clearly important to develop interventions which focus on this highly infectious stage of HIV infection to prevent further transmission in the risk networks of acutely and recently infected individuals. Project Protect tries to find recently and acutely infected individuals and prevents HIV transmission in their risk networks. Participants are recruited by community health outreach workers at community-based HIV testing sites and drug users’ community venues, by coupon referrals and through referrals from AIDS clinics. When a network with acute/recent infection is identified, network members are interviewed about their risky behaviors, network information is collected, and blood is drawn for HIV testing. Participants are also educated and given prevention materials (condoms, syringes, educational materials); HIV-infected participants are referred to AIDS clinics and are assisted with access to care. Community alerts about elevated risk of HIV transmission are distributed within the risk networks of recently infected. Overall, 342 people were recruited to the project and screened for acute/recent HIV infection. Only six index cases of recent infection (2.3% of all people screened) were found through primary screening at voluntary counseling and testing (VCT) sites, but six cases of recent infection were found through contact tracing of these recently infected participants (7% of network members who came to the interview). Combining screening at VCT sites and contact tracing the number of recently infected people we located as compared to VCT screening alone. No adverse events were encountered. These first results provide evidence for the theory behind the intervention, i.e., in the risk networks of recently infected people there are other people with recent HIV infection and they can be successfully located

  14. HIV rapid testing in a Veterans Affairs hospital ED setting: a 5-year sustainability evaluation.

    PubMed

    Knapp, Herschel; Hagedorn, Hildi; Anaya, Henry D

    2014-08-01

    Routine HIV testing in primary care settings is now recommended in the United States. The US Department of Veterans Affairs (VA) has increased the number of patients tested for HIV, but overall HIV testing rates in VA remain low. A proven strategy for increasing such testing involves nurse-initiated HIV rapid testing (HIV RT). The purpose of this work was to use a mixed methodology approach to evaluate the 5-year sustainability of an intervention that implemented HIV RT in a VA emergency department setting in a large, urban VA medical center to reduce missed diagnostic and treatment opportunities in this vulnerable patient population. In-person semistructured interviews were conducted with providers and stakeholders. Interview notes were qualitatively coded for emerging themes. Quarterly testing rates were evaluated for a 5-year time span starting from the launch in July 2008. Findings indicate that HIV RT was sustained by the enthusiasm of 2 clinical champions who oversaw the registered nurses responsible for conducting the testing. The departure of the clinical champions was correlated with a substantial drop-off in testing. Findings also indicate potential strategies for improving sustainability including engaging senior leadership in the project, engaging line staff in the implementation planning from the start to increase ownership over the innovation, incorporating information into initial training explaining the importance of the innovation to quality patient care, providing ongoing training to maintain skills, and providing routine progress reports to staff to demonstrate the ongoing impact of their efforts. PMID:24908442

  15. HIV prevention interventions in Chennai, India: are men who have sex with men being reached?

    PubMed

    Thomas, Beena; Mimiaga, Matthew J; Mayer, Kenneth H; Johnson, Carey V; Menon, Sunil; Chandrasekaran, V; Murugesan, P; Swaminathan, Soumya; Safren, Steven A

    2009-11-01

    India has the greatest number of HIV infections in Asia and the third highest total number of infected persons globally. Men who have sex with men (MSM) are considered by the Government of India's National AIDS Control Organization (NACO) a "core risk group" for HIV in need of HIV prevention efforts. However there is a dearth of information on the frequency of participation in HIV prevention interventions and subsequent HIV risk and other correlates among MSM in India. Recruited through peer outreach workers, word of mouth and snowball sampling techniques, 210 MSM in Chennai completed an interviewer-administered assessment, including questions about participating in any HIV prevention interventions in the past year, sexual risk taking, demographics, MSM identities, and other psychosocial variables. Bivariate and multivariable logistic regression procedures were used to examine behavioral and demographic correlates with HIV prevention intervention participation. More than a quarter (26%) of the sample reported participating in an HIV prevention intervention in the year prior to study participation. Participants who reported engaging in unprotected anal sex (UAS; odds ratio [OR] = 0.28; p = 0.01) in the 3 months prior to study enrollment were less likely to have participated in an HIV prevention program in the past year. MSM who were older (OR = 1.04; p = 0.05), kothis (feminine acting/appearing and predominantly receptive partners in anal sex) compared to panthis (masculine appearing, predominantly insertive partners; OR = 5.52, p = 0.0004), those with higher educational attainment (OR = 1.48, p = 0.01), being "out" about having sex with other men (OR = 4.03, p = 0.0001), and MSM who reported ever having been paid in exchange for sex (OR = 2.92, p = 0.001) were more likely to have reported participation in an HIV prevention intervention in the preceding year. In a multivariable model, MSM reporting UAS in the prior 3 months were less likely to have participated in

  16. Safety-related moderators of a parent-based HIV prevention intervention in South Africa.

    PubMed

    Tarantino, Nicholas; Goodrum, Nada; Armistead, Lisa P; Cook, Sarah L; Skinner, Donald; Toefy, Yoesrie

    2014-12-01

    Our study examined factors influencing the effectiveness of a parent-based HIV prevention intervention implemented in Cape Town, South Africa. Caregiver-youth dyads (N = 99) were randomized into intervention or control conditions and assessed longitudinally. The intervention improved a parenting skill associated with youth sexual risk, parent-child communication about sex and HIV. Analyses revealed that over time, intervention participants (female caregivers) who experienced recent intimate partner violence (IPV) or unsafe neighborhoods discussed fewer sex topics with their adolescent children than caregivers in safer neighborhoods or who did not report IPV. Participants with low or moderate decision-making power in their intimate relationships discussed more topics over time only if they received the intervention. The effectiveness of our intervention was challenged by female caregivers' experience with IPV and unsafe neighborhoods, highlighting the importance of safety-related contextual factors when implementing behavioral interventions for women and young people in high-risk environments. Moderation effects did not occur for youth-reported communication outcomes. Implications for cross-cultural adaptations of parent-based HIV prevention interventions are discussed. PMID:25286174

  17. What HIV-Positive Young Women Want from Behavioral Interventions: A Qualitative Approach

    PubMed Central

    Brothers, Jennifer; Lemos, Diana

    2012-01-01

    Abstract Young women living with HIV in the United States face many social and psychological challenges, including involvement in health care and secondary prevention efforts. The factors that put these young women at risk for HIV acquisition initially, such as poverty, gender roles, cultural norms, and limited perceived control over sexual relationships, continue to place them at risk for both adverse mental and physical health outcomes that impact their daily lives and secondary prevention efforts. This study utilized focus groups with young HIV-positive women in order to better understand their perceived problems and pressures and to inform a developmentally appropriate secondary prevention intervention for young HIV-positive women that could be implemented in clinical care settings. Focus groups with young HIV-positive women were convened in three U.S. cities: Baltimore, Chicago, and Tampa. A total of 17 young, HIV-positive women, age range 17–24 (mean age=21), participated in the focus groups. This article describes the psychological and social challenges these young women face as well as their suggestions regarding secondary HIV prevention intervention components. PMID:22675725

  18. HIV/STI Risk-Reduction- Intervention Efficacy with South African Adolescents Over 54 Months

    PubMed Central

    Jemmott, John B.; Jemmott, Loretta S.; O’Leary, Ann; Ngwane, Zolani; Lewis, David A.; Bellamy, Scarlett L.; Icard, Larry D.; Carty, Craig; Heeren, G. Anita; Tyler, Joanne C.; Makiwane, Monde B.; Teitelman, Anne

    2015-01-01

    Objective Little research has tested HIV/STI risk-reduction-interventions’ effects on early adolescents as they age into middle and late adolescence. This study tested whether intervention-induced reductions in unprotected intercourse during a 12-month period endured over a 54-month period and whether the intervention reduced sexually transmitted infections (STIs), which increase risk for HIV. Method Grade-6 learners (mean age = 12.4 years), participants in a 12-month trial in Eastern Cape Province, South Africa in which nine matched-pairs of schools were randomly selected and within pairs randomized to a theory-based HIV/STI risk-reduction intervention or an attention-control intervention, were eligible, provided parental consent, and completed 42- and 54-month postintervention measures of unprotected intercourse, the primary outcome, other sexual behaviors, theoretical constructs, and, at 42- and 54-month follow-up only, biologically confirmed curable STIs (chlamydial infection, gonorrhea, and trichomoniasis) and herpes-simplex virus 2. Results The HIV/STI risk-reduction intervention reduced unprotected intercourse averaged over the entire follow-up period, OR = 0.42, 95% CI [0.22, 0.84], an effect not significantly reduced at 42- and 54-month follow-up compared with 3, 6, and 12-month follow-ups. The intervention caused positive changes on theoretical constructs averaged over the five follow-ups, though most effects weakened at long-term follow-up. Although the intervention’s main effect on STI was nonsignificant, an Intervention-Condition x Time interaction revealed it significantly reduced curable STIs at 42-month follow-up in adolescents who reported sexual experience. Conclusion These results suggest that theory-based behavioral interventions with early adolescents can have long-lived effects in the context of a generalized severe HIV epidemic. PMID:25110841

  19. Modeling the Impact of Interventions Along the HIV Continuum of Care in Newark, New Jersey

    PubMed Central

    Birger, Ruthie B.; Hallett, Timothy B.; Sinha, Anushua; Grenfell, Bryan T.; Hodder, Sally L.

    2014-01-01

    Background. The human immunodeficiency virus (HIV) epidemic in Newark, New Jersey, is among the most severe in the United States. Prevalence ranges up to 3.3% in some groups. The aim of this study is to use a mathematical model of the epidemic in Newark to assess the impact of interventions along the continuum of care, leading to virologic suppression. Methods. A model was constructed of HIV infection including specific care-continuum steps. The model was calibrated to HIV/AIDS cases in Newark among different populations over a 10-year period. Interventions applied to model fits were increasing proportions tested, linked and retained in care, linked and adherent to treatment, and increasing testing frequency, high-risk-group testing, and adherence. Impacts were assessed by measuring incidence and death reductions 10 years postintervention. Results. The most effective interventions for reducing incidence were improving treatment adherence and increasing testing frequency and coverage. No single intervention reduced incidence in 2023 by >5%, and the most effective combination of interventions reduced incidence by approximately 16% (2%–24%). The most efficacious interventions for reducing deaths were increasing retention, linkage to care, testing coverage, and adherence. Increasing retention reduced deaths by approximately 27% (24%–29%); the most efficacious combination of interventions reduced deaths in 2023 by approximately 52% (46%–57%). Conclusions. Reducing HIV deaths in Newark over a 10-year period may be a realizable goal, but reducing incidence is less likely. Our results highlight the importance of addressing leaks across the entire continuum of care and reinforcing efforts to prevention new HIV infections with additional interventions. PMID:24140971

  20. Enhancing linkage and retention in HIV care: a review of interventions for highly resourced and resource-poor settings.

    PubMed

    Okeke, N Lance; Ostermann, Jan; Thielman, Nathan M

    2014-12-01

    Given the widespread availability of effective antiretroviral therapy, engagement of HIV-infected persons in care is a global priority. We reviewed 51 studies, published in the past decade, assessing strategies for improving linkage to and retention in HIV care. The review included studies from highly resourced settings (HRS) and resource-poor settings (RPS), specifically the USA and sub-Saharan Africa. In HRS, strength-based case management was best supported for improving linkage and retention in care; peer navigation and clinic-based health promotion were supported for improving retention. In RPS, point of care CD4 testing was best supported for improving linkage to care; decentralization, and task-shifting for improving retention. Novel interventions continue to emerge in HRS and RPS, yet many strategies have not been adequately evaluated. Further consideration should be given to analyses that identify which interventions, or combinations of interventions, are most effective, cost-effective, scalable, and aligned with patient preferences for HIV care. PMID:25323298

  1. Modelling HIV/AIDS epidemics in Botswana and India: impact of interventions to prevent transmission.

    PubMed Central

    Nagelkerke, Nico J. D.; Jha, Prabhat; de Vlas, Sake J.; Korenromp, Eline L.; Moses, Stephen; Blanchard, James F.; Plummer, Frank A.

    2002-01-01

    OBJECTIVE: To describe a dynamic compartmental simulation model for Botswana and India, developed to identify the best strategies for preventing spread of HIV/AIDS. METHODS: The following interventions were considered: a behavioural intervention focused on female sex workers; a conventional programme for the treatment of sexually transmitted infections; a programme for the prevention of mother-to-child transmission; an antiretroviral treatment programme for the entire population, based on a single regimen; and an antiretroviral treatment programme for sex workers only, also based on a single regimen. FINDINGS: The interventions directed at sex workers as well as those dealing with sexually transmitted infections showed promise for long-term prevention of human immunodeficiency virus (HIV) infection, although their relative ranking was uncertain. In India, a sex worker intervention would drive the epidemic to extinction. In Botswana none of the interventions alone would achieve this, although the prevalence of HIV would be reduced by almost 50%. Mother-to-child transmission programmes could reduce HIV transmission to infants, but would have no impact on the epidemic itself. In the long run, interventions targeting sexual transmission would be even more effective in reducing the number of HIV-infected children than mother-to-child transmission programmes. Antiretroviral therapy would prevent transmission in the short term, but eventually its effects would wane because of the development of drug resistance. CONCLUSION: Depending on the country and how the antiretroviral therapy was targeted, 25-100% of HIV cases would be drug- resistant after 30 years of use. PMID:11953786

  2. The effects of HIV/AIDS intervention groups for high-risk women in urban clinics.

    PubMed Central

    Kelly, J A; Murphy, D A; Washington, C D; Wilson, T S; Koob, J J; Davis, D R; Ledezma, G; Davantes, B

    1994-01-01

    OBJECTIVE. This study reports the results of a behavior change intervention offered to women at high risk for human immunodeficiency virus (HIV) infection seen in an urban primary health care clinic. METHODS. Participants were 197 women randomly assigned to either an HIV/acquired immunodeficiency syndrome (AIDS) risk reduction group or a comparison group. Women in the HIV/AIDS intervention group attended five group sessions focusing on risk education; skills training in condom use, sexual assertiveness, problem solving, and risk trigger self-management; and peer support for change efforts. Women in the comparison group attended sessions on health topics unrelated to AIDS. RESULTS. At the 3-month follow-up, women in the HIV/AIDS intervention group had increased in sexual communication and negotiation skills. Unprotected sexual intercourse had declined significantly and condom use had increased from 26% to 56% of all intercourse occasions. Women in the comparison group showed no change. CONCLUSIONS. Socially disadvantaged women can be assisted in reducing their risk of contracting HIV infection. Risk reduction behavior change interventions should be offered routinely in primary health care clinics serving low-income and high-risk patients. PMID:7998630

  3. A narrative review of cost-effectiveness analysis of people living with HIV treated with HAART: from interventions to outcomes

    PubMed Central

    Tse, Wah Fung; Yang, Weimin; Huang, Wenlong

    2015-01-01

    Background Since its introduction in 1996, highly active antiretroviral therapy (HAART), which involves the combination of antiretroviral drugs, has resulted in significant improvements in the morbidity, mortality, and life expectancy of HIV-infected patients. Numerous studies of the cost-effectiveness of HAART from different perspectives in HIV have been reported. Aim To investigate the economic outcomes and relevance of HAART for people living with HIV. Materials and methods A narrative literature review was conducted on 22 peer-reviewed full economic evaluations of people living with HIV treated with different HAART regimens and published in English between January 2005 and December 2014. Information regarding study details, such as interventions, outcomes, and modeling methods, was extracted. The high heterogeneity of the included studies rendered a meta-analysis inappropriate; therefore, we conducted a comparative analysis of studies grouped according to the similarity of the different intervention types and outcomes. Results Most of the economic evaluations of HAART focused on comparisons between the specific HAART regimens and others from the following perspectives: injecting drug users versus noninjecting drug users, HIV-infected adults without AIDS versus those with AIDS, regimens based on developed world guidelines versus those based on developing world guidelines, self-administered HAART versus directly observed HAART, and “ideal” versus “typical” regimens. Conclusion In general, HAART is more cost-effective than other therapeutic regimens adopted so far. Further investigations, especially head-to-head comparisons of “ideal” and “typical” trials of different regimen combinations, are required to identify the optimal HAART regimens. PMID:26316787

  4. Cost-Effectiveness of an Intervention to Reduce HIV/STI Incidence and Promote Condom Use among Female Sex Workers in the Mexico–US Border Region

    PubMed Central

    Burgos, José L.; Gaebler, Julia A.; Strathdee, Steffanie A.; Lozada, Remedios; Staines, Hugo; Patterson, Thomas L.

    2010-01-01

    Background Previous research demonstrated efficacy of a brief behavioral intervention to reduce incidence of HIV and sexually transmitted infections (STIs) among female sex workers (FSWs) in Tijuana and Ciudad Juarez, Mexico, cities on Mexico's border with the US. We assessed this intervention's cost-effectiveness. Methodology and Principal Findings A life-time Markov model was developed to estimate HIV cases prevented, changes in quality-adjusted life expectancy (QALE), and costs per additional quality-adjusted life year gained (QALY), comparing (in US$2,009) no intervention to a once-only and annual intervention. Future costs and health benefits were discounted annually at 3%. Sensitivity analyses evaluated model robustness. We found that for a hypothetical 1,000 FSWs receiving the once-only intervention, there were 33 HIV cases prevented and 5.7 months of QALE gained compared to no intervention. The additional cost per QALY gained was US$183. For FSWs receiving the intervention annually, there were 29 additional HIV cases prevented and 4.5 additional months of QALE compared to the once-only intervention. The additional cost per QALY was US$1,075. When highly active antiretroviral therapy (HAART) was included in the model, the annual intervention strategy resulted in net savings and dominated both once-only and no intervention strategies, and remained robust across extensive sensitivity analyses. Even when considering clinical benefits from HAART, ignoring added costs, the cost per QALY gained remained below three times the Mexican GDP per capita, and below established cost-effectiveness thresholds. Conclusions/Significance This brief intervention was shown to be cost-effective among FSWs in two Mexico-US border cities and may have application for FSWs in other resource-limited settings. Trial Registration ClinicalTrials.gov NCT00338845 PMID:20617193

  5. A novel economic intervention to reduce HIV risks among school-going AIDS orphans in rural Uganda.

    PubMed

    Ssewamala, Fred M; Alicea, Stacey; Bannon, William M; Ismayilova, Leyla

    2008-01-01

    This study tested an economic intervention to reduce HIV risks among AIDS-orphaned adolescents. Adolescents (n = 96) were randomly assigned to receive the intervention or usual care for orphans in Uganda. Data obtained at baseline and 12-month follow-up revealed significant differences between the treatment and control groups in HIV prevention attitudes and educational planning. PMID:18155037

  6. Effect of an Online Video-Based Intervention to Increase HIV Testing in Men Who Have Sex with Men in Peru

    PubMed Central

    Blas, Magaly M.; Alva, Isaac E.; Carcamo, Cesar P.; Cabello, Robinson; Goodreau, Steven M.; Kimball, Ann M.; Kurth, Ann E.

    2010-01-01

    Background Although many men who have sex with men (MSM) in Peru are unaware of their HIV status, they are frequent users of the Internet, and can be approached by that medium for promotion of HIV testing. Methods We conducted an online randomized controlled trial to compare the effect of HIV-testing motivational videos versus standard public health text, both offered through a gay website. The videos were customized for two audiences based on self-identification: either gay or non-gay men. The outcomes evaluated were ‘intention to get tested’ and ‘HIV testing at the clinic.’ Findings In the non-gay identified group, 97 men were randomly assigned to the video-based intervention and 90 to the text-based intervention. Non-gay identified participants randomized to the video-based intervention were more likely to report their intention of getting tested for HIV within the next 30 days (62.5% vs. 15.4%, Relative Risk (RR): 2.77, 95% Confidence Interval (CI): 1.42–5.39). After a mean of 125.5 days of observation (range 42–209 days), 11 participants randomized to the video and none of the participants randomized to text attended our clinic requesting HIV testing (p = 0.001). In the gay-identified group, 142 men were randomized to the video-based intervention and 130 to the text-based intervention. Gay-identified participants randomized to the video were more likely to report intentions of getting an HIV test within 30 days, although not significantly (50% vs. 21.6%, RR: 1.54, 95% CI: 0.74–3.20). At the end of follow up, 8 participants who watched the video and 10 who read the text visited our clinic for HIV testing (Hazard Ratio: 1.07, 95% CI: 0.40–2.85). Conclusion This study provides some evidence of the efficacy of a video-based online intervention in improving HIV testing among non-gay-identified MSM in Peru. This intervention may be adopted by institutions with websites oriented to motivate HIV testing among similar MSM populations. Trial

  7. A Randomized Controlled Trial of a Parent-Centered Intervention in Preventing Substance Use and HIV Risk Behaviors in Hispanic Adolescents

    ERIC Educational Resources Information Center

    Prado, Guillermo; Pantin, Hilda; Briones, Ervin; Schwartz, Seth J.; Feaster, Daniel; Huang, Shi; Sullivan, Summer; Tapia, Maria I.; Sabillon, Eduardo; Lopez, Barbara; Szapocznik, Jose

    2007-01-01

    The present study evaluated the efficacy of Familias Unidas + Parent-Preadolescent Training for HIV Prevention (PATH), a Hispanic-specific, parent-centered intervention, in preventing adolescent substance use and unsafe sexual behavior. Two hundred sixty-six 8th-grade Hispanic adolescents and their primary caregivers were randomly assigned to 1 of…

  8. Effectiveness of a video-based motivational skills-building HIV risk-reduction intervention for female military personnel.

    PubMed

    Essien, E James; Mgbere, Osaro; Monjok, Emmanuel; Ekong, Ernest; Holstad, Marcia M; Kalichman, Seth C

    2011-01-01

    Anecdotal evidence suggests that the HIV/AIDS prevalence rates in several African armed forces are high, with gender inequality rendering female military personnel more vulnerable to the disease. The objective of this study was to replicate a successful videotape-based HIV prevention intervention among Nigerian female military personnel in an effort to establish the cross-cultural stability, feasibility and cost-effectiveness of this approach in resource-limited countries. Enlisted women (N346) were recruited from two cantonments in Southwestern Nigeria and randomly assigned to either (a) a 5-session video-based, small group, cognitive-behavioral, HIV prevention intervention, or (b) a 5-session, video-based, contact-matched, HIV education control condition. Participants provided self-report of their HIV/AIDS-related knowledge and sexual behaviors at baseline, 3 and 6 months after completing the intervention. The results indicate that the motivational skills-building intervention did not improve participants' knowledge of HIV/AIDS any better than did the HIV education control condition at each assessment period, but it significantly increased condom use among women in this group by 53.6% at 3-month follow-up. HIV preventive behaviors among women in the motivational skills-building intervention group improved significantly, being 2 and 3 times more, compared to women in the HIV education control group at 3-month and 6-month follow-up assessments. The intervention also significantly improved behavioral intentions of participants as well as reduced alcohol use before sex by 25%, after 3 months; and number of sexual partners by 12% after 6 months. Women in the intervention group were five times more likely than women in HIV education control group to suggest that their new male partners use condom. These findings indicate that a videotape-based, HIV prevention intervention is a feasible and effective approach to HIV prevention among female military personnel from sub

  9. The efficacy of an HIV risk reduction intervention for Hispanic women.

    PubMed

    Peragallo, Nilda; Gonzalez-Guarda, Rosa M; McCabe, Brian E; Cianelli, Rosina

    2012-07-01

    Culturally-specific HIV risk reduction interventions for Hispanic women are needed. SEPA (Salud/Health, Educación/Education, Promoción/Promotion, y/and Autocuidado/Self-care) is a culturally-specific and theoretically-based group intervention for Hispanic women. The SEPA intervention consists of five sessions covering STI and HIV prevention; communication, condom negotiation and condom use; and violence prevention. A randomized trial tested the efficacy of SEPA with 548 adult U.S. Hispanic women (SEPA n = 274; delayed intervention control n = 274) who completed structured interviews at baseline and 3, 6, and 12 months post-baseline. Intent-to-treat analyses indicated that SEPA decreased positive urine samples for Chlamydia; improved condom use, decreased substance abuse and IPV; improved communication with partner, improved HIV-related knowledge, improved intentions to use condoms, decreased barriers to condom use, and increased community prevention attitudes. Culturally-specific interventions have promise for preventing HIV for Hispanic women in the U.S. The effectiveness of SEPA should be tested in a translational community trial. PMID:21969175

  10. The Efficacy of an HIV Risk Reduction Intervention for Hispanic Women

    PubMed Central

    Peragallo, Nilda; McCabe, Brian E.; Cianelli, Rosina

    2012-01-01

    Culturally-specific HIV risk reduction interventions for Hispanic women are needed. SEPA (Salud/Health, Educación/Education, Promoción/Promotion, y/ and Autocuidado/Self-care) is a culturally-specific and theoretically-based group intervention for Hispanic women. The SEPA intervention consists of five sessions covering STI and HIV prevention; communication, condom negotiation and condom use; and violence prevention. A randomized trial tested the efficacy of SEPA with 548 adult U.S. Hispanic women (SEPA n = 274; delayed intervention control n = 274) who completed structured interviews at baseline and 3, 6, and 12 months post-baseline. Intent-to-treat analyses indicated that SEPA decreased positive urine samples for Chlamydia; improved condom use, decreased substance abuse and IPV; improved communication with partner, improved HIV-related knowledge, improved intentions to use condoms, decreased barriers to condom use, and increased community prevention attitudes. Culturally-specific interventions have promise for preventing HIV for Hispanic women in the U.S. The effectiveness of SEPA should be tested in a translational community trial. PMID:21969175

  11. Considerations for a Human Rights Impact Assessment of a Population Wide Treatment for HIV Prevention Intervention.

    PubMed

    Hanefeld, Johanna; Bond, Virginia; Seeley, Janet; Lees, Shelley; Desmond, Nicola

    2015-12-01

    Increasing attention is being paid to the potential of anti-retroviral treatment (ART) for HIV prevention. The possibility of eliminating HIV from a population through a universal test and treat intervention, where all people within a population are tested for HIV and all positive people immediately initiated on ART, as part of a wider prevention intervention, was first proposed in 2009. Several clinical trials testing this idea are now in inception phase. An intervention which relies on universally testing the entire population for HIV will pose challenges to human rights, including obtaining genuine consent to testing and treatment. It also requires a context in which people can live free from fear of stigma, discrimination and violence, and can access services they require. These challenges are distinct from the field of medical ethics which has traditionally governed clinical trials and focuses primarily on patient researcher relationship. This paper sets out the potential impact of a population wide treatment as prevention intervention on human rights. It identifies five human right principles of particular relevance: participation, accountability, the right to health, non-discrimination and equality, and consent and confidentiality. The paper proposes that explicit attention to human rights can strengthen a treatment as prevention intervention, contribute to mediating likely health systems challenges and offer insights on how to reach all sections of the population. PMID:26524615

  12. Adaptation of an HIV Medication Adherence Intervention for Adolescents and Young Adults

    PubMed Central

    Thurston, Idia B.; Bogart, Laura M.; Wachman, Madeline; Closson, Elizabeth F.; Skeer, Margie R.; Mimiaga, Matthew J.

    2014-01-01

    Rising rates of human immunodeficiency virus (HIV) infection among adolescents and young adults underscore the importance of interventions for this population. While the morbidity and mortality of HIV has greatly decreased over the years, maintaining high rates of adherence is necessary to receive optimal medication effects. Few studies have developed interventions for adolescents and young adults and none have specifically been developed for sexual minority (lesbian, gay, and bisexual; LGB) youth. Guided by an evidence-based adult intervention and adolescent qualitative interviews, we developed a multicomponent, technology-enhanced, customizable adherence intervention for adolescents and young adults for use in a clinical setting. The two cases presented in this paper illustrate the use of the five-session positive strategies to enhance problem solving (Positive STEPS) intervention, based on cognitive-behavioral techniques and motivational interviewing. We present a perinatally infected heterosexual woman and a behaviorally infected gay man to demonstrate the unique challenges faced by these youth and showcase how the intervention can be customized. Future directions include varying the number of intervention sessions based on mode of HIV infection and incorporating booster sessions. PMID:25452680

  13. Testing the efficacy of an HIV stigma reduction intervention with medical students in Puerto Rico: the SPACES project

    PubMed Central

    Varas-Díaz, Nelson; Neilands, Torsten B; Cintrón-Bou, Francheska; Marzán-Rodríguez, Melissa; Santos-Figueroa, Axel; Santiago-Negrón, Salvador; Marques, Domingo; Rodríguez-Madera, Sheilla

    2013-01-01

    Introduction Stigma associated with HIV has been documented as a barrier for accessing quality health-related services. When the stigma manifests in the healthcare setting, people living with HIV receive substandard services or even be denied care altogether. Although the consequences of HIV stigma have been documented extensively, efforts to reduce these negative attitudes have been scarce. Interventions to reduce HIV stigma should be implemented as part of the formal training of future healthcare professionals. The interventions that have been tested with healthcare professionals and published have several limitations that must be surpassed (i.e., lack of comparison groups in research designs and longitudinal follow-up data). Furthermore, Latino healthcare professionals have been absent from these intervention efforts even though the epidemic has affected this population disproportionately. Methods In this article, we describe an intervention developed to reduce HIV stigma among medical students in Puerto Rico. A total of 507 medical students were randomly introduced into our intervention and control conditions. Results The results show statistically significant differences between the intervention and control groups; intervention group participants had lower HIV stigma levels than control participants after the intervention. In addition, differences in HIV stigma levels between the groups were sustained for a 12-month period. Conclusions The results of our study demonstrate the efficacy of the modes of intervention developed by us and serve as a new training tool for future healthcare professionals with regard to stigma reduction. PMID:24242260

  14. Barriers and facilitators to the implementation of SPNS interventions designed to engage and retain HIV positive women of color in medical care.

    PubMed

    Garcia, Iliana A; Blank, Arthur E; Eastwood, Elizabeth A; Karasz, Alison

    2015-04-01

    The use of evidence-based strategies to increase access to medical care and improve health outcomes for people living with HIV is a major public health priority in the United States. As part of a multi-site evaluation funded under the Health Resources and Services Administration (HRSA), a process evaluation was conducted with the goal of understanding barriers and facilitators to the implementation of eleven heterogeneous interventions designed to engage and retain HIV positive women of color (WoC) in medical care. Findings identified barriers and facilitators to program implementation at five levels: (1) program; (2) team; (3) agency; (4) partner network; and (5) the larger socio-ecological context. We conclude with a series of recommendations that may be useful for the implementation of similar interventions focused on recruitment and retention of WoC in HIV medical care. PMID:25107362

  15. Enhancement of a Locally Developed HIV Prevention Intervention for Hispanic/Latino MSM: A Partnership of Community-Based Organizations, a University, and the Centers for Disease Control and Prevention.

    PubMed

    Rhodes, Scott D; Alonzo, Jorge; Mann, Lilli; Freeman, Arin; Sun, Christina J; Garcia, Manuel; Painter, Thomas M

    2015-08-01

    Hispanic/Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs); however, no efficacious behavioral HIV/STD prevention interventions are currently available for use with this vulnerable population. We describe the enhancement of HOLA en Grupos, a community-based behavioral HIV/STD prevention intervention for Spanish-speaking Hispanic/Latino MSM that is currently being implemented and evaluated in North Carolina with support from the Centers of Disease Control and Prevention (CDC). Our intervention enhancement process included incorporating local data on risks and context; identifying community needs and priorities; defining intervention core elements and key characteristics; developing a logic model; developing an intervention logo; enhancing intervention activities and materials; scripting intervention delivery; expanding the comparison intervention; and establishing a materials review committee. If the CDC-sponsored evaluation determines that HOLA en Grupos is efficacious, it will be the first such behavioral HIV/STD prevention intervention to be identified for potential use with Hispanic/Latino MSM, thereby contributing to the body of evidence-based resources that may be used for preventing HIV/STD infection among these MSM and their sex partners. PMID:26241382

  16. The HoMBReS and HoMBReS Por un Cambio Interventions to Reduce HIV Disparities Among Immigrant Hispanic/Latino Men.

    PubMed

    Rhodes, Scott D; Leichliter, Jami S; Sun, Christina J; Bloom, Fred R

    2016-02-12

    Hispanics/Latinos in the United States are affected disproportionately by human immunodeficiency virus (HIV) infection, acquired immunodeficiency syndrome (AIDS), and other sexually transmitted diseases (STDs); however, few effective evidence-based prevention interventions for this population exist. This report describes the Hombres Manteniendo Bienestar y Relaciones Saludables (Men Maintaining Wellbeing and Healthy Relationships) (HoMBReS) intervention, which was developed by a community-based, participatory research partnership in North Carolina and initially implemented during 2005-2009. HoMBReS is an example of an effective intervention that uses lay health advisors (known as Navegantes [navigators]) in the context of existing social networks (i.e., recreational soccer teams) to promote consistent condom use and HIV and STD testing among Hispanic/Latino men. In 2012, HoMBReS was classified as a best-evidence community-level HIV prevention intervention (CDC. Compendium of evidence-based behavioral interventions and best practices for HIV prevention. Atlanta, GA: US Department of Health and Human Services, CDC; 2015). The intervention has been implemented elsewhere, enhanced, and further evaluated in longitudinal intervention and implementation studies. HoMBReS has been adapted for other populations, including men who have sex with men and transgender persons. Additional evaluation has found that Navegantes continue in their roles as health advisors, opinion leaders, and community advocates after study support ends. Hispanic/Latino men's social networks can be leveraged to promote sexual health within the community by decreasing HIV risk behaviors among Hispanics/Latinos in the United States. PMID:26916740

  17. A systematic review examining whether interventions are effective in reducing cognitive delay in children infected and affected with HIV.

    PubMed

    Sherr, Lorraine; Croome, Natasha; Bradshaw, Katie; Parra Castaneda, Katherine

    2014-01-01

    Cognitive delay has been recorded in children infected and affected by HIV. This finding is well established, yet few countries report provision of special educational interventions for this group of children. The general rehabilitation literature describes an array of effective interventions for children with learning difficulties. These have rarely been adapted for children affected by HIV, despite their growing numbers. A systematic review was conducted to examine effective interventions for cognitive delay in children (under 18 years) infected with HIV and/or exposed to HIV (HIV-negative child born to an HIV-positive mother). A keyword search of electronic databases with reference follow-up generated 1745 hits. These abstracts were screened for relevance, resulting in 17 papers available for shortlisting. Studies were then included if they were randomised control trials, were longitudinal, pre/post or cohort studies and presented empirical data on an intervention for children infected by HIV or exposed to HIV and had at least one cognitive measure. Carer interventions were included if they had at least one child cognitive measure. Of the 17 papers, 4 met the inclusion criteria based on design and quality. Interventions included cognitive rehearsal, home-based stimulation and parental support. All four interventions showed at least one significant child improvement at follow-up. Despite such improvements, many children still scored within the disability range at follow-up. These results show that the effective interventions are available and should be scaled up to meet the needs of children. Complex interventions are not sufficiently studied. This review suggests an ongoing need to build evidence-based interventions, but calls on evidence-based programmes to be initiated for HIV-positive and HIV-affected children. PMID:24720704

  18. Peer-Led Interventions to Reduce HIV Risk of Youth: A Review

    ERIC Educational Resources Information Center

    Maticka-Tyndale, Eleanor; Barnett, Jessica Penwell

    2010-01-01

    One approach in HIV prevention programming targeting youth is to use peer leaders in what is referred to as peer education programming. This paper critically reviews and synthesizes the results and lessons learned from 24 evaluated peer-led programs with an HIV/AIDS risk reduction component that target youth in the communities where they live and…

  19. Adapting an Evidence-Based Intervention Targeting HIV-Infected Prisoners in Malaysia.

    PubMed

    Copenhaver, Michael M; Tunku, Noor; Ezeabogu, Ifeoma; Potrepka, Jessica; Zahari, Muhammad Muhsin A; Kamarulzaman, Adeeba; Altice, Frederick L

    2011-01-01

    HIV-infected prisoners in Malaysia represent a critical target population for secondary HIV risk reduction interventions and care. We report on the process and outcome of our formative research aimed at systematically selecting and adapting an EBI designed to reduce secondary HIV risk and improve adherence to antiretroviral therapy among soon-to-be-released HIV-infected prisoners. Our formative work involved a critical examination of established EBIs and associated published reports complemented by data elicited through structured interviews and focus groups with key stakeholders, members of the target population, and their family members. Based on all information, we adapted the Holistic Health Recovery Program targeting people living with HIV (HHRP+), an EBI, to consist of eight 2-hour sessions that cover a range of specified topics so that participants may individually apply intervention content as needed to accommodate their particular substance abuse, HIV risk, and antiretroviral adherence issues. This study provides a complete example of the process of selecting and adapting an EBI-taking into account both empirical evidence and input from target organization stakeholders and target population members and their families-for use in real world prison settings where high-risk populations are concentrated. PMID:21860786

  20. Examination of an interventionist-led HIV intervention among criminal justice-involved female prisoners

    PubMed Central

    Havens, Jennifer R.; Leukefeld, Carl G.; Oser, Carrie B.; Staton-Tindall, Michele; Knudsen, Hannah K.; Mooney, Jennifer; Duvall, Jamieson L.; Clarke, Jennifer G.; Frisman, Linda; Surratt, Hilary L.; Inciardi, James A.

    2009-01-01

    The purpose of this study was to examine the implementation, adherence and protocol fidelity for the Reducing Risky Relationships for HIV (RRR-HIV) study. The RRR-HIV study is a phase III trial of a randomized intervention to reduce human immunodeficiency virus (HIV) risk behaviors among incarcerated women in four US states: Connecticut, Delaware, Kentucky and Rhode Island. The intervention consists of five interventionist-led prison-based group sessions and a sixth individual community-based session. Data on adherence, implementation, acceptability and fidelity of the intervention were obtained from forms completed after the five prison-based sessions by both the interventionist and participant. Data from the sixth session were collected by the interventionist. Of the 363 women recruited to date, 173 (47.6%) have been randomly allocated to the experimental RRR intervention, of which implementation measures were available for 162 (93.6%). Almost three-quarters of women attended all five sessions, each of which lasted a median of 90 minutes, indicating successful implementation of the protocol across multiple study sites. Interventionists and participants alike reported that all of the topics for each session were discussed, suggesting adherence to the protocol. In addition, protocol interventionists indicated that more than 95% of the women were engaged/involved, interested, and understood the materials presented, indicating high levels of acceptability among the participants and fidelity to the intervention protocols. The majority of participants also answered all of the post-test questions correctly, which is another strong indicator of the fidelity to the intervention. Results suggest that the RRR-HIV study has been successfully implemented across multiple study sites. Adherence to the protocol, as well as protocol fidelity and acceptability, were also strong, which is essential to establish prior to examining outcome data. PMID:20090928

  1. Interventions and Patterns of Risk in Adolescent HIV/AIDS Prevention

    PubMed Central

    Malow, Robert M.; Rosenberg, Rhonda; Donenberg, Geri; Dévieux, Jessy G.

    2007-01-01

    Mid-way through the third decade of experience in preventing HIV/AIDS among adolescents, behavioral interventions and outcomes for high risk subgroups have generated evidence extremely instructive for navigating future priorities in reducing transmission risk behavior. Youth who abuse alcohol or drugs, who are detained or incarcerated, or have mental health co-morbidity such as externalizing disorders, represent the most significant challenge to current and future efforts to control the epidemic among the adolescent population. Although there is no unambiguous, standard intervention approach with adolescents, patterns of risks and outcomes with these subgroups are instructive in the critical priority of creating more sustainable gains with our HIV prevention resources. This article provides a synthesis of the evidence with these subgroups, discusses important limitations and difficulties in the current intervention science and highlights promising directions for the next generation of effort in reducing adolescent HIV-related sexual risk behavior. Because individual-level interventions have had only modest effects, a key current emphasis within the field is to develop multilevel interventions with a more ecological or contextual focus. We review various pragmatic responses that acknowledge this priority and the debt owed to individual-level intervention work with adolescents. PMID:19088859

  2. Development of a multilevel intervention to increase HIV clinical trial participation among rural minorities.

    PubMed

    Corbie-Smith, Giselle; Odeneye, Ebun; Banks, Bahby; Shandor Miles, Margaret; Roman Isler, Malika

    2013-06-01

    Minorities are disproportionately affected by HIV/AIDS in the rural Southeast; therefore, it is important to develop targeted, culturally appropriate interventions to support rural minority participation in HIV/AIDS research. Using intervention mapping, we developed a comprehensive multilevel intervention for service providers (SPs) and people living with HIV/AIDS (PLWHA). The authors collected data from both groups through 11 focus groups and 35 individual interviews. Resultant data were used to develop matrices of behavioral outcomes, performance objectives, and learning objectives. Each performance objective was mapped with changeable, theory-based determinants to inform components of the intervention. Behavioral outcomes for the intervention included the following: (a) eligible PLWHA will enroll in clinical trials and (2) SPs will refer eligible PLWHA to clinical trials. The ensuing intervention consists of four SPs and six PLWHA educational sessions. Its contents, methods, and strategies were grounded in the theory of reasoned action, social cognitive theory, and the concept of social support. All materials were pretested and refined for content appropriateness and effectiveness. PMID:22991051

  3. Development of a Multilevel Intervention to Increase HIV Clinical Trial Participation among Rural Minorities

    PubMed Central

    Corbie-Smith, Giselle; Odeneye, Ebun; Banks, Bahby; Miles, Margaret Shandor; Isler, Malika Roman

    2013-01-01

    Minorities are disproportionately affected by HIV/AIDS in the rural Southeast; therefore, it is important to develop targeted, culturally appropriate interventions to support rural minority participation in HIV/AIDS research. Using Intervention Mapping, we developed a comprehensive multilevel intervention for service providers (SPs) and people living with HIV/AIDS (PLWHA). We collected data from both groups through 11 focus groups and 35 individual interviews. Resultant data were used to develop matrices of behavioral outcomes, performance objectives and learning objectives. Each performance objective was mapped with changeable, theory-based determinants to inform components of the intervention. Behavioral outcomes for the intervention included: (a) Eligible PLWHA will enroll in clinical trials; and (b) SPs will refer eligible PLWHA to clinical trials. The ensuing intervention consists of four SPs and six PLWHA educational sessions. Its contents, methods and strategies were grounded in the theory of reasoned action, social cognitive theory, and the concept of social support. All materials were pretested and refined for content appropriateness and effectiveness. PMID:22991051

  4. Acceptability, feasibility and challenges of implementing an HIV prevention intervention for people living with HIV/AIDS among healthcare providers in Mozambique: results of a qualitative study.

    PubMed

    Jaiantilal, Prafulta; Gutin, Sarah A; Cummings, Beverley; Mbofana, Francisco; Rose, Carol Dawson

    2015-01-01

    Despite the Mozambique government's efforts to curb human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), national prevalence is 11.5% and support is needed to expand HIV-related services and improve program quality. Positive prevention (PP) programs, which prioritize HIV prevention with people living with HIV and AIDS (PLHIV), have been recognized as an important intervention for preventing new HIV infections. To address this, an evidence-based PP training intervention was implemented with HIV healthcare providers in Mozambique. This study focuses on the acceptability and feasibility of a PP intervention in HIV clinics from the healthcare provider perspective. In-depth interviews were conducted with 31 healthcare providers from three provinces who participated in PP trainings in Mozambique. Interview data were coded using content analysis. Study data suggest that healthcare providers found PP acceptable, feasible to implement in their HIV work in clinic settings, and valued this strategy to improve HIV prevention. The PP training also led providers to feel more comfortable counseling their patients about prevention, with a more holistic approach that included HIV testing, treatment and encouraging PLHIV to live positively. While overall acceptance of the PP training was positive, several barriers to feasibility surfaced in the data. Patient-level barriers included resistance to disclosing HIV status due to fear of stigma and discrimination, difficulty negotiating for condom use, difficulty engaging men in testing and treatment, and the effects of poverty on accessing care. Providers also identified work environment barriers including high patient load, time constraints, and frequent staff turnover. Recognizing PP as an important intervention, healthcare providers should be trained to provide comprehensive prevention, care and treatment for PLHIV. Further work is needed to explore the complex social dynamics and cultural challenges such as

  5. Acceptability, feasibility and challenges of implementing an HIV prevention intervention for people living with HIV/AIDS among healthcare providers in Mozambique: Results of a qualitative study

    PubMed Central

    Jaiantilal, Prafulta; Gutin, Sarah A.; Cummings, Beverley; Mbofana, Francisco; Rose, Carol Dawson

    2015-01-01

    Abstract Despite the Mozambique government's efforts to curb human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), national prevalence is 11.5% and support is needed to expand HIV-related services and improve program quality. Positive prevention (PP) programs, which prioritize HIV prevention with people living with HIV and AIDS (PLHIV), have been recognized as an important intervention for preventing new HIV infections. To address this, an evidence-based PP training intervention was implemented with HIV healthcare providers in Mozambique. This study focuses on the acceptability and feasibility of a PP intervention in HIV clinics from the healthcare provider perspective. In-depth interviews were conducted with 31 healthcare providers from three provinces who participated in PP trainings in Mozambique. Interview data were coded using content analysis. Study data suggest that healthcare providers found PP acceptable, feasible to implement in their HIV work in clinic settings, and valued this strategy to improve HIV prevention. The PP training also led providers to feel more comfortable counseling their patients about prevention, with a more holistic approach that included HIV testing, treatment and encouraging PLHIV to live positively. While overall acceptance of the PP training was positive, several barriers to feasibility surfaced in the data. Patient-level barriers included resistance to disclosing HIV status due to fear of stigma and discrimination, difficulty negotiating for condom use, difficulty engaging men in testing and treatment, and the effects of poverty on accessing care. Providers also identified work environment barriers including high patient load, time constraints, and frequent staff turnover. Recognizing PP as an important intervention, healthcare providers should be trained to provide comprehensive prevention, care and treatment for PLHIV. Further work is needed to explore the complex social dynamics and cultural challenges

  6. The Ethics of Screening for Early Intervention in HIV Disease.

    ERIC Educational Resources Information Center

    Levine, Carol; Bayer, Ronald

    1989-01-01

    Discusses the ethical aspects of screening and testing for clinical detection of individuals infected with asymptomatic human immunodeficiency virus (HIV). Careful consideration must be given to individuals' rights, respect for their privacy, and society's obligations to provide needed clinical and social services in translating cautious medical…

  7. Parents Questioning Immunization: Evaluation of an Intervention

    ERIC Educational Resources Information Center

    Gust, Deborah A.; Kennedy, Allison; Weber, Deanne; Evans, Geoff; Kong, Yuan; Salmon, Daniel

    2009-01-01

    Objectives: To compare attitudes of parents who filed or considered filing an exemption to school immunization requirements and/or would not have their child immunized if it were not required by law (cases) to controls. To develop and evaluate a brochure intervention for parents considering an exemption. Methods: Interviews, focus groups, mailed…

  8. Effectiveness of a Behavioral Intervention for Increasing Safer Sex Behaviors in HIV-positive MSM Methamphetamine Users: Results from the EDGE Study

    PubMed Central

    Mausbach, Brent T.; Semple, Shirley J.; Strathdee, Steffanie A.; Zians, Jim; Patterson, Thomas L.

    2007-01-01

    Background Methamphetamine use has been associated with rising STI/HIV transmission rates, particularly among men who have sex with men (MSM). Interventions which successfully reduce risk for HIV transmission among this population are a public health priority. This study examined the efficacy of a behavioral intervention for increasing safer sex behaviors in the context of ongoing methamphetamine use in a sample of HIV-positive, methamphetamine-using MSM. Methods Three-hundred forty one participants from San Diego, CA were randomly assigned to receive either a safer sex behavioral intervention (EDGE) or a time-equivalent diet-and-exercise attention-control condition. Random effects regression analyses were used to evaluate change in safer sex behaviors over a 12-month period. Results Participants in the EDGE intervention engaged in significantly more protected sex acts at the 8-month (p = .034) and 12-month assessment (p = 0.007). By 12-months post-baseline, a greater percentage of protected sex acts that was observed for EDGE (25.8%) vs. control participants (18.7%) (p = 0.038). There was a significant time-by-intervention interaction (p = .018) for self-efficacy for condom use, suggesting that EDGE participants’ self-efficacy demonstrated a greater increase over time compared to control participants. Conclusions These results suggest that it is possible to reduce high risk sexual behaviors in the context of ongoing methamphetamine use among HIV-infected MSM. PMID:17182196

  9. Internet-Based Health Information Consumer Skills Intervention for People Living with HIV/AIDS

    ERIC Educational Resources Information Center

    Kalichman, Seth C.; Cherry, Charsey; Cain, Demetria; Pope, Howard; Kalichman, Moira; Eaton, Lisa; Weinhardt, Lance; Benotsch, Eric G.

    2006-01-01

    Medical information can improve health, and there is an enormous amount of health information available on the Internet. A randomized clinical trial tested the effectiveness of an intervention based on social-cognitive theory to improve information use among people living with HIV/AIDS. Men and women (N = 448) were placed in either (a) an…

  10. Research on rehabilitation interventions for adults living with HIV: a scoping review.

    PubMed

    Stevens, Marianne E; Nixon, Stephanie A

    2016-06-01

    The aim of this paper is to use a scoping review to investigate the extent, range, and nature of research on rehabilitation interventions for adults living with HIV. Electronic databases (MEDLINE, EMBASE, CINAHL, AMED, and PsychINFO) and reference lists of the included articles were searched. Authors were emailed when possible for unavailable articles. A total of 897 titles and abstracts were retrieved. Thirty-three articles were included. There were 27 different rehabilitation interventions delivered by 18 professions. The studies were completed in four different countries. Most studies were published in 2008. A randomized-controlled trial was the most used method. The nature of the studies was analyzed according to the three-core concepts of the International Classification of Functioning, Disability and Health: 28 studies addressed impairments; six studies addressed activity limitations; and 14 studies addressed participation restrictions. This scoping study advances the knowledge of research on rehabilitation interventions for adults living with HIV. More research on rehabilitation interventions is needed in sub-Saharan Africa and other low-income and middle-income countries to ensure that these individuals are receiving the best possible care. There is a need for the HIV field to recognize the important contribution of rehabilitation toward the HIV care continuum. PMID:27028287

  11. Criminality among Female Drug Users Following an HIV Risk-Reduction Intervention

    ERIC Educational Resources Information Center

    Theall, Katherine P.; Elifson, Kirk W.; Sterk, Claire E.; Stewart, Eric A.

    2007-01-01

    The main objectives of this article are to determine the prevalence of criminality among a sample of female African American drug users and to examine change in criminality over time, including the correlates associated with this change. Data were collected from 336 adult women who participated in an HIV risk-reduction intervention focused on the…

  12. A Randomized Clinical Trial of Alternative Stress Management Interventions in Persons with HIV Infection

    ERIC Educational Resources Information Center

    McCain, Nancy L.; Gray, D. Patricia; Elswick, R. K., Jr.; Robins, Jolynne W.; Tuck, Inez; Walter, Jeanne M.; Rausch, Sarah M.; Ketchum, Jessica McKinney

    2008-01-01

    Research in psychoneuroimmunology suggests that immunosuppression associated with perceived stress may contribute to disease progression in persons with HIV infection. While stress management interventions may enhance immune function, few alternative approaches have yet been tested. This randomized clinical trial was conducted to test effects of…

  13. Implementing a Community Intervention to Reduce Young People's Risks for Getting HIV: Unraveling the Complexities

    ERIC Educational Resources Information Center

    Visser, Maretha J.; Schoeman, Johan B.

    2004-01-01

    The ineffectiveness of community-based interventions can often be traced to problems that occur during implementation. In this study, we outline the implementation of a human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) prevention program in an educational setting in South Africa. An action research approach was used in the…

  14. Mediation Analysis of an Adolescent HIV/STI/Pregnancy Prevention Intervention

    ERIC Educational Resources Information Center

    Glassman, Jill R.; Franks, Heather M.; Baumler, Elizabeth R.; Coyle, Karin K.

    2014-01-01

    Most interventions designed to prevent HIV/STI/pregnancy risk behaviours in young people have multiple components based on psychosocial theories (e.g. social cognitive theory) dictating sets of mediating variables to influence to achieve desired changes in behaviours. Mediation analysis is a method for investigating the extent to which a variable…

  15. A Mixed-Method Analysis of African-American Women's Attendance at an HIV Prevention Intervention

    ERIC Educational Resources Information Center

    Pinto, R. M.; McKay, M. M.

    2006-01-01

    Grounded in a model of service utilization, this study conceptualizes attendance of African-American women at an HIV prevention intervention as associated with influences across three ecological domains--individual, service (program), and social network. First, the texts of responses to semistructured, open-ended elicitation interviews were…

  16. Mechanisms of Partner Violence Reduction in a Group HIV-Risk Intervention for Hispanic Women.

    PubMed

    McCabe, Brian E; Gonzalez-Guarda, Rosa M; Peragallo, Nilda P; Mitrani, Victoria B

    2016-08-01

    The objective of this study was to test whether partner communication about HIV and/or alcohol intoxication mediated reductions in intimate partner violence (IPV) in SEPA (Salud [health], Educación [education], Promoción [promotion], y [and] Autocuidado [self-care]), a culturally specific, theoretically based group HIV-risk reduction intervention for Hispanic women. SEPA had five sessions covering sexually transmitted infection (STI)/HIV prevention, partner communication, condom negotiation and use, and IPV. SEPA reduced IPV and alcohol intoxication, and improved partner communication compared with controls in a randomized trial with adult U.S. Hispanic women (SEPA, n = 274; delayed intervention control, n = 274) who completed structured interviews at baseline and 3, 6, and 12 months post-baseline. Parallel process latent growth curve models indicated that partner communication about HIV mediated the reduction in male-to-female IPV in SEPA, B = -0.78, SE = 0.14, p< .001, but alcohol intoxication did not, B = -0.15, SE = 0.19, p = .431. Male-to-female IPV mediated the intervention effect on female-to-male IPV, B = -1.21, SE = 0.24, p< .001. Skills building strategies originally designed to enhance women's communication with their partners about sexual risk behaviors also worked to reduce male-to-female IPV, which in turn reduced female-to-male IPV. These strategies could be integrated into other types of health promotion interventions. PMID:25805845

  17. An HIV-Prevention Intervention for Sex Workers in Tijuana, Mexico: A Pilot Study

    ERIC Educational Resources Information Center

    Patterson, Thomas L.; Semple, Shirley J.; Fraga, Miguel; Bucardo, Jesus; Davila-Fraga, Wendy; Strathdee, Steffanie A.

    2005-01-01

    Female sex workers (FSW) are at high risk of acquiring sexually transmitted infections (STIs), including HIV, and putting their clients and other partners at risk for infection. There is considerable evidence that Social Cognitive Theory (SCT)?based interventions are effective in reducing high-risk sexual behavior among at-risk populations in the…

  18. An Effective Intervention to Reduce Intravaginal Practices Among HIV-1 Uninfected Kenyan Women

    PubMed Central

    McClelland, R. Scott; Ravel, Jacques; Ahmed, Aabid; Cleland, Charles M.; Gajer, Pawel; Mwamzaka, Musa; Marshed, Fatma; Shafi, Juma; Masese, Linnet; Fajans, Mark; Anderson, Molly E.; Jaoko, Walter; Kurth, Ann E.

    2014-01-01

    Abstract Intravaginal practices (IVP) are common among African women and are associated with HIV acquisition. A behavioral intervention to reduce IVP is a potential new HIV risk-reduction strategy. Fifty-eight HIV-1-uninfected Kenyan women reporting IVP and 42 women who denied IVP were followed for 3 months. Women using IVP attended a skill-building, theory-based group intervention occurring weekly for 3 weeks to encourage IVP cessation. Vaginal swabs at each visit were used to detect yeast, to detect bacterial vaginosis, and to characterize the vaginal microbiota. Intravaginal insertion of soapy water (59%) and lemon juice (45%) was most common among 58 IVP women. The group-counseling intervention led to a decrease in IVP from 95% (54/58) at baseline to 0% (0/39) at month 3 (p=0.001). After 3 months of cessation, there was a reduction in yeast on vaginal wet preparation (22% to 7%, p=0.011). Women in the IVP group were more likely to have a Lactobacillus iners-dominated vaginal microbiota at baseline compared to controls [odds ratio (OR), 6.4, p=0.006] without significant change in the microbiota after IVP cessation. The group counseling intervention was effective in reducing IVP for 3 months. Reducing IVP may be important in itself, as well as to support effective use of vaginal microbicides, to prevent HIV acquisition. PMID:25265254

  19. Ithubalethu-Intervention to Address Drug Use and Sexual HIV Risk Patterns among Female Commercial Sex Workers in Durban, South Africa.

    PubMed

    Carney, Tara; Petersen Williams, Petal M; Parry, Charles D H

    2016-01-01

    Previous research shows that interventions aimed at female sex workers (FSWs) can be successful in reducing HIV risk behavior. The current study evaluated a specific HIV prevention intervention for substance-using FSWs in Durban, South Africa by comparing such behaviors before and after the intervention. The intervention was provided by trained outreach workers by an organization that worked with FSWs, and consisted of community-based outreach, HIV and substance use education and information. Safer sex practices were also taught. The sample consisted of 457 substance-using FSWs, with findings indicating a significant decrease in the number of sexual partners (z = -16.05, p < 0.001), number of times they engaged in vaginal sex (z = -8.07, p < 0.001), and a significant decrease in all substances used with the exception of over-the-counter or prescription substances. The intervention therefore seemed to reduce certain risk behaviors among this group of FSWs. Future research should focus on the aspects of the substance use-sex risk intervention that were associated with decreased risk behavior, and include a randomized controlled trial to assess effectiveness of the intervention. PMID:27437563

  20. Efficacy of a Process Improvement Intervention on Delivery of HIV Services to Offenders: A Multisite Trial

    PubMed Central

    Shafer, Michael S.; Dembo, Richard; del Mar Vega-Debién, Graciela; Pankow, Jennifer; Duvall, Jamieson L.; Belenko, Steven; Frisman, Linda K.; Visher, Christy A.; Pich, Michele; Patterson, Yvonne

    2014-01-01

    Objectives. We tested a modified Network for the Improvement of Addiction Treatment (NIATx) process improvement model to implement improved HIV services (prevention, testing, and linkage to treatment) for offenders under correctional supervision. Methods. As part of the Criminal Justice Drug Abuse Treatment Studies, Phase 2, the HIV Services and Treatment Implementation in Corrections study conducted 14 cluster-randomized trials in 2011 to 2013 at 9 US sites, where one correctional facility received training in HIV services and coaching in a modified NIATx model and the other received only HIV training. The outcome measure was the odds of successful delivery of an HIV service. Results. The results were significant at the .05 level, and the point estimate for the odds ratio was 2.14. Although overall the results were heterogeneous, the experiments that focused on implementing HIV prevention interventions had a 95% confidence interval that exceeded the no-difference point. Conclusions. Our results demonstrate that a modified NIATx process improvement model can effectively implement improved rates of delivery of some types of HIV services in correctional environments. PMID:25322311

  1. Using Mixed-Methods Research to Adapt and Evaluate a Family Strengthening Intervention in Rwanda

    PubMed Central

    Betancourt, Theresa S.; Meyers-Ohki, Sarah E.; Stevenson, Anne; Ingabire, Charles; Kanyanganzi, Fredrick; Munyana, Morris; Mushashi, Christina; Teta, Sharon; Fayida, Ildephonse; Cyamatare, Felix Rwabukwisi; Stulac, Sara; Beardslee, William R.

    2013-01-01

    Introduction Research in several international settings indicates that children and adolescents affected by HIV and other compounded adversities are at increased risk for a range of mental health problems including depression, anxiety, and social withdrawal. More intervention research is needed to develop valid measurement and intervention tools to address child mental health in such settings. Objective This article presents a collaborative mixed-methods approach to designing and evaluating a mental health intervention to assist families facing multiple adversities in Rwanda. Methods Qualitative methods were used to gain knowledge of culturally-relevant mental health problems in children and adolescents, individual, family and community resources, and contextual dynamics among HIV-affected families. This data was used to guide the selection and adaptation of mental health measures to assess intervention outcomes. Measures were subjected to a quantitative validation exercise. Qualitative data and community advisory board input also informed the selection and adaptation of a family-based preventive intervention to reduce the risk for mental health problems among children in families affected by HIV.. Community-based participatory methods were used to ensure that the intervention targeted relevant problems manifest in Rwandan children and families and built on local strengths. Results Qualitative data on culturally-appropriate practices for building resilience in vulnerable families has enriched the development of a Family-Strengthening Intervention (FSI). Input from community partners has also contributed to creating a feasible and culturally-relevant intervention. Mental health measures demonstrate strong performance in this population. Conclusion The mixed-methods model discussed represents a refined, multi-phase protocol for incorporating qualitative data and community input in the development and evaluation of feasible, culturally-sound quantitative assessments

  2. Evaluation of the Positive Prevention HIV/STD Curriculum

    ERIC Educational Resources Information Center

    LaChausse, Robert G.

    2006-01-01

    This study evaluated the effectiveness of Positive Prevention, a theory-based, HIV/STD prevention education curriculum for high school youth. Three hundred fifty-three students participated in a longitudinal experimental design to determine the impact of the curriculum on HIV/AIDS knowledge, self-efficacy to abstain from sex, self-efficacy of…

  3. The effects of psychiatric comorbidity on response to an HIV prevention intervention.

    PubMed

    Compton, W M; Cottler, L B; Ben-Abdallah, A; Cunningham-Williams, R; Spitznagel, E L

    2000-03-01

    Drug abusers with psychiatric comorbidity are at high risk for becoming exposed to HIV. To address this compelling public health issue, our randomized HIV prevention study compares the effectiveness of the NIDA standard HIV testing and counseling protocol to a four session, peer-delivered, educational intervention for out-of-treatment cocaine users with and without antisocial personality disorder (ASPD) and major depression. Among the 966 out-of-treatment cocaine users who have completed the 3 month follow-up, all groups, regardless of assignment to standard vs. peer-delivered intervention or psychiatric status, improved significantly in: crack cocaine use, injection drug use, number of IDU sex partners and overall number of sex partners, but not in condom use. Nevertheless, when stratified by psychiatric status, ASPD was associated with significantly less improvement in crack cocaine use (P = 0.04) and with a trend for less improvement in having multiple sex partners and having IDU sex partners (P = 0.06 and 0.08, respectively). ASPD status was not associated with change in injection drug use or condom use. Depression was associated with a trend (P = 0.07) for greater improvement in crack cocaine use but not in any of the other behaviors. When examining the standard and peer intervention groups separately, no consistent differences in the association of psychiatric comorbidity with outcome were discerned between the two groups. We conclude that persons with ASPD and depression respond well to standard HIV prevention interventions, but these psychiatric disorders respectively attenuate and enhance response somewhat. Behavioral interventions tailored for persons with these conditions may be indicated if long-term change in HIV risk behaviors is to be achieved. PMID:10759035

  4. Cost of surgical intervention for reconstructive therapy of HIV-associated facial lipoatrophy

    PubMed Central

    Massella, M; Ivanovic, J; Bellagamba, R; De Vita, R; Fracasso, L; Tozzi, V; Fragola, V; Rizzica, M; Narciso, P

    2011-01-01

    This study aims to assess direct cost of reconstructive interventions with facial fillers for treatment of HIV (human immunodeficiency virus)-associated facial lipoatrophy (FLA). Evaluation was performed on data from patients enrolled in one arm of a comparative study of immediate versus delayed reconstructive treatment of facial lipoatrophy. Median costs were standardized for efficacy, estimated using data reported by physicians and patient reported outcomes. The variations of the results were evaluated with a sensitivity analysis. Evaluation was performed on 66 patients characterized by significant differences in terms of severity of FLA. Total cost resulted of €140,416.15, with a median cost per patient of €2126.04 (interquartile range [IQR]: 1599–2822). Taking into consideration severity of disease, median costs were €1641.67 (IQR: 1326.67–2126.04) and 2557.12 (IQR: 1939.34–2872.04) (P = 0.0) respectively for patients with low and high severity scores at baseline. Significant differences in term of cost-effectiveness ratios were also found between patients with different severity of FLA, and sensitivity analysis showed that these ratios increase with higher severity scores at baseline and vary widely depending on the costs of filler. Although these results cannot be considered representative because of important limitations, the present study suggests the severity of disease as an important determinant of costs. PMID:21660104

  5. Mediation Analysis of the Efficacy of the Eban HIV/STD Risk-Reduction Intervention for African American HIV Serodiscordant Couples.

    PubMed

    El-Bassel, Nabila; Jemmott, John B; Bellamy, Scarlett L; Pequegnat, Willo; Wingood, Gina M; Wyatt, Gail E; Richard Landis, J; Remien, Robert H

    2016-06-01

    Targeting couples is a promising behavioral HIV risk-reduction strategy, but the mechanisms underlying the effects of such interventions are unknown. We report secondary analyses testing whether Social-Cognitive-Theory variables mediated the Eban HIV-risk-reduction intervention's effects on condom-use outcomes. In a multisite randomized controlled trial conducted in four US cities, 535 African American HIV-serodiscordant couples were randomized to the Eban HIV risk-reduction intervention or attention-matched control intervention. Outcomes were proportion condom-protected sex, consistent condom use, and frequency of unprotected sex measured pre-, immediately post-, and 6 and 12 months post-intervention. Potential mediators included Social-Cognitive-Theory variables: outcome expectancies and self-efficacy. Mediation analyses using the product-of-coefficients approach in a generalized-estimating-equations framework revealed that condom-use outcome expectancy, partner-reaction outcome expectancy, intention, self-efficacy, and safer-sex communication improved post-intervention and mediated intervention-induced improvements in condom-use outcomes. These findings underscore the importance of targeting outcome expectancies, self-efficacy, and safer-sex communication in couples-level HIV risk-reduction interventions. PMID:26577402

  6. Participation and Diffusion Effects of a Peer-Intervention for HIV Prevention among Adults in Rural Malawi

    PubMed Central

    Crittenden, Kathleen S.; Kaponda, Chrissie P. N.; Jere, Diana L.; McCreary, Linda L.; Norr, Kathleen F.

    2015-01-01

    This paper examines whether a peer group intervention that reduced self-reported risky behaviors for rural adults in Malawi also had impacts on non-participants in the same communities. We randomly assigned two districts to the intervention and control conditions, and conducted surveys at baseline and 18 months post-intervention using unmatched independent random samples of intervention and control communities in 2003-2006. The six-session peer group intervention was offered to same-gender groups by trained volunteers. In this analysis, we divided the post-intervention sample into three exposure groups: 243 participants and 170 non-participants from the intervention district (total n=415) and 413 control individuals. Controlling for demographics and participation, there were significant favorable diffusion effects on five partially overlapping behavioral outcomes: partner communication, ever used condoms, unprotected sex, recent HIV test, and a community HIV prevention index. Non-participants in the intervention district had more favorable outcomes on these behaviors than survey respondents in the control district. One behavioral outcome, community HIV prevention, showed both participation and diffusion effects. Participating in the intervention had a significant effect on six psychosocial outcomes: HIV knowledge (two measures), hope, condom attitudes, and self-efficacy for community HIV prevention and for safer sex; there were no diffusion effects. This pattern of results suggests that the behavioral changes promoted in the intervention spread to others in the same community, most likely through direct contact between participants and non-participants. These findings support the idea that diffusion of HIV-related behavior changes can occur for peer group interventions in communities, adding to the body of research supporting diffusion of innovations theory as a robust approach to accelerating change. If diffusion occurs, peer group intervention may be more cost

  7. Refining a Personalized mHealth Intervention to Promote Medication Adherence among HIV+ Methamphetamine Users

    PubMed Central

    Montoya, Jessica L.; Georges, Shereen; Poquette, Amelia; Depp, Colin A.; Atkinson, J. Hampton; Moore, David J.

    2014-01-01

    Mobile health (mHealth) interventions to promote antiretroviral therapy (ART) adherence have shown promise; however, among persons living with HIV who abuse methamphetamine (MA) effective tailoring of content to match the expressed needs of this patient population may be necessary. This study aimed: 1) to understand patient perspectives of barriers and facilitators of ART adherence among people with HIV who use MA, and 2) to obtain feedback on the thematic content of an mHealth intervention in order to tailor the intervention to this subgroup. Two separate focus groups, each with ten HIV+/MA+ individuals, were conducted. Transcribed audio recordings were qualitatively analyzed to identify emergent themes. Interrater reliability of themes was high (mean Kappa=.97). Adherence barriers included MA use, misguided beliefs about ART adherence, memory and planning difficulties, social barriers and perceived stigma, and mental heath issues. Facilitators of effective ART adherence were cognitive compensatory strategies, promotion of well being, health care supports, adherence education, and social support. Additionally, the focus groups generated content for reminder text messages to be used in the medication adherence intervention. This qualitative study demonstrates feasibility of using focus groups to derive patient-centered intervention content to address the health challenge at hand in targeted populations. Clinical Trial # NCT01317277 PMID:24911433

  8. Refining a personalized mHealth intervention to promote medication adherence among HIV+ methamphetamine users.

    PubMed

    Montoya, Jessica L; Georges, Shereen; Poquette, Amelia; Depp, Colin A; Atkinson, J Hampton; Moore, David J

    2014-01-01

    Mobile health (mHealth) interventions to promote antiretroviral therapy (ART) adherence have shown promise; however, among persons living with HIV who abuse methamphetamine (MA), effective tailoring of content to match the expressed needs of this patient population may be necessary. This study aimed (1) to understand patient perspectives of barriers and facilitators of ART adherence among people with HIV who use MA, and (2) to obtain feedback on the thematic content of an mHealth intervention in order to tailor the intervention to this subgroup. Two separate focus groups, each with 10 HIV+/MA+ individuals, were conducted. Transcribed audio recordings were qualitatively analyzed to identify emergent themes. Inter-rater reliability of themes was high (mean Kappa = .97). Adherence barriers included MA use, misguided beliefs about ART adherence, memory and planning difficulties, social barriers and perceived stigma, and mental heath issues. Facilitators of effective ART adherence were cognitive compensatory strategies, promotion of well-being, health-care supports, adherence education, and social support. Additionally, the focus groups generated content for reminder text messages to be used in the medication adherence intervention. This qualitative study demonstrates the feasibility of using focus groups to derive patient-centered intervention content to address the health challenge at hand in targeted populations. PMID:24911433

  9. Evaluating Feasible and Referable Behavioral Counseling Interventions.

    PubMed

    Krist, Alex H; Baumann, Linda J; Holtrop, Jodi Summers; Wasserman, Melanie R; Stange, Kurt C; Woo, Meghan

    2015-09-01

    The U.S. Preventive Services Task Force (USPTF) recognizes that behaviors have a major impact on health and well-being. Currently, the USPSTF has 11 behavioral counseling intervention (BCI) recommendations. These BCIs can be delivered in a primary care setting or patients can be referred to other clinical or community programs. Unfortunately, many recommended BCIs are infrequently and ineffectually delivered, suggesting that more evidence is needed to understand which BCIs are feasible and referable. In response, the USPSTF convened an expert forum in 2013 to inform the evaluation of BCI feasibility. This manuscript reports on findings from the forum and proposes that researchers use several frameworks to help clinicians and the USPSTF evaluate which BCIs work under usual conditions. A key recommendation for BCI researchers is to use frameworks whose components can support dissemination and implementation efforts. These frameworks include the Template for Intervention Description and Replication (TIDieR), which helps describe the essential components of an intervention, and pragmatic frameworks like Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) or Pragmatic-Explanatory Continuum Indicator Summary (PRECIS), which help to report study design elements and outcomes. These frameworks can both guide the design of more-feasible BCIs and produce clearer feasibility evidence. Critical evidence gaps include a better understanding of which patients will benefit from a BCI, how flexible interventions can be without compromising effectiveness, required clinician expertise, necessary intervention intensity and follow-up, impact of patient and clinician intervention adherence, optimal conditions for BCI delivery, and how new care models will influence BCI feasibility. PMID:26296548

  10. Combined Intimate Partner Violence and HIV/AIDS Prevention in Rural Uganda: Design of the SHARE Intervention Strategy.

    PubMed

    Wagman, Jennifer A; King, Elizabeth J; Namatovu, Fredinah; Kiwanuka, Deus; Kairania, Robert; Semanda, John Baptist; Nalugoda, Fred; Serwadda, David; Wawer, Maria J; Gray, Ronald; Brahmbhatt, Heena

    2016-01-01

    Intimate partner violence (IPV) has a bidirectional relationship with HIV infection. Researchers from the Rakai Health Sciences Program (RHSP), an HIV research and services organization in rural Uganda, conducted a combination IPV and HIV prevention intervention called the Safe Homes and Respect for Everyone (SHARE) Project between 2005 and 2009. SHARE was associated with significant declines in physical and sexual IPV and overall HIV incidence, and its model could be adopted as a promising practice in other settings. In this article we describe how SHARE's IPV-prevention strategies were integrated into RHSP's existing HIV programming and provide recommendations for replication of the approach. PMID:26086189

  11. ‘I woke up after I joined Stepping Stones’: meanings of an HIV behavioural intervention in rural South African young people's lives

    PubMed Central

    Jewkes, Rachel; Wood, Katharine; Duvvury, Nata

    2010-01-01

    Evaluation of the Stepping Stones human immunodeficiency virus (HIV) prevention programme in South Africa showed sustained reduction in men and women's herpes simplex type 2 virus incidence and male violence, but no impact on HIV in women. Companion qualitative research was undertaken to explore how participants made meaning from the programme and how it influenced their lives. In-depth interviews were conducted with 10 men and 11 women before the intervention (one to three interviews per person). Then 9–12 months later, 18 follow-up interviews and 4 focus groups were held. Stepping Stones empowered participants and engendered self-reflection, in a process circumscribed by social and cultural context. Participants generally sought to be ‘better’, rather than ‘different’, men and women. Men shaped a more benign patriarchy, i.e. less violent and anti-social, and sought to avoid potential risks, ranging from imprisonment, witchcraft to HIV. While some women showed greater assertiveness and some agency in HIV risk reduction, most challenged neither their male partners nor the existing cultural norms of conservative femininities. This may explain the lack of impact of the intervention on HIV in women, since they lacked the power to embrace a greater feminist consciousness. Stepping Stones might be more effective for women when combined with other structural interventions. PMID:20937673

  12. Screening and Brief Intervention for Substance Misuse: Does It Reduce Aggression and HIV-Related Risk Behaviours?

    PubMed Central

    Ward, Catherine L.; Mertens, Jennifer R.; Bresick, Graham F.; Little, Francesca; Weisner, Constance M.

    2015-01-01

    Purpose: To explore whether reducing substance misuse through a brief motivational intervention also reduces aggression and HIV risk behaviours. Methods: Participants were enrolled in a randomized controlled trial in primary care if they screened positive for substance misuse. Substance misuse was assessed using the Alcohol, Smoking and Substance Involvement Screening Test; aggression, using a modified version of the Explicit Aggression Scale; and HIV risk, through a count of common risk behaviours. The intervention was received on the day of the baseline interview, with a 3-month follow-up. Results: Participants who received the intervention were significantly more likely to reduce their alcohol use than those who did not; no effect was identified for other substances. In addition, participants who reduced substance misuse (whether as an effect of the intervention or not) also reduced aggression but not HIV risk behaviours. Conclusions: Reducing substance misuse through any means reduces aggression; other interventions are needed for HIV risk reduction. PMID:25731180

  13. Physiotherapy intervention as a complementary treatment for people living with HIV/AIDS

    PubMed Central

    Pullen, Sara D; Chigbo, Nnenna Nina; Nwigwe, Emmanuel Chukwudi; Chukwuka, Chinwe J; Amah, Christopher Chim; Idu, Stanley C

    2014-01-01

    Background The advent of highly active antiretroviral therapy has dramatically extended the life expectancy of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome. Despite this increased longevity, HIV disease and its pharmacological treatment can cause long-term and acute health complications, many of which can be treated successfully by physiotherapy. The purpose of this paper is to report the effect of a 12-week rehabilitation program on several health-related markers in a 43-year-old woman living with HIV. Methods This case study examined the effect of a 12-week exercise and manual therapy intervention on morphology, pain, cardiopulmonary fitness, strength, neurological balance, immune markers (CD4 cell count), and quality of life in a 43-year-old woman living with HIV. Results The results showed complete elimination of pain and shortness of breath on exertion. There was also a reduction in resting heart rate, waist circumference, exercise duration, muscle strength, and endurance. The patient showed an increase in peak expiratory flow rate, maximal heart rate attained, upper arm, forearm, and thigh circumference, and CD4+ cell count. The patient also showed improvements in the quality of life domains of general health, pain, energy/fatigue, social and physical functioning, and emotional well-being. Conclusion Physiotherapy interventions consisting of exercise and manual therapy appear beneficial in several areas as an adjunct therapy in HIV management. PMID:24936132

  14. Peer Outreach Work as Economic Activity: Implications for HIV Prevention Interventions among Female Sex Workers

    PubMed Central

    George, Annie; Blankenship, Kim M.

    2015-01-01

    Female sex workers (FSWs) who work as peer outreach workers in HIV prevention programs are drawn from poor socio-economic groups and consider outreach work, among other things, as an economic activity. Yet, while successful HIV prevention outcomes by such programs are attributed in part to the work of peers who have dense relations with FSW communities, there is scant discussion of the economic implications for FSWs of their work as peers. Using observational data obtained from an HIV prevention intervention for FSWs in south India, we examined the economic benefits and costs to peers of doing outreach work and their implications for sex workers’ economic security. We found that peers considered their payment incommensurate with their workload, experienced long delays receiving compensation, and at times had to advance money from their pockets to do their assigned peer outreach work. For the intervention these conditions resulted in peer attrition and difficulties in recruitment of new peer workers. We discuss the implications of these findings for uptake of services, and the possibility of reaching desired HIV outcomes. Inadequate and irregular compensation to peers and inadequate budgetary outlays to perform their community-based outreach work could weaken peers’ relationships with FSW community members, undermine the effectiveness of peer-mediated HIV prevention programs and invalidate arguments for the use of peers. PMID:25775122

  15. Why are Children Still Being Infected with HIV? Impact of an Integrated Public Health and Clinical Practice Intervention on Mother-to-Child HIV Transmission in Las Vegas, Nevada, 2007–2012

    PubMed Central

    Ezeanolue, EE; Pharr, JR; Hunt, A; Patel, D; Jackson, D

    2015-01-01

    Background: During a 9 months period, September 2005 through June 2006, Nevada documented six cases of pediatric HIV acquired through mother-to-child transmission. Subsequently, a community-based approach to the care of women and children living with or exposed to HIV was implemented. Subjects and Methods: A detailed review of mother-infant pairs where HIV transmission occurred was performed to identify missed opportunities for prevention of mother-to-child HIV transmission. An intervention program was developed and implemented using the six-step process. Data were collected prospectively over a 6 years period (2007–2012) and were evaluated for six core outcomes measures: (1) adequacy of prenatal care (2) HIV diagnoses of expectant mothers prior to delivery (3) appropriate use of antiretroviral (ARV) therapy before delivery (4) appropriate use of cesarean section for delivery (5) adequacy of zidovudine prophylaxis to newborn (6) HIV transmission rate. Results: Twenty-six infants were born to HIV-infected mothers from July 2005 to June 2006 with 6 documented infections. One hundred and five infants were born to HIV infected mothers from January 2007 to December 2012. Postimplementation, adequacy of prenatal care increased from 58% (15/26) to 85% (89/105); appropriate use of ARV therapy before delivery increased from 73% (19/26) to 86% (90/105); cesarean section as the method for delivery increased from 62% (16/26) to 74% (78/105); adequacy of zidovudine prophylaxis to newborn increased from 54% (14/26) to 87% (91/105). HIV transmission rate dropped from 23% (6/26) to 0%. Conclusion: Integrating public health and clinical services in the care of HIV-infected pregnant women and exposed infants leads to better coordination of care and improved quality of care. PMID:26229713

  16. Optimization of Multicomponent Behavioral and Biobehavioral Interventions for the Prevention and Treatment of HIV/AIDS.

    PubMed

    Collins, Linda M; Kugler, Kari C; Gwadz, Marya Viorst

    2016-01-01

    To move society toward an AIDS-free generation, behavioral interventions for prevention and treatment of HIV/AIDS must be not only effective, but also cost-effective, efficient, and readily scalable. The purpose of this article is to introduce to the HIV/AIDS research community the multiphase optimization strategy (MOST), a new methodological framework inspired by engineering principles and designed to develop behavioral interventions that have these important characteristics. Many behavioral interventions comprise multiple components. In MOST, randomized experimentation is conducted to assess the individual performance of each intervention component, and whether its presence/absence/setting has an impact on the performance of other components. This information is used to engineer an intervention that meets a specific optimization criterion, defined a priori in terms of effectiveness, cost, cost-effectiveness, and/or scalability. MOST will enable intervention science to develop a coherent knowledge base about what works and does not work. Ultimately this will improve behavioral interventions systematically and incrementally. PMID:26238037

  17. Epidemic Impacts of a Community Empowerment Intervention for HIV Prevention among Female Sex Workers in Generalized and Concentrated Epidemics

    PubMed Central

    Wirtz, Andrea L.; Pretorius, Carel; Beyrer, Chris; Baral, Stefan; Decker, Michele R.; Sherman, Susan G.; Sweat, Michael; Poteat, Tonia; Butler, Jennifer; Oelrichs, Robert; Semini, Iris; Kerrigan, Deanna

    2014-01-01

    Introduction Sex workers have endured a high burden of HIV infection in and across HIV epidemics. A comprehensive, community empowerment-based HIV prevention intervention emphasizes sex worker organization and mobilization to address HIV risk and often includes community-led peer education, condom distribution, and other activities. Meta-analysis of such interventions suggests a potential 51% reduction in inconsistent condom use. Mathematical modeling exercises provide theoretical insight into potential impacts of the intervention on HIV incidence and burden in settings where interventions have not yet been implemented. Methods We used a deterministic model, Goals, to project the impact on HIV infections when the community empowerment interventions were scaled up among female sex workers in Kenya, Thailand, Brazil, and Ukraine. Modeling scenarios included expansion of the comprehensive community empowerment-based HIV prevention intervention from baseline coverage over a 5-year period (5–65% in Kenya and Ukraine; 10–70% in Thailand and Brazil), while other interventions were held at baseline levels. A second exercise increased the intervention coverage simultaneously with equitable access to ART for sex workers. Impacts on HIV outcomes among sex workers and adults are observed from 2012–2016 and, compared to status quo when all interventions are held constant. Results Optimistic but feasible coverage (65%–70%) of the intervention demonstrated a range of impacts on HIV: 220 infections averted over 5 yrs. among sex workers in Thailand, 1,830 in Brazil, 2,220 in Ukraine, and 10,800 infections in Kenya. Impacts of the intervention for female sex workers extend to the adult population, cumulatively averting 730 infections in Thailand to 20,700 adult infections in Kenya. Impacts vary by country, influenced by HIV prevalence in risk groups, risk behaviors, intervention use, and population size. Discussion A community empowerment approach to HIV prevention and

  18. Family-Based HIV Preventive Intervention: Child Level Results from the CHAMP Family Program

    PubMed Central

    McBride, Cami K.; Baptiste, Donna; Traube, Dorian; Paikoff, Roberta L.; Madison-Boyd, Sybil; Coleman, Doris; Bell, Carl C.; Coleman, Ida; McKay, Mary M.

    2010-01-01

    SUMMARY Social indicators suggest that African American adolescents are in the highest risk categories of those contracting HIV/AIDS (CDC, 2001). The dramatic impact of HIV/AIDS on urban African American youth have influenced community leaders and policy makers to place high priority on programming that can prevent youth’s exposure to the virus (Pequegnat & Szapocznik, 2000). Program developers are encouraged to design programs that reflect the developmental ecology of urban youth (Tolan, Gorman-Smith, & Henry, 2003). This often translates into three concrete programmatic features: (1) Contextual relevance; (2) Developmental-groundedness; and (3) Systemic Delivery. Because families are considered to be urban youth’s best hope to grow up and survive multiple-dangers in urban neighborhoods (Pequegnat & Szapocznik, 2000), centering prevention within families may ensure that youth receive ongoing support, education, and messages that can increase their capacity to negotiate peer situations involving sex. This paper will present preliminary data from an HIV/AIDS prevention program that is contextually relevant, developmentally grounded and systematically-delivered. The collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP) is aimed at decreasing HIV/AIDS risk exposure among a sample of African American youth living in a poverty-stricken, inner-city community in Chicago. This study describes results from this family-based HIV preventive intervention and involves 88 African American pre-adolescents and their primary caregivers. We present results for the intervention group at baseline and post intervention. We compare post test results to a community comparison group of youth. Suggestions for future research are provided. PMID:20852742

  19. Family-Based HIV Preventive Intervention: Child Level Results from the CHAMP Family Program.

    PubMed

    McBride, Cami K; Baptiste, Donna; Traube, Dorian; Paikoff, Roberta L; Madison-Boyd, Sybil; Coleman, Doris; Bell, Carl C; Coleman, Ida; McKay, Mary M

    2007-05-01

    Social indicators suggest that African American adolescents are in the highest risk categories of those contracting HIV/AIDS (CDC, 2001). The dramatic impact of HIV/AIDS on urban African American youth have influenced community leaders and policy makers to place high priority on programming that can prevent youth's exposure to the virus (Pequegnat & Szapocznik, 2000). Program developers are encouraged to design programs that reflect the developmental ecology of urban youth (Tolan, Gorman-Smith, & Henry, 2003). This often translates into three concrete programmatic features: (1) Contextual relevance; (2) Developmental-groundedness; and (3) Systemic Delivery. Because families are considered to be urban youth's best hope to grow up and survive multiple-dangers in urban neighborhoods (Pequegnat & Szapocznik, 2000), centering prevention within families may ensure that youth receive ongoing support, education, and messages that can increase their capacity to negotiate peer situations involving sex.This paper will present preliminary data from an HIV/AIDS prevention program that is contextually relevant, developmentally grounded and systematically-delivered. The collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP) is aimed at decreasing HIV/AIDS risk exposure among a sample of African American youth living in a poverty-stricken, inner-city community in Chicago. This study describes results from this family-based HIV preventive intervention and involves 88 African American pre-adolescents and their primary caregivers. We present results for the intervention group at baseline and post intervention. We compare post test results to a community comparison group of youth. Suggestions for future research are provided. PMID:20852742

  20. Risk Reduction Among HIV-Seroconcordant and -Discordant Couples: The Zambia NOW2 Intervention

    PubMed Central

    Kashy, Deborah; Chitalu, Ndashi; Kankasa, Chipepo; Mumbi, Mirriam; Cook, Ryan; Weiss, Stephen

    2014-01-01

    Abstract Heterosexual HIV transmission remains the leading cause of HIV incidence in adult men and women in sub-Saharan Africa. This study assessed whether an HIV risk-reduction intervention would be more likely to increase sexual barrier acceptability and decrease risk behavior when delivered to couples in gender concordant groups or in an individual format. This study also examined the mutual impact of couple members as a source of influence on acceptability, and assessed whether product acceptability, intimate partner violence (IPV), and/or partner communication predicted sexual barrier use. HIV seroconcordant and serodiscordant couples (n=216) were recruited in Lusaka, Zambia, and randomized to a four session gender-concordant intervention. Participants were assessed at baseline, 6, and 12 months. Willingness to use barriers (p=0.012), acceptability (p<0.001), and barrier use (p<0.001) increased over time in both conditions, and were influenced by gender preferences. IPV decreased (p=0.040) and positive communication increased (p<0.001) in both conditions. Individual and gender concordant group sessions achieved similar increases in sexual barrier use following the intervention. Results highlight the influence of partners as well as product acceptability as predictors of sexual barrier use among couples in sub-Saharan Africa. Future prevention studies should consider both product acceptability and partner influence to achieve optimal sexual risk behavior outcomes. PMID:24983201

  1. Psychosocial support intervention for HIV-affected families in Haiti: implications for programs and policies for orphans and vulnerable children.

    PubMed

    Smith Fawzi, Mary C; Eustache, Eddy; Oswald, Catherine; Louis, Ermaze; Surkan, Pamela J; Scanlan, Fiona; Hook, Sarah; Mancuso, Anna; Mukherjee, Joia S

    2012-05-01

    Given the increased access of antiretroviral therapy (ART) throughout the developing world, what was once a terminal illness is now a chronic disease for those receiving treatment. This requires a paradigmatic shift in service provision for those affected by HIV/AIDS in low-resource settings. Although there is a need for psychosocial support interventions for HIV-affected youth and their caregivers, to date there has been limited empirical evidence on the effectiveness of curriculum-based psychosocial support groups in HIV-affected families in low-income countries. Therefore, the purpose of this study is to examine the feasibility and assess the preliminary effectiveness of a psychosocial support group intervention for HIV-affected youth and their caregivers in central Haiti. The study was conducted at six Partners In Health-affiliated sites between February 2006 and September 2008 and included quantitative as well as qualitative methods. HIV-affected youth (n = 168) and their caregivers (n = 130) completed a baseline structured questionnaire prior to participation in a psychosocial support group intervention. Ninety-five percent of families completed the intervention and a follow-up questionnaire. Psychological symptoms, psychosocial functioning, social support, and HIV-related stigma at baseline were compared with outcomes one year later. Qualitative methods were also used to assess the participants' perspectives of the intervention. Comparing pre- and post-intervention assessment, youth affected by HIV experienced decreased psychological symptoms as well as improved psychosocial functioning and social support. Caregivers (95% HIV-positive) demonstrated a significant reduction in depressive symptoms, improved social support, and decreased HIV-related stigma. Although further study is needed to assess effectiveness in a randomized controlled trial, corroborative findings from qualitative data reflected reduced psychological distress, less social isolation and

  2. Violence and HIV/AIDS prevention among female out-of-school youths in southwestern Nigeria: lessons learnt from interventions targeted at hawkers and apprentices.

    PubMed

    Fawole, O I; Ajuwon, A J; Osungbade, K O

    2004-12-01

    Between 1997 and 2003, four studies on hawkers and apprentices in motor parks and work shops in south west, Nigeria were carried out to evaluate the effectiveness of interventions aimed at preventing HIV infection and gender based violence (GBV). The studies were in 3 phases namely baseline survey, intervention and end line survey. Interventions consisting of:--development and distribution of education materials and training programmes for the police, judiciary, instructors, drivers, traders and apprentices/hawkers, including micro-credit facilities were implemented in some of the studies. The major lessons learnt were that: Young girls working in the informal sector of the Nigerian economy face dual risks of HIV infection and GBV and yet they are seldom targets of intervention; Many had been victims of GBV and did not seek redress either because they accept it is their lot, are afraid of being stigmatized or are put off the prolonged legal system; Perpetrators tend to deny their involvement in violence; Despite the challenges involved, interventions implemented among female apprentices and hawkers, especially those that involve multiple stakeholders, made a difference in protecting this group from dual risks of GBV and HIV/AIDS infection. We recommend more intervention programmes for this population, and regulation of activities in the informal sector of the Nigerian economy. PMID:15977443

  3. Efficacy of an HIV/STI Sexual Risk-Reduction Intervention for African American Adolescent Girls in Juvenile Detention Centers: A Randomized Controlled Trial

    PubMed Central

    DiClemente, Ralph J.; Davis, Teaniese L.; Swartzendruber, Andrea; Fasula, Amy M.; Boyce, Lorin; Gelaude, Deborah; Gray, Simone C.; Hardin, James; Rose, Eve; Carry, Monique; Sales, Jessica M.; Brown, Jennifer L.; Staples-Horne, Michelle

    2014-01-01

    Background Few HIV/STI interventions exist for African American adolescent girls in juvenile detention. Objective The objective was to evaluate the efficacy of an intervention to reduce incident STIs, improve HIV-preventive behaviors, and enhance psychosocial outcomes. Methods We conducted a randomized controlled trial among African American adolescent girls (13-17 years, N=188) in juvenile detention from March 2011 to May 2012. Assessments occurred at baseline and 3- and 6-months post-randomization and included: audio computer-assisted self-interview, condom skills assessment, and self-collected vaginal swab to detect Chlamydia and gonorrhea. Intervention The Imara intervention included three individual-level sessions and four phone sessions; expedited partner therapy was offered to STI-positive adolescents. The comparison group received the usual care provided by the detention center: STI testing, treatment and counseling. Results At the 6-month assessment (3-months post-intervention) Imara participants reported higher condom use self-efficacy (p<0.001), HIV/STI knowledge (p<0.001), and condom use skills (p<0.001) compared to control participants. No significant differences were observed between trial conditions in incident Chlamydia or gonorrhea infections, condom use, or number of vaginal sex partners. Conclusions Imara for detained African American adolescent girls can improve condom use skills and psychosocial outcomes; however, a critical need for interventions to reduce sexual risk remains. PMID:25190056

  4. Health behaviour change of people living with HIV after a comprehensive community-based HIV stigma reduction intervention in North-West Province in South Africa

    PubMed Central

    Chidrawi, H. Christa; Greeff, Minrie; Temane, Q. Michael

    2014-01-01

    Abstract All over the world, health behaviour is considered a complex, far reaching and powerful phenomenon. People's lives are influenced by their own or others' health behaviour on a daily basis. Whether it has to do with smoking, drinking, pollution, global warming or HIV management, it touches lives and it challenges personal and community responses. Health behaviour, and health behaviour change, probably holds the key to many a person's immediate or prolonged life or death outcomes. The same can be said about communities, culture groups and nations. This SANPAD-funded study focused on research questions relating to health behaviour change for people living with HIV (PLWH) in the North-West Province in South Africa. It investigated whether a comprehensive community-based HIV stigma reduction intervention caused health behaviour change in PLWH. An quantitative single system research design with one pre- and four repetitive post-tests utilizing purposive sampling was used to test change-over-time in the health behaviour of 18 PLWH. The results of the study indicated statistical and/or practical significant change-over-time. The intervention not only addressed the health behaviour of PLWH, but also their HIV stigma experiences, HIV signs and symptoms and their quality of life in the context of being HIV positive. The recommendations include popularization of the comprehensive community-based HIV stigma reduction intervention and extending it to include a second intervention to strengthen health behaviour and quality of life for PLWH in the community at large. PMID:25495580

  5. Effectiveness of Peer Education Interventions for HIV Prevention in Developing Countries: A Systematic Review and Meta-Analysis

    PubMed Central

    Medley, Amy; Kennedy, Caitlin; O’Reilly, Kevin; Sweat, Michael

    2014-01-01

    Background Peer education for HIV prevention has been widely implemented in developing countries, yet the effectiveness of this intervention has not been systematically evaluated. Methods We conducted a systematic review and meta-analysis of peer education interventions in developing countries published between January 1990 and November 2006. Standardized methods of searching and data abstraction were utilized. Merged effect sizes were calculated using random effects models. Results Thirty studies were identified. In meta-analysis, peer education interventions were significantly associated with increased HIV knowledge (OR:2.28; 95% CI:1.88, 2.75), reduced equipment sharing among injection drug users (OR:0.37; 95% CI:0.20, 0.67), and increased condom use (OR:1.92; 95% CI:1.59, 2.33). Peer education programs had a non-significant effect on STI infection (OR: 1.22; 95% CI:0.88, 1.71). Conclusions Meta-analysis indicates that peer education programs in developing countries are moderately effective at improving behavioral outcomes, but show no significant impact on biological outcomes. Further research is needed to determine factors that maximize the likelihood of program success. PMID:19519235

  6. Feasibility of a Computer-Based Intervention Addressing Barriers to HIV Testing Among Young Patients Who Decline Tests at Triage.

    PubMed

    Aronson, Ian David; Cleland, Charles M; Perlman, David C; Rajan, Sonali; Sun, Wendy; Bania, Theodore C

    2016-09-01

    Young people face greatly increased human immunodeficiency virus (HIV) risk and high rates of undiagnosed HIV, yet are unlikely to test. Many also have limited or inconsistent access to health care, including HIV testing and prevention education, and prior research has documented that youth lack knowledge necessary to understand the HIV test process and to interpret test results. Computer-based interventions have been used to increase HIV test rates and knowledge among emergency department (ED) patients, including those who decline tests offered at triage. However, patients aged 18-24 years have been less likely to test, even after completing an intervention, compared to older patients in the same ED setting. The current pilot study sought to examine the feasibility and acceptability of a new tablet-based video intervention designed to address established barriers to testing among ED patients aged 18-24 years. In particular, we examined whether young ED patients would: agree to receive the intervention; complete it quickly enough to avoid disrupting clinical workflows; accept HIV tests offered by the intervention; demonstrate increased postintervention knowledge; and report they found the intervention acceptable. Over 4 weeks, we recruited 100 patients aged 18-24 in a high-volume urban ED; all of them declined HIV tests offered at triage. Almost all (98%) completed the intervention (mean time <9 mins), 30% accepted HIV tests offered by the tablets. Knowledge was significantly higher after than before the intervention (t = -6.67, p < .001) and patients reported generally high acceptability. Additional research appears warranted to increase postintervention HIV testing. PMID:27565191

  7. STD/HIV prevention in Turkey: planning a sequence of interventions.

    PubMed

    Aral, S O; Fransen, L

    1995-12-01

    This study was initiated to assess which mix of early STD/HIV prevention interventions would potentially be effective, cost-effective and sustainable in Turkey; and to program an intervention sequence to maximize synergy among the interventions. During rapid assessment we: 1) reviewed past issues of 3 leading newspapers; 2) collected information on TV coverage; 3) interviewed key informants including taxicab drivers, hotel employees, grocery store owners, academicians in public health and law, investigators of STD/HIV and reproductive tract infections, and officials in the ministry of health; 4) reviewed available evidence on STD/HIV morbidity, sexual behavior patterns, migration patterns and same/opposite gender sex trade. We found: 1) discrepancies between decision makers' perceptions and social realities with respect to the epidemiology of sexual behavior and STDs, and the state of public health programs; 2) discrepancies between sexual practices and public expression regarding sexual practices; 3) economic, demographic, and political pressures in Turkey and in surrounding countries for the expansion of prostitution; 4) a sexual double standard and gender specific migration patterns which sustain a high demand for commercial sex; 5) patterns of health care seeking behaviors and provision of STD clinical services which indicate other STDs may play a very important role in spread of HIV infection; 6) an important mass media role in opinion formation; 7) consensual denial of risk for the majority based on beliefs embedded in machismo, nationalism and religion, and a resulting marginalization and externalization of STD/HIV risk; 8) high prevalence of syphilis among both Turkish and immigrant female prostitutes in Istanbul (early latent 8 and 13%; late latent 0 and 4%; previous history 9 and 22%) 9) and high rates of syphilis among male prostitutes (early latent 11%, late latent 21% and previous history 58%). We concluded that interventions should initially include

  8. Feasibility, Acceptability, and Preliminary Efficacy of an Online HIV Prevention Program for Diverse Young Men who have Sex with Men: The Keep It Up! Intervention

    PubMed Central

    Mustanski, Brian; Garofalo, Robert; Monahan, Colleen; Gratzer, Beau; Andrews, Rebecca

    2013-01-01

    Young men who have sex with men (YMSM) are disproportionately infected with HIV/AIDS and there are few prevention programs with published efficacy for this population. This study evaluated the feasibility, acceptability, and preliminary efficacy of an online, interactive, and highly engaging HIV prevention program called Keep It Up! The intervention was designed to be delivered to diverse YMSM upon receiving an HIV negative text result, with the goal for them to “Keep It Up” and stay negative. In a randomized clinical trial, the intervention was compared to an online didactic HIV knowledge condition. The study sample included 102 sexually active YMSM. Participants reported completing online modules in settings that were private and not distracting. Mixed methods data showed intervention participants felt the program was valuable and acceptable. Compared to the control condition, participants in the intervention arm had a 44 % lower rate of unprotected anal sex acts at the 12-week follow-up (p < 0.05). PMID:23673793

  9. Development and use of role model stories in a community level HIV risk reduction intervention.

    PubMed Central

    Corby, N H; Enguídanos, S M; Kay, L S

    1996-01-01

    A theory-based HIV prevention intervention was implemented as part of a five-city AIDS Community Demonstration Project for the development and testing of a community-level intervention to reduce AIDS risk among historically underserved groups. This intervention employed written material containing stories of risk-reducing experiences of members of the priority populations, in this case, injecting drug users, their female sex partners, and female sex workers. These materials were distributed to members of these populations by their peers, volunteers from the population who were trained to deliver social reinforcement for interest in personal risk reduction and the materials. The participation of the priority populations in the development and implementation of the intervention was designed to increase the credibility of the intervention and the acceptance of the message. The techniques involved in developing role-model stories are described in this paper. PMID:8862158

  10. A systematic review of behavioral interventions to prevent HIV infection and transmission among heterosexual, adult men in low-and middle-income countries.

    PubMed

    Townsend, Loraine; Mathews, Catherine; Zembe, Yanga

    2013-02-01

    Prevention of new HIV infections needs to move to the forefront in the fight against HIV and AIDS. In the current economic crisis, low- and middle-income countries (LMICs) should invest limited resources to amass reliable evidence-based information about behavioral prevention efforts, and on behaviors that are driving the epidemic among people who are engaging in those behaviors. This paper aims to provide a systematic review and synthesis of behavioral interventions among a group of people in high HIV-burden countries: heterosexual men in LMICs. The review includes articles published between January 2001 and May 2010 that evaluated behavioral prevention interventions among heterosexual males aged 18+ years in LMICs. The studies were evaluated using the quality assessment tool for quantitative studies developed by the Effective Public Health Practice Project. The review identified 19 articles that met the review's inclusion criteria. Most studies were conducted in South Africa (n=6); two each in Uganda and Thailand; and one in each of Angola, Brazil, Bulgaria, India, Nigeria, the Philippines, Russia, Ukraine and Zimbabwe. Eight of 19 interventions increased condom use among their respective populations. Those interventions that sought to reduce the number of sexual partners had little effect, and those that addressed alcohol consumption and intimate partner violence had mixed effects. There was no evidence for any specific format of intervention that impacted best on any of the targeted risk behaviors. The paucity of evaluated interventions for heterosexual men in LMICs suggests that adult men in these countries remain underrepresented in HIV prevention efforts. PMID:23111548

  11. Sustained High HIV Incidence in Young Women in Southern Africa: Social, Behavioral and Structural Factors and Emerging Intervention Approaches

    PubMed Central

    Harrison, Abigail; Colvin, Christopher J.; Kuo, Caroline; Swartz, Alison; Lurie, Mark

    2015-01-01

    Young women in southern Africa experience some of the highest incidence rates of HIV infection in the world. Across southern Africa, HIV prevalence among women increases rapidly between the teenage years and young adulthood. Adult HIV prevalence is 16.8 percent in South Africa, 23 percent in Botswana, 23 percent in Lesotho and 26.5 percent in Swaziland. Existing research has illuminated some of the key social, behavioral and structural factors associated with young women's disproportionate HIV risk, including gendered social norms that advantage male power in sexual relationships, and age disparities in relationships between younger women and older male partners. Important structural factors include the region's history of labor migration and legacy of family disruption, and entrenched social and economic inequalities. New interventions are emerging to address these high levels of HIV risk in the key population of young women, including structural interventions, biomedical prevention such as PrEP, and combined HIV prevention approaches. PMID:25855338

  12. The HIV Medication Taking Self-Efficacy Scale: Psychometric Evaluation

    PubMed Central

    Erlen, Judith A.; Cha, EunSeok; Kim, Kevin H.; Caruthers, Donna; Sereika, Susan M.

    2010-01-01

    Aim This paper is a report of an examination of the psychometric properties of the HIV Medication Taking Self-efficacy Scale. Background Self-efficacy is a critically important component of strategies to improve HIV medication-taking; however, valid and reliable tools for assessing HIV medication-taking self-efficacy are limited. Method We used a cross-sectional, correlational design. Between 2003 and 2007, 326 participants were recruited from sites in Pennsylvania and Ohio in the United States of America. Six self-report questionnaires administered at baseline and 12 weeks later during “Improving Adherence to Antiretroviral Therapy” were used to examine the variables of interest. Means and variances, reliability, criterion, and construct validity of the HIV Medication Taking Self-efficacy Scale were assessed. Findings Participants reported high self-confidence in their ability to carry out specific medication-related tasks (mean=8.31) and in the medication’s ability to effect good outcomes (mean=8.56). The HIV Medication Taking Self-efficacy Scale and subscales showed excellent reliability (α = .93 ~ .94). Criterion validity was well-established by examining the relationships between the HIV Medication Taking Self-efficacy Scale and selected physiological and psychological factors, and self-reported medication adherence (r = −.20 ~ .58). A two-factor model with a correlation between self-efficacy belief and outcome expectancy fitted the data well (model χ2 = 3871.95, df = 325, p<001; CFA =.96; RMSEA =.046). Conclusion The HIV Medication Taking Self-efficacy Scale is a psychometrically sound measure of medication-taking self-efficacy for use by researchers and clinicians with people with HIV. The findings offer insight into the development of interventions to promote self-efficacy and medication adherence in persons with HIV. PMID:20722799

  13. Understanding the Impact of Male Circumcision Interventions on the Spread of HIV in Southern Africa

    PubMed Central

    Hallett, Timothy B.; Singh, Kanwarjit; Smith, Jennifer A.; White, Richard G.; Abu-Raddad, Laith J.; Garnett, Geoff P.

    2008-01-01

    Background Three randomised controlled trials have clearly shown that circumcision of adult men reduces the chance that they acquire HIV infection. However, the potential impact of circumcision programmes – either alone or in combination with other established approaches – is not known and no further field trials are planned. We have used a mathematical model, parameterised using existing trial findings, to understand and predict the impact of circumcision programmes at the population level. Findings Our results indicate that circumcision will lead to reductions in incidence for women and uncircumcised men, as well as those circumcised, but that even the most effective intervention is unlikely to completely stem the spread of the virus. Without additional interventions, HIV incidence could eventually be reduced by 25–35%, depending on the level of coverage achieved and whether onward transmission from circumcised men is also reduced. However, circumcision interventions can act synergistically with other types of prevention programmes, and if efforts to change behaviour are increased in parallel with the scale-up of circumcision services, then dramatic reductions in HIV incidence could be achieved. In the long-term, this could lead to reduced AIDS deaths and less need for anti-retroviral therapy. Any increases in risk behaviours following circumcision , i.e. ‘risk compensation’, could offset some of the potential benefit of the intervention, especially for women, but only very large increases would lead to more infections overall. Conclusions Circumcision will not be the silver bullet to prevent HIV transmission, but interventions could help to substantially protect men and women from infection, especially in combination with other approaches. PMID:18493593

  14. The Effects of Dietary Intervention on HIV Dyslipidaemia: A Systematic Review and Meta-Analysis

    PubMed Central

    Stradling, Clare; Chen, Yen-Fu; Russell, Tracy; Connock, Martin; Thomas, G. Neil; Taheri, Shahrad

    2012-01-01

    Background Efficacy of dietary intervention for treatment and prevention of HIV-related lipid disturbances has not been well established. Methods We conducted a systematic search of electronic databases supplemented with manual searches and conference abstracts, without language restriction. All randomised controlled trials (RCTs) with blood lipid outcomes, involving dietary intervention or supplementation for the treatment or prevention of adult HIV dyslipidaemia, versus no or other intervention were included. Two authors using predefined data fields, including study quality indicators, extracted data independently. Results Eighteen studies (n = 873) met our inclusion criteria. Seven RCTs for omega-3 supplementation (n = 372), and four RCTs for dietary intervention (n = 201) were meta-analysed using random-effects models. Mild statistical heterogeneity was observed. Dietary intervention reduced triglyceride levels by −0·46 mmol/l (95%CI: −0·85 to −0·07 mmol/l) compared to control. Omega-3 supplementation reduced triglyceride levels by −1.12 mmol/l, (95%CI: −1·57 to −0·67 mmol/l) and total cholesterol, −0·36 mmol/l (95%CI: −0·67 to −0·05 mmol/l) compared to placebo/control. Conclusions Both omega-3 supplementation and dietary intervention reduced triglyceride level, with the latter possibly to a smaller extent. While dietary interventions are beneficial, more stringent dietary approaches may be necessary to fully address lipid disturbances in HIV patients. Trial Registration PROSPERO 2011:CRD42011001329. PMID:22701607

  15. Condom use within marriage: a neglected HIV intervention.

    PubMed Central

    Ali, Mohamed M.; Cleland, John; Shah, Iqbal H.

    2004-01-01

    OBJECTIVE: To assess the contraceptive effectiveness of condoms versus oral contraceptive pills and estimate the reproductive consequences of a major shift from pill to condom use. METHODS: Secondary analysis was performed on nationally representative cross-sectional surveys of women in 16 developing countries. FINDINGS: In the 16 countries, the median per cent of married couples currently using condoms was 2%, compared with 13% for the pill. Condom users reported a higher 12-month failure and higher method-related discontinuation rates than pill users (9% and 44% vs 6% and 30%, respectively). Condom users were more likely to report subsequent abortion following failure (21% vs 14%), and also more likely to switch rapidly to another method (76% vs 58%). The reproductive consequences, in terms of abortion and unwanted births, of a hypothetical reversal of the relative prevalence of condom and pill were estimated to be minor. The main reason for this unexpected result is that the majority of abortions and unwanted births arise from non-use of any contraceptive method. CONCLUSION: A massive shift from the more effective oral contraceptive pills to the less effective condom would not jeopardize policy goals of reducing abortions and unwanted births. However, such a shift would potentially have an added benefit of preventing human immunodeficiency virus (HIV) infections, especially in countries with generalized HIV epidemics. PMID:15112006

  16. Sex, age, race and intervention type in clinical studies of HIV cure: a systematic review.

    PubMed

    Johnston, Rowena E; Heitzeg, Mary M

    2015-01-01

    This systematic review was undertaken to determine the extent to which adult subjects representing sex (female), race (nonwhite), and age (>50 years) categories are included in clinical studies of HIV curative interventions and thus, by extension, the potential for data to be analyzed that may shed light on the influence of such demographic variables on safety and/or efficacy. English-language publications retrieved from PubMed and from references of retrieved papers describing clinical studies of curative interventions were read and demographic, recruitment year, and intervention-type details were noted. Variables of interest included participation by sex, age, and race; changes in participation rates by recruitment year; and differences in participation by intervention type. Of 151 publications, 23% reported full demographic data of study enrollees, and only 6% reported conducting efficacy analyses by demographic variables. Included studies recruited participants from 1991 to 2011. No study conducted safety analyses by demographic variables. The representation of women, older people, and nonwhites did not reflect national or international burdens of HIV infection. Participation of demographic subgroups differed by intervention type and study location. Rates of participation of demographic groups of interest did not vary with time. Limited data suggest efficacy, particularly of early therapy initiation followed by treatment interruption, may vary by demographic variables, in this case sex. More data are needed to determine associations between demographic characteristics and safety/efficacy of curative interventions. Studies should be powered to conduct such analyses and cure-relevant measures should be standardized. PMID:25313793

  17. Sex, Age, Race and Intervention Type in Clinical Studies of HIV Cure: A Systematic Review

    PubMed Central

    Heitzeg, Mary M.

    2015-01-01

    Abstract This systematic review was undertaken to determine the extent to which adult subjects representing sex (female), race (nonwhite), and age (>50 years) categories are included in clinical studies of HIV curative interventions and thus, by extension, the potential for data to be analyzed that may shed light on the influence of such demographic variables on safety and/or efficacy. English-language publications retrieved from PubMed and from references of retrieved papers describing clinical studies of curative interventions were read and demographic, recruitment year, and intervention-type details were noted. Variables of interest included participation by sex, age, and race; changes in participation rates by recruitment year; and differences in participation by intervention type. Of 151 publications, 23% reported full demographic data of study enrollees, and only 6% reported conducting efficacy analyses by demographic variables. Included studies recruited participants from 1991 to 2011. No study conducted safety analyses by demographic variables. The representation of women, older people, and nonwhites did not reflect national or international burdens of HIV infection. Participation of demographic subgroups differed by intervention type and study location. Rates of participation of demographic groups of interest did not vary with time. Limited data suggest efficacy, particularly of early therapy initiation followed by treatment interruption, may vary by demographic variables, in this case sex. More data are needed to determine associations between demographic characteristics and safety/efficacy of curative interventions. Studies should be powered to conduct such analyses and cure-relevant measures should be standardized. PMID:25313793

  18. Randomised controlled pilot study to assess the feasibility of a Mediterranean Portfolio dietary intervention for cardiovascular risk reduction in HIV dyslipidaemia: a study protocol

    PubMed Central

    Thomas, G Neil; Hemming, Karla; Frost, Gary; Garcia-Perez, Isabel; Redwood, Sabi; Taheri, Shahrad

    2016-01-01

    Introduction HIV drug treatment has greatly improved life expectancy, but increased risk of cardiovascular disease remains, potentially due to the additional burdens of infection, inflammation and antiretroviral treatment. The Mediterranean Diet has been shown to reduce cardiovascular risk and mortality in the general population, but no evidence exists for this effect in the HIV population. This study will explore the feasibility of a randomised controlled trial (RCT) to examine whether a Mediterranean-style diet that incorporates a portfolio of cholesterol-lowering foods, reduces cardiovascular risk in people with HIV dyslipidaemia. Methods and analysis 60 adults with stable HIV infection on antiretroviral treatment and low-density lipoprotein cholesterol >3 mmol/L will be recruited from 3 West Midlands HIV services. Participants will be randomised 1:1 to 1 of 2 dietary interventions, with stratification by gender and smoking status. Participants allocated to Diet1 will receive advice to reduce saturated fat intake, and those to Diet2 on how to adopt the Mediterranean Portfolio Diet with additional cholesterol-lowering foods (nuts, stanols, soya, oats, pulses). Measurements of fasting blood lipids, body composition and arterial stiffness will be conducted at baseline, and month 6 and 12 of the intervention. Food intake will be assessed using the Mediterranean Diet Score, 3-day food diaries and metabolomic biomarkers. Questionnaires will be used to assess quality of life and process evaluation. Qualitative interviews will explore barriers and facilitators to making dietary changes, and participant views on the intervention. Qualitative data will be analysed using the Framework Method. Feasibility will be assessed in terms of trial recruitment, retention, compliance to study visits and the intervention. SD of outcomes will inform the power calculation of the definitive RCT. Ethics The West Midlands Ethics Committee has approved this study and informed consent

  19. Analyzing Direct Effects in Randomized Trials with Secondary Interventions: An Application to HIV Prevention Trials.

    PubMed

    Rosenblum, Michael; Jewell, Nicholas P; van der Laan, Mark; Shiboski, Steve; van der Straten, Ariane; Padian, Nancy

    2009-04-01

    The Methods for Improving Reproductive Health in Africa (MIRA) trial is a recently completed randomized trial that investigated the effect of diaphragm and lubricant gel use in reducing HIV infection among susceptible women. 5,045 women were randomly assigned to either the active treatment arm or not. Additionally, all subjects in both arms received intensive condom counselling and provision, the "gold standard" HIV prevention barrier method. There was much lower reported condom use in the intervention arm than in the control arm, making it difficult to answer important public health questions based solely on the intention-to-treat analysis. We adapt an analysis technique from causal inference to estimate the "direct effects" of assignment to the diaphragm arm, adjusting for condom use in an appropriate sense. Issues raised in the MIRA trial apply to other trials of HIV prevention methods, some of which are currently being conducted or designed. PMID:20827388

  20. Analyzing Direct Effects in Randomized Trials with Secondary Interventions: An Application to HIV Prevention Trials

    PubMed Central

    Rosenblum, Michael; Jewell, Nicholas P.; van der Laan, Mark; Shiboski, Steve; van der Straten, Ariane; Padian, Nancy

    2010-01-01

    Summary The Methods for Improving Reproductive Health in Africa (MIRA) trial is a recently completed randomized trial that investigated the effect of diaphragm and lubricant gel use in reducing HIV infection among susceptible women. 5,045 women were randomly assigned to either the active treatment arm or not. Additionally, all subjects in both arms received intensive condom counselling and provision, the “gold standard” HIV prevention barrier method. There was much lower reported condom use in the intervention arm than in the control arm, making it difficult to answer important public health questions based solely on the intention-to-treat analysis. We adapt an analysis technique from causal inference to estimate the “direct effects” of assignment to the diaphragm arm, adjusting for condom use in an appropriate sense. Issues raised in the MIRA trial apply to other trials of HIV prevention methods, some of which are currently being conducted or designed. PMID:20827388

  1. A systematic review of school-based sexual health interventions to prevent STI/HIV in sub-Saharan Africa

    PubMed Central

    Paul-Ebhohimhen, Virginia A; Poobalan, Amudha; van Teijlingen, Edwin R

    2008-01-01

    Background The HIV/AIDS epidemic remains of global significance and there is a need to target (a) the adolescent age-groups in which most new infections occur; and (b) sub-Saharan Africa where the greatest burden of the epidemic lies. A focused systematic review of school-based sexual health interventions in sub-Saharan Africa to prevent HIV/AIDS and Sexually Transmitted Infections (STI) in this age group was therefore conducted. Methods Searches were conducted in Medline, Embase, Cinahl and PsychINFO according to agreed a priori criteria for studies published between 1986 and 2006. Further searches were conducted in UNAIDS and WHO (World Health Organization) websites, and 'Google'. Relevant journals were hand-searched and references cited in identified articles were followed up. Data extraction and quality assessment was carried out on studies selected for full text appraisal, and results were analysed and presented in narrative format. Results Some 1,020 possible titles and abstracts were found, 23 full text articles were critically appraised, and 12 articles (10 studies) reviewed, reflecting the paucity of published studies conducted relative to the magnitude of the HIV epidemic in sub-Saharan Africa. Knowledge and attitude-related outcomes were the most associated with statistically significant change. Behavioural intentions were more difficult to change and actual behaviour change was least likely to occur. Behaviour change in favour of abstinence and condom use appeared to be greatly influenced by pre-intervention sexual history. Conclusion There is a great need in sub-Saharan Africa for well-evaluated and effective school-based sexual health interventions. PMID:18179703

  2. Implementation of Computer-delivered Brief Alcohol Intervention in HIV Clinical Settings: Who Agrees to Participate?

    PubMed Central

    Yang, Cui; Crane, Heidi M; Cropsey, Karen; Hutton, Heidi; Chander, Geetanjali; Saag, Michael; McCaul, Mary E

    2016-01-01

    Objective Addressing alcohol use in primary HIV settings can improve medical outcomes and overall quality of life of persons living with HIV (PLWH). In order to assess the feasibility of computer-delivered brief alcohol intervention (CBI) and to inform future efforts to improve access to CBI, we examined patient-level socio-demographic, clinical and behavioral characteristics associated with agreement to participate in CBI among non-treatment seeking PLWH with alcohol misuse. Methods Participants were recruited from two Centres for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) HIV clinics. PLWH completed a clinical assessment of patient-reported measures and outcomes using tablet-based assessments, including socio-demographic and behavioural characteristics. HIV biological indicators, i.e., CD4 count and viral load, were also available from the electronic medical record. Participants were approached for CBI participation based on scores on the Alcohol Use Disorders Identification Test (AUDIT); no incentives were offered for CBI participation. We performed chi-square tests, analysis of variance and multivariate logistic regression to compare socio-demographic, behavioural and clinical factors among participants who agreed to participate compared with those who refused/postponed participation. Results We observed that 42% of non-treatment seeking, non-incentivized PLWH with alcohol misuse provided written agreement to participate in on-site CBI delivered in their HIV primary care clinic. A larger proportion of PLWH who agreed to enrol in CBI had detectable viral loads, heavier weekly alcohol use, and higher DSM-5 alcohol use disorder symptom counts and mental health symptoms. Neither socio-demographic background nor drug use status was associated with CBI enrolment. Conclusion CBI implementation reached those patients most in need of care. The findings of this study may assist HIV-care providers to better identify appropriate patients and

  3. Evaluation of Olfactory and Gustatory Function of HIV Infected Women

    PubMed Central

    Kuti, Kehinde Mobolanle; Nwaorgu, Onyekwere George; Akinyinka, Olusina Olusegun

    2016-01-01

    Background. Compliance with medication requires good sense of smell and taste. Objective. To evaluate the olfactory and gustatory function of HIV infected women in Ibadan, Nigeria. Methods. A case control study of women comprising 83 HIV infected women and 79 HIV uninfected women. Subjective self-rating of taste and smell function was by visual analogue scale. Olfactory function was measured via olfactory threshold (OT), olfactory discrimination (OD), olfactory identification (OI), and TDI using “Sniffin' sticks” kits and taste function (Total Taste Strips (TTS) score) measurement was by taste strips. Results. The mean age of the HIV infected women was 43.67 years ± 10.72 and control was 41.48 years ± 10.99. There was no significant difference in the self-reported assessment of smell (p = 0.67) and taste (p = 0.84) of HIV infected and uninfected women. Although the mean OT, OD, OI, TDI, and TTS scores of HIV infected and uninfected women were within the normosmic and normogeusic values, the values were significantly higher in the controls (p < 0.05). Hyposmia was in 39.7% of subjects and 12.6% of controls while hypogeusia was in 15.7% of subjects and 1.3% of controls. Conclusions. Hyposmia and hypogeusia are commoner among the HIV infected women than the HIV uninfected women and the risk increases with an increased duration of highly active antiretroviral therapy. PMID:27047688

  4. Clinical evaluation of BioPlex 2200 HIV Ag-Ab, an automated screening method providing discrete detection of HIV-1 p24 antigen, HIV-1 antibody, and HIV-2 antibody.

    PubMed

    Salmona, Maud; Delarue, Severine; Delaugerre, Constance; Simon, François; Maylin, Sarah

    2014-01-01

    Early and accurate diagnosis is essential for optimal therapeutic outcomes in patients infected with HIV. Currently, none of the commercially available fourth-generation assays differentiate HIV-1 and HIV-2 antibodies (Ab) or the HIV-1 p24 antigen (Ag). The aim of this study was to evaluate the performance of a novel assay, the BioPlex 2200 HIV Ag-Ab. This assay uses a multiplex flow immunoassay design allowing the simultaneous detection and identification of antibodies to HIV-1 (groups M and O), HIV-2, and the HIV-1 p24 antigen, in addition to providing a traditional composite result. A total of 1,505 routine serum samples were prospectively tested. Results were compared with those from the Architect HIV Combo assay. The sensitivity of the BioPlex 2200 was 100%. The specificity assessed on repeated false-positive samples was 99.5%. In addition, 524 frozen specimens from patients known to be infected with HIV-1 or HIV-2 were tested. Of these specimens, 420 were infected with HIV-1, including 156 of known genotypes, 86 were infected with HIV-2, 7 were infected with HIV-1 and HIV-2, and 11 were from patients with acute HIV infection. Sensitivity was 100% for the HIV genotypes tested. The differentiation capabilities of the BioPlex 2200 HIV Ag-Ab assay for HIV-1, HIV-2, dual HIV-1/HIV-2, and early infections were 100%, 90.7%, 100%, and 90.9%, respectively. The BioPlex 2200 is a sensitive and specific assay that offers advantages over conventional HIV combo assays, also referred to as fourth-generation assays, to accurately differentiate and report HIV-1 p24 antigen and HIV-1 and HIV-2 antibodies. PMID:24153130

  5. Pilot trial of an expressive writing intervention with HIV-positive methamphetamine-using men who have sex with men.

    PubMed

    Carrico, Adam W; Nation, Austin; Gómez, Walter; Sundberg, Jeffrey; Dilworth, Samantha E; Johnson, Mallory O; Moskowitz, Judith T; Rose, Carol Dawson

    2015-06-01

    Among men who have sex with men (MSM), the co-occurrence of trauma and stimulant use has negative implications for HIV/AIDS prevention. HIV-positive, methamphetamine-using MSM were recruited to pilot test a 7-session, multicomponent resilient affective processing (RAP) intervention that included expressive writing exercises targeting HIV-related traumatic stress. An open-phase pilot with 10 participants provided support for feasibility of intervention delivery such that 99% of the RAP sessions were completed in a 1-month period. Subsequently, 23 additional participants were enrolled in a pilot randomized controlled trial of the RAP intervention (n = 12) versus an attention-control condition that included writing exercises about neutral topics (n = 11). Acceptability was evidenced by participants randomized to RAP expressing significantly more negative emotions in their writing and reporting greater likelihood of recommending expressive writing exercises to a friend living with HIV. Over the 3-month follow-up period, attention-control participants reported significant decreases in HIV-related traumatic stress while RAP intervention participants reported no significant changes. Compared to attention-control participants, those in the RAP intervention reported significant reductions in the frequency of methamphetamine use immediately following the 1-month RAP intervention period. Thematic analyses of RAP expressive writing exercises revealed that multiple negative life events characterized by social stigma or loss contribute to the complex nature of HIV-related traumatic stress. Findings support the feasibility and acceptability of an exposure-based intervention targeting HIV-related traumatic stress. However, more intensive intervention approaches that simultaneously target trauma and stimulant use will likely be needed to optimize HIV/AIDS prevention efforts with this population. (PsycINFO Database Record PMID:25437153

  6. Interventions to improve the rate or timing of initiation of antiretroviral therapy for HIV in sub-Saharan Africa: meta-analyses of effectiveness

    PubMed Central

    Fox, Matthew P; Rosen, Sydney; Geldsetzer, Pascal; Bärnighausen, Till; Negussie, Eyerusalem; Beanland, Rachel

    2016-01-01

    Introduction As global policy evolves toward initiating lifelong antiretroviral therapy (ART) regardless of CD4 count, initiating individuals newly diagnosed with HIV on ART as efficiently as possible will become increasingly important. To inform progress, we conducted a systematic review of pre-ART interventions aiming to increase ART initiation in sub-Saharan Africa. Methods We searched PubMed, Embase and the ISI Web of Knowledge from 1 January 2008 to 1 March 2015, extended in PubMed to 25 May 2016, for English language publications pertaining to any country in sub-Saharan Africa and reporting on general adult populations. We included studies describing interventions aimed at increasing linkage to HIV care, retention in pre-ART or uptake of ART, which reported ART initiation as an outcome. We synthesized the evidence on causal intervention effects in meta-analysis of studies belonging to distinct intervention categories. Results and discussion We identified 22 studies, which evaluated 25 interventions and included data on 45,393 individual patients. Twelve of twenty-two studies were observational. Rapid/point-of-care (POC) CD4 count technology (seven interventions) (relative risk, RR: 1.26; 95% confidence interval, CI: 1.02–1.55), interventions within home-based testing (two interventions) (RR: 2.00; 95% CI: 1.36–2.92), improved clinic operations (three interventions) (RR: 1.36; 95% CI: 1.25–1.48) and a package of patient-directed services (three interventions) (RR: 1.54; 95% CI: 1.20–1.97) were all associated with increased ART initiation as was HIV/TB service integration (three interventions) (RR: 2.05; 95% CI: 0.59–7.09) but with high imprecision. Provider-initiated testing (three interventions) was associated with reduced ART initiation (RR: 0.91; 95% CI: 0.86–0.97). Counselling and support interventions (two interventions) (RR 1.08; 95% CI: 0.94–1.26) had no impact on ART initiation. Overall, the evidence was graded as low or moderate quality

  7. Resilience Processes Demonstrated by Young Gay and Bisexual Men Living with HIV: Implications for Intervention

    PubMed Central

    Bruce, Douglas; Hosek, Sybil G.; Fernandez, M. Isabel; Rood, Brian A.

    2014-01-01

    Abstract Given the increasing numbers of young gay/bisexual men (YGBM) diagnosed with HIV, it is important to understand the resilience processes enacted by this population in order to develop interventions that support their healthy development. Qualitative interviews were conducted with 54 YGBM (ages 17 to 24; 57% African American, 22% Latino) living with HIV from four geographically diverse clinics in the United States. Resilience processes clustered into four primary thematic areas: (1) engaging in health-promoting cognitive processes; (2) enacting healthy behavioral practices; (3) enlisting social support from others; and (4) empowering other young gay/bisexual men. These data suggest that YGBM living with HIV demonstrate resilience across multiple dimensions, including intrapersonal-level resilience related to individual cognitions and behaviors, as well as interpersonal-level resilience related to seeking support and providing support to others. Implications for the development of culturally-appropriate and strengths-based secondary prevention and other psychosocial interventions for YGBM living with HIV are discussed. PMID:25329778

  8. Efficacy of an HIV/STI sexual risk-reduction intervention for African American adolescent girls in juvenile detention centers: a randomized controlled trial.

    PubMed

    DiClemente, Ralph J; Davis, Teaniese L; Swartzendruber, Andrea; Fasula, Amy M; Boyce, Lorin; Gelaude, Deborah; Gray, Simone C; Hardin, James; Rose, Eve; Carry, Monique; Sales, Jessica M; Brown, Jennifer L; Staples-Horne, Michelle

    2014-01-01

    Few HIV/STI interventions exist for African American adolescent girls in juvenile detention. The objective was to evaluate the efficacy of an intervention to reduce incident STIs, improve HIV-preventive behaviors, and enhance psychosocial outcomes. We conducted a randomized controlled trial among African American adolescent girls (13-17 years, N = 188) in juvenile detention from March 2011 to May 2012. Assessments occurred at baseline and 3- and 6-months post-randomization and included: audio computer-assisted self-interview, condom skills assessment, and self-collected vaginal swab to detect Chlamydia and gonorrhea. The Imara intervention included three individual-level sessions and four phone sessions; expedited partner therapy was offered to STI-positive adolescents. The comparison group received the usual care provided by the detention center: STI testing, treatment, and counseling. At the 6-month assessment (3-months post-intervention), Imara participants reported higher condom use self-efficacy (p < 0.001), HIV/STI knowledge (p < 0.001), and condom use skills (p < 0.001) compared to control participants. No significant differences were observed between trial conditions in incident Chlamydia or gonorrhea infections, condom use, or number of vaginal sex partners. Imara for detained African American adolescent girls can improve condom use skills and psychosocial outcomes; however, a critical need for interventions to reduce sexual risk remains. PMID:25190056

  9. Experiences of people living with HIV and people living close to them of a comprehensive HIV stigma reduction community intervention in an urban and a rural setting

    PubMed Central

    French, Heleen; Greeff, Minrie; Watson, Martha J.

    2014-01-01

    Abstract HIV stigma remains high globally. Although there is a selection of HIV stigma reduction interventions discussed in the literature, there is a paucity of research about the effectiveness of these interventions. This study aimed at gaining a deeper understanding of the experiences of people living with HIV (PLWH) and people living close to them from six designated groups during and after having undergone a comprehensive HIV stigma reduction community intervention in both an urban and a rural setting. Attention was focused on their expressed experiences of the workshop and projects executed. A qualitative interpretive description approach was used. PLWH as participants were selected through purposive voluntary sampling and through snowball sampling for the people living close to them. Recruitment was from both urban and rural settings in the North West Province, South Africa. Data collection was via in-depth interviews with 23 PLWH and 60 people living close to them from specific designated groups. The data were thematically analysed through manual open coding. The results from the urban and rural settings were pooled, as there were no noteworthy differences in the themes between them. The results indicated that there was an increase in knowledge in all the groups, as well as experiences of enhanced relationships and of being equipped with leadership skills in order to go out into the community and being part of HIV stigma reduction actions. The intervention in its comprehensive nature was found to have been successful and promising for future use in reducing HIV stigma. PMID:25019454

  10. Home-based rehabilitation interventions for adults living with HIV: a scoping review.

    PubMed

    Cobbing, Saul; Hanass-Hancock, Jill; Myezwa, Hellen

    2016-01-01

    Home-based rehabilitation (HBR) has been shown to improve the lives of people living with a wide range of chronic diseases in resource-rich settings. This may also be a particularly effective strategy in resource-poor settings, where access to institution-based rehabilitation is limited. This review aimed to summarise and discuss the evidence related to the effectiveness of home-based rehabilitation (HBR) interventions designed specifically for adults living with HIV. A scoping review methodology was employed, involving systematic search techniques and appraisal of appropriate evidence. English-language journal articles that assessed the quality of life or functional ability outcomes of HBR interventions for adults living with HIV were considered for this review. Out of an initial 1 135 publications retrieved from the search of databases, six articles met this review's inclusion criteria. While this review highlights the scarcity of empirical evidence related to HBR interventions for adults living with HIV, the findings of these six articles are that HBR is a safe management option that may confer a number of physical and psychological benefits for this population. Future research on HBR interventions should include a wider range of assessment measures, including cost-benefit analyses and specific tools designed to assess the functional ability and participation in activities of daily living of participants involved in these programmes. In particular, more research on HBR is required in resource-poor environments, such as sub-Saharan Africa where HIV is endemic, to assess whether this is a feasible strategy that is both effective and practical in the areas that may need it most. PMID:27002360

  11. Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya.

    PubMed

    Vreeman, Rachel C; Scanlon, Michael L; Marete, Irene; Mwangi, Ann; Inui, Thomas S; McAteer, Carole I; Nyandiko, Winstone M

    2015-01-01

    Knowledge of one's own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of Kenyan children enrolled in an intervention study to promote disclosure of HIV status. Among 285 caregiver-child dyads enrolled in the study, children's mean age was 12.3 years. Caregivers were more likely to report that the child knew his/her diagnosis (41%) compared to self-reported disclosure by children (31%). Caregivers of disclosed children reported significantly more positive views about disclosure compared to caregivers of non-disclosed children, who expressed fears of disclosure related to the child being too young to understand (75%), potential psychological trauma for the child (64%), and stigma and discrimination if the child told others (56%). Overall, the vast majority of children scored within normal ranges on screenings for behavioral and emotional difficulties, depression, and quality of life, and did not differ by whether or not the child knew his/her HIV status. A number of factors were associated with a child's knowledge of his/her HIV diagnosis in multivariate regression, including older age (OR 1.8, 95% CI 1.5-2.1), better WHO disease stage (OR 2.5, 95% CI 1.4-4.4), and fewer reported caregiver-level adherence barriers (OR 1.9, 95% CI 1.1-3.4). While a minority of children in this cohort knew their HIV status and caregivers reported significant barriers to disclosure including fears about negative emotional impacts, we found that disclosure was not associated with worse psychosocial outcomes. PMID:26616121

  12. HIV-Related Knowledge and Perceptions by Academic Major: Implications for University Interventions.

    PubMed

    Smith, Matthew Lee; La Place, Lisa L; Menn, Mindy; Wilson, Kelly L

    2014-01-01

    Most universities offer human sexuality courses, although they are not required for graduation. While students in health-related majors may receive sexuality education in formal settings, majority of college students never receive formal sexual health or HIV/AIDS-related education, which may lead to elevated engagement in high-risk sexual behaviors. This study examines perceived knowledge about HIV/AIDS, perceived risk, and perceived consequences among college students by two distinct classifications of academic majors. Data were collected from 510 college students. Binary and multinomial logistic regressions were performed to compare HIV-related covariates by academic major category. Limited differences were observed by science, technology, engineering, and mathematics categorization. Relative to health and kinesiology majors, those who self-reported being "completely knowledgeable" about HIV were less likely to be physical sciences, mathematics, engineering, and business (PMEB) (OR = 0.41, P = 0.047) or education, humanities, and social sciences majors (OR = 0.25, P = 0.004). PMEB majors were less likely to report behavioral factors as a risk for contracting HIV (OR = 0.86, P = 0.004) and perceived acquiring HIV would be more detrimental to their quality of life (OR = 2.14, P = 0.012), but less detrimental to their mental well-being (OR = 0.58, P = 0.042). Findings can inform college-wide campaigns and interventions to raise HIV/AIDS awareness and improve college health. PMID:24660165

  13. HIV-Related Knowledge and Perceptions by Academic Major: Implications for University Interventions

    PubMed Central

    Smith, Matthew Lee; La Place, Lisa L.; Menn, Mindy; Wilson, Kelly L.

    2014-01-01

    Most universities offer human sexuality courses, although they are not required for graduation. While students in health-related majors may receive sexuality education in formal settings, majority of college students never receive formal sexual health or HIV/AIDS-related education, which may lead to elevated engagement in high-risk sexual behaviors. This study examines perceived knowledge about HIV/AIDS, perceived risk, and perceived consequences among college students by two distinct classifications of academic majors. Data were collected from 510 college students. Binary and multinomial logistic regressions were performed to compare HIV-related covariates by academic major category. Limited differences were observed by science, technology, engineering, and mathematics categorization. Relative to health and kinesiology majors, those who self-reported being “completely knowledgeable” about HIV were less likely to be physical sciences, mathematics, engineering, and business (PMEB) (OR = 0.41, P = 0.047) or education, humanities, and social sciences majors (OR = 0.25, P = 0.004). PMEB majors were less likely to report behavioral factors as a risk for contracting HIV (OR = 0.86, P = 0.004) and perceived acquiring HIV would be more detrimental to their quality of life (OR = 2.14, P = 0.012), but less detrimental to their mental well-being (OR = 0.58, P = 0.042). Findings can inform college-wide campaigns and interventions to raise HIV/AIDS awareness and improve college health. PMID:24660165

  14. Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya

    PubMed Central

    Vreeman, Rachel C.; Scanlon, Michael L.; Marete, Irene; Mwangi, Ann; Inui, Thomas S.; McAteer, Carole I.; Nyandiko, Winstone M.

    2015-01-01

    Knowledge of one’s own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of Kenyan children enrolled in an intervention study to promote disclosure of HIV status. Among 285 caregiver–child dyads enrolled in the study, children’s mean age was 12.3 years. Caregivers were more likely to report that the child knew his/her diagnosis (41%) compared to self-reported disclosure by children (31%). Caregivers of disclosed children reported significantly more positive views about disclosure compared to caregivers of non-disclosed children, who expressed fears of disclosure related to the child being too young to understand (75%), potential psychological trauma for the child (64%), and stigma and discrimination if the child told others (56%). Overall, the vast majority of children scored within normal ranges on screenings for behavioral and emotional difficulties, depression, and quality of life, and did not differ by whether or not the child knew his/her HIV status. A number of factors were associated with a child’s knowledge of his/her HIV diagnosis in multivariate regression, including older age (OR 1.8, 95% CI 1.5–2.1), better WHO disease stage (OR 2.5, 95% CI 1.4–4.4), and fewer reported caregiver-level adherence barriers (OR 1.9, 95% CI 1.1–3.4). While a minority of children in this cohort knew their HIV status and caregivers reported significant barriers to disclosure including fears about negative emotional impacts, we found that disclosure was not associated with worse psychosocial outcomes. PMID:26616121

  15. A social-media based HIV prevention intervention using peer leaders.

    PubMed

    Young, Sean D; Zhao, Mindy; Teiu, Kevin; Kwok, Justin; Gill, Harkiran; Gill, Navkiranjit

    2013-10-01

    This study seeks to investigate qualities of peer leaders in a social media-based peer-led HIV intervention. African American and Latino men who have sex with men (MSM) peer leaders were recruited through online/offline methods. They were required to have experience with health communication and social media. Over 57% of reported using social networking for seeking sex partners within 3 months. Over 53% spent over 3 hours per week online and about 53% of peer leaders had fewer than 200 Facebook friends. Results suggest that peer leaders can be recruited for social media-based health interventions. Qualities of peer leaders are discussed. PMID:24526928

  16. The development, feasibility and acceptability of an Internet-based STI–HIV prevention intervention for young Chilean women

    PubMed Central

    Villegas, N.; Santisteban, D.; Cianelli, R.; Ferrer, L.; Ambrosia, T.; Peragallo, N.; Lara, L.

    2014-01-01

    Background Young Chilean women between 18 and 24 years of age are at high risk of contracting sexually transmitted infection (STI) and human immunodeficiency virus (HIV). The literature shows a shortage of STI–HIV prevention interventions focused on this specific high-risk population and a unique set of barriers to receiving prevention messages. Internet-based interventions are promising for delivering STI–HIV prevention interventions and avoiding barriers to services. Aims The study aimed to develop a culturally informed Internet-based STI–HIV prevention intervention for Chilean women between 18 and 24 years of age, to investigate its feasibility and acceptability, and to compile recommendations on what would make the intervention more acceptable and feasible for these women. Methods The development of the Internet intervention was facilitated by a process that featured consultation with content and technology experts. A pre-post test design was used to test the acceptability and feasibility of the intervention with 40 young Chilean women between 18 and 24 years of age. Results The intervention website consisted of four modules of content and activities that support learning. The intervention was feasible and acceptable for young Chilean women between 18 and 24 years of age. Discussion and conclusion This study demonstrated the value of engaging multiple expert panels to develop culturally informed and technology-based interventions. The results of this study support the feasibility and acceptability of conducting an Internet-based intervention with multiple sessions, yielding high participation rates in a population in which there are barriers to discussion of STI–HIV prevention and sex-related content. Implications for nursing and health policy The outcomes have implications for nursing education and clinical practice and they can be used for the legal and judicial systems to promote or reinforce policies that encourage STI–HIV prevention strategies

  17. Revisiting “Success”: Posttrial Analysis of a Gender-Specific HIV/STD Prevention Intervention

    PubMed Central

    Dworkin, Shari L.; Exner, Theresa; Melendez, Rita; Hoffman, Susie; Ehrhardt, Anke A.

    2014-01-01

    Alongside the recognized need to foster the development of innovative gender-specific HIV interventions, researchers face the urgent need to further understand how current interventions do or do not work. Few studies build posttrial qualitative analysis into standardized interview assessments in randomized controlled trials in order to bolster an assessment of how interventions work. The current investigation is a posttrial qualitative analysis carried out on a randomly selected subsample (N=180), representing 50% of women who participated in a 3-arm randomized controlled trial known as Project FIO (The Future Is Ours). FIO was a gender-specific HIV prevention intervention carried out with heterosexually active women in a high seroprevalence area of New York City. Posttrial qualitative results extend an understanding of the success of the trial (e.g., reductions in unsafe sex). Qualitative results reflect how the Modified AIDS Risk Reduction Model operated in the expected direction across experimental groups. Results also highlight women’s empowerment narratives, reflecting the salience of bodily and sexual rights aspects of the intervention. PMID:16570217

  18. The VUKA Family Program: Piloting a family-based psychosocial intervention to promote health and mental health among HIV infected early adolescents in South Africa

    PubMed Central

    Bhana, Arvin; Mellins, Claude Ann; Petersen, Inge; Alicea, Stacey; Myeza, Nonhlahla; Holst, Helga; Abrams, Elaine; John, Sally; Chhagan, Meera; Nestadt, Danielle F; Leu, Cheng-Shiun; McKay, Mary

    2013-01-01

    An increasing number of adolescents born with HIV in South Africa are on antiretroviral treatment and have to confront complex issues related to coping with a chronic, stigmatizing and transmittable illness. Very few evidence-based mental health and health promotion programs for this population exist in South Africa. This study builds on a previous collaboratively designed and developmentally-timed family-based intervention for early adolescents (CHAMP). The study uses community-based participatory approach as part of formative research to evaluate a pilot randomized control trial at two hospitals. The paper reports on the development, feasibility and acceptability of the VUKA family-based program and its short-term impact on a range of psychosocial variables for HIV+ pre-adolescents and their caregivers. A ten session intervention of approximately 3 months duration was delivered to 65 pre-adolescents aged 10-13 years and their families. VUKA participants were noted to improve on all dimensions, including mental health, youth behaviour, HIV treatment knowledge, stigma, communication and adherence to medication. VUKA shows promise as a family-based mental and HIV prevention program for HIV+ pre-adolescents and which could be delivered by trained lay staff. PMID:23767772

  19. Process evaluation of school-based peer education for HIV prevention among Yemeni adolescents.

    PubMed

    Al-Iryani, Buthaina; Basaleem, Huda; Al-Sakkaf, Khaled; Kok, Gerjo; van den Borne, Bart

    2013-03-01

    In 2005, a survey was conducted among all the 27 high schools of Aden, which revealed low levels of knowledge on major prevention measures, and a high level of stigma and discrimination towards people living with HIV (PLWH). The results served as a baseline for implementing a school-based peer education intervention for HIV prevention in the 27 schools of Aden. In 2008, and after 3 years of implementation, a quasi-experimental evaluation was conducted, which revealed that the peer education intervention has succeeded in improving HIV knowledge and skills; and in decreasing stigmatization of PLWH. This process evaluation aims to give a deeper understanding of the quasi-experimental evaluation which was conducted in the 27 high schools of Aden, and to highlight the factors that facilitated or inhibited school peer education in such a conservative Muslim setting. Qualitative methodologies were pursued, where 12 focus group discussions and 12 in-depth interviews were conducted with peer educators, targeted students, school principals, social workers, and parents of peer educators. Results revealed that school-peer education was well received. There was an apparent positive effect on the life skills of peer educators, but the intervention had a lesser effect on targeted students. Key enabling factors have been the high quality of training for peer educators, supportive school principals, and acceptance of the intervention by parents. These findings are important for improving the life skills and peer education intervention at the school level, and in better planning and implementation of life skills and peer programmes at a national scale. PMID:23777570

  20. Effectiveness of an integrated intimate partner violence and HIV prevention intervention in Rakai, Uganda: analysis of an intervention in an existing cluster randomised cohort

    PubMed Central

    Wagman, Jennifer A; Gray, Ronald H; Campbell, Jacquelyn C; Thoma, Marie; Ndyanabo, Anthony; Ssekasanvu, Joseph; Nalugoda, Fred; Kagaayi, Joseph; Nakigozi, Gertrude; Serwadda, David; Brahmbhatt, Heena

    2015-01-01

    Summary Background Intimate partner violence (IPV) is associated with HIV infection. We aimed to assess whether provision of a combination of IPV prevention and HIV services would reduce IPV and HIV incidence in individuals enrolled in the Rakai Community Cohort Study (RCCS), Rakai, Uganda. Methods We used pre-existing clusters of communities randomised as part of a previous family planning trial in this cohort. Four intervention group clusters from the previous trial were provided standard of care HIV services plus a community-level mobilisation intervention to change attitudes, social norms, and behaviours related to IPV, and a screening and brief intervention to promote safe HIV disclosure and risk reduction in women seeking HIV counselling and testing services (the Safe Homes and Respect for Everyone [SHARE] Project). Seven control group clusters (including two intervention groups from the original trial) received only standard of care HIV services. Investigators for the RCCS did a baseline survey between February, 2005, and June, 2006, and two follow-up surveys between August, 2006, and April, 2008, and June, 2008, and December, 2009. Our primary endpoints were self-reported experience and perpetration of past year IPV (emotional, physical, and sexual) and laboratory-based diagnosis of HIV incidence in the study population. We used Poisson multivariable regression to estimate adjusted prevalence risk ratios (aPRR) of IPV, and adjusted incidence rate ratios (aIRR) of HIV acquisition. This study was registered with ClinicalTrials.gov, number NCT02050763. Findings Between Feb 15, 2005, and June 30, 2006, we enrolled 11 448 individuals aged 15–49 years. 5337 individuals (in four intervention clusters) were allocated into the SHARE plus HIV services group and 6111 individuals (in seven control clusters) were allocated into the HIV services only group. Compared with control groups, individuals in the SHARE intervention groups had fewer self-reports of past

  1. The diffusion of a community-level HIV intervention for women: lessons learned and best practices.

    PubMed

    King, Winifred; Nu'Man, Jeanette; Fuller, Talleria R; Brown, Mari; Smith, Shuenae; Howell, A Vyann; Little, Stacey; Patrick, Patricia; Glover, LaShon

    2008-09-01

    Abstract Early in the HIV/AIDS epidemic in the United States, relatively few women were diagnosed with HIV infection and AIDS. Today, the epidemic represents a growing and persistent health threat to women in the United States, especially young women and women of color. In 2005, the leading cause of HIV infection among African American women and Latinas was heterosexual contact. In addressing HIV prevention needs among women, community-level strategies are needed to increase consistent condom use by women and their partners and to change community norms to support safer sex behaviors. The Real AIDS Prevention Project (RAPP) is a community-based HIV prevention intervention for women and their partners. RAPP is based on a community mobilization model that involves a combination of activities, including street outreach, one-on-one discussions called stage-based encounters, role model stories, community networks, and small group activities. The objectives of RAPP are to increase consistent condom use by women and their partners and change community norms associated with perceptions of condom use and high-risk behaviors in an effort to make safer sex practice more acceptable. This paper describes the Centers for Disease Control and Prevention (CDC) Division of HIV/AIDS Prevention (DHAP) effort to nationally diffuse RAPP from March 2003 through May 2007 and lessons learned from that diffusion experience. The paper specifically discusses (1) collaborating and planning with researchers, (2) a diffusion needs assessment that was designed to assess prior implementation experiences among select agencies, (3) developing the intervention package, (4) developing and piloting training for community-based organizations (CBOs), (5) a rollout of national trainings for health departments and community-based organizations interested in implementing RAPP, and (6) ongoing quality assurance activities and the provision of technical assistance and support. RAPP has been proven effective

  2. The "work" of women when considering and using interventions to reduce mother-to-child transmission (MTCT) of HIV.

    PubMed

    Giles, Michelle L; Hellard, Margaret E; Lewin, Sharon R; O'Brien, Mary L

    2009-10-01

    This paper explores HIV-infected women's experiences of considering and using recommended interventions during pregnancy and postpartum to reduce mother-to-child transmission of HIV. Data were collected from 45 HIV-infected women aged 18-44 years living in Melbourne, Australia. A semi-structured interview was used to collect qualitative information on women's reproductive experience and intentions. The 15 women who had their children after their HIV diagnosis engaged in significant work including surveillance and safety work to minimise stigma and infection, information work to inform decisions and actions, accounting work to calculate risk and benefit, hope and worry work concerning a child's infection status and impact of interventions, work to redefine an acceptable maternal identity, work to prepare an alternative story to counter the disclosure effect of the intervention and emotional work to reconcile guilt when considering these interventions. This study provides a framework to help clinicians understand the real and on-going "work" that women engage in when they are considering interventions recommended by their physicians to reduce transmission of HIV. Even in circumstances where access to and acceptance of interventions are high, women continue to engage in this work even after they have a made a decision about a particular intervention. PMID:20024698

  3. From brothel to boardroom: prospects for community leadership of HIV interventions in the context of global funding practices.

    PubMed

    Cornish, Flora; Campbell, Catherine; Shukla, Anuprita; Banerji, Riddhi

    2012-05-01

    The empowerment of marginalised communities to lead local responses to HIV/AIDS is a key strategy of funding agencies' globalised HIV/AIDS policies, given evidence that disempowerment is a root source of vulnerability to HIV. We report on two multi-level ethnographies at the interface between HIV prevention projects for sex workers in India and their funding environment, examining the extent to which the funding environment itself promotes or undermines sex worker empowerment. We show how the 'new managerialism' characteristic of the funding system undermines sex worker leadership of HIV interventions. By requiring local projects to conform to global management standards, funding agencies risk undermining the very localism and empowerment that their intervention policies espouse. PMID:22469531

  4. Librarian-initiated HIV/AIDS prevention intervention program outcome in rural communities in Oyo State, Nigeria.

    PubMed

    Ajuwon, G A; Komolafe-Opadeji, H O; Ikhizama, B

    2013-01-01

    The objective of this study was to meet the HIV/AIDS information and service needs of citizens living in selected rural, underserved communities in Oyo State, Nigeria. This was a librarian-initiated intervention program (pre-post) study of heads of rural households in Oyo State. A questionnaire was used for pre- and post-intervention assessment. The education covered knowledge about HIV/AIDS, routes of transmission, prevention strategies, and attitude toward persons living with HIV. It increased participants' knowledge about AIDS and improved attitude toward those living with HIV. Provision and dissemination of information on HIV/AIDS through librarians to rural settlers is an important prevention strategy and librarians can make major contributions. PMID:25228485

  5. Effects of a Family Intervention in Reducing HIV Risk Behaviors Among High-Risk Hispanic Adolescents

    PubMed Central

    Prado, Guillermo; Pantin, Hilda; Huang, Shi; Cordova, David; Tapia, Maria I.; Velazquez, Maria-Rosa; Calfee, Meghan; Malcolm, Shandey; Arzon, Margaret; Villamar, Juan; Jimenez, Giselle Leon; Cano, Nicole; Brown, C. Hendricks; Estrada, Yannine

    2013-01-01

    Objective To determine the efficacy of a family intervention in reducing human immunodeficiency virus (HIV) risk behaviors among Hispanic delinquent adolescents. Design Randomized controlled trial. Setting Miami–Dade County Public School System and Miami–Dade County’s Department of Juvenile Services, Florida. Participants A total of 242 Hispanic delinquent youth aged 12 to 17 years and their primary caregivers completed outcome assessments at baseline and 3 months after intervention. Intervention Participants were randomized to either Familias Unidas (120 participants), a Hispanic-specific, family intervention designed to reduce HIV risk behaviors among Hispanic youth, or a community practice control condition (122 participants). Main Outcome Measures Self-reported measures included unprotected sexual behavior, engaging in sex while under the influence of alcohol and/or drugs, number of sexual partners, and incidence of sexually transmitted diseases. Family functioning (eg, parent-adolescent communication, positive parenting, and parental monitoring) was also assessed via self-report measures. Results Compared with community practice, Familias Unidas was efficacious in increasing condom use during vaginal and anal sex during the past 90 days, reducing the number of days adolescents were under the influence of drugs or alcohol and had sex without a condom, reducing sexual partners, and preventing unprotected anal sex at the last sexual intercourse. Familias Unidas was also efficacious, relative to community practice, in increasing family functioning and most notably in increasing parent-adolescent communication and positive parenting. Conclusion These results suggest that culturally tailored, family-centered prevention interventions may be appropriate and efficacious in reducing HIV risk behaviors among Hispanic delinquent adolescents. Trial Registration clinicaltrials.gov Identifier: NCT01257022 PMID:21969363

  6. Evaluation of the siemens HIV antigen-antibody immunoassay.

    PubMed

    Vallefuoco, Luca; Aden Abdi, Fatima; Sorrentino, Rosanna; Spalletti-Cernia, Daniela; Mazzarella, Claudia; Barbato, Sara; Perna, Enzo; Buffolano, Wilma; Di Nicuolo, Giuseppe; Portella, Giuseppe

    2014-01-01

    Fourth-generation assays for the simultaneous detection of human immunodeficiency virus (HIV) antigen and antibodies are available on the international market and are currently used for blood donor screening and for HIV diagnosis. In this study we evaluated the performance of the novel automated fourth-generation ADVIA Centaur® HIV Ag/Ab Combo assay. The assay detected seroconversion at the same bleed or at least one bleed earlier in panels with respect to other assays and showed a detection efficacy equal to those of other assays in a low-titer panel. Samples obtained from blood donors (n = 2,778) or from HIV-positive patients (HIV-1 B subtype, n = 82; non-B subtype, n = 71) were also tested, showing a good correlation with other fourth-generation assays. We assessed the performance of 3 fourth-generation assays for detecting in utero transmitted anti-HIV antibodies and found a more specific detection efficiency with the ADVIA Centaur HIV Ag/Ab Combo assay compared to the other fourth-generation assays. PMID:24557036

  7. eHealth Interventions for HIV Prevention in High-Risk Men Who Have Sex With Men: A Systematic Review

    PubMed Central

    Travers, Jasmine; Rojas, Marlene; Carballo-Diéguez, Alex

    2014-01-01

    Background While the human immunodeficiency virus (HIV) incidence rate has remained steady in most groups, the overall incidence of HIV among men who have sex with men (MSM) has been steadily increasing in the United States. eHealth is a platform for health behavior change interventions and provides new opportunities for the delivery of HIV prevention messages. Objective The purpose of this systematic review was to examine the use of eHealth interventions for HIV prevention in high-risk MSM. Methods We systematically searched PubMed, OVID, ISI Web of Knowledge, Google Scholar, and Google for articles and grey literature reporting the original results of any studies related to HIV prevention in MSM and developed a standard data collection form to extract information on study characteristics and outcome data. Results In total, 13 articles met the inclusion criteria, of which five articles targeted HIV testing behaviors and eight focused on decreasing HIV risk behaviors. Interventions included Web-based education modules, text messaging (SMS, short message service), chat rooms, and social networking. The methodological quality of articles ranged from 49.4-94.6%. Wide variation in the interventions meant synthesis of the results using meta-analysis would not be appropriate. Conclusions This review shows evidence that eHealth for HIV prevention in high-risk MSM has the potential to be effective in the short term for reducing HIV risk behaviors and increasing testing rates. Given that many of these studies were short term and had other limitations, but showed strong preliminary evidence of improving outcomes, additional work needs to rigorously assess the use of eHealth strategies for HIV prevention in high-risk MSM. PMID:24862459

  8. Factors Associated with Loss-to-Follow-Up during Behavioral Interventions and HIV Testing Cohort among Men Who Have Sex with Men in Nanjing, China

    PubMed Central

    Tang, Weiming; Huan, Xiping; Zhang, Ye; Mahapatra, Tanmay; Li, Jianjun; Liu, Xiaoyan; Mahapatra, Sanchita; Yan, Hongjing; Fu, Gengfeng; Zhao, Jinkou; Gu, Chenghua; Detels, Roger

    2015-01-01

    Background Behavioral interventions (BIs) remained the cornerstone of HIV prevention in resource-limited settings. One of the major concerns for such efforts is the loss-to-follow-up (LTFU) that threatens almost every HIV control program involving high-risk population groups. Methods To evaluate the factors associated with LTFU during BIs and HIV testing among men who have sex with men (MSM), 410 HIV sero-negatives MSM were recruited using respondent driven sampling (RDS) in Nanjing, China during 2008, they were further followed for 18 months. At baseline and each follow-up visits, each participant was counseled about various HIV risk-reductions BIs at a designated sexually transmitted infection (STI) clinic. Results Among 410 participants recruited at baseline, altogether 221 (53.9%) were LTFU at the 18-month follow-up visit. Overall, 46 participants were found to be positive for syphilis infection at baseline while 13 participants were HIV sero-converted during the follow-up period. Increasing age was less (Adjusted Odds Ratio(aOR) of 0.90, 95% confidence Interval (CI) 0.86–0.94) and official residency of provinces other than Nanjing (AOR of 2.49, 95%CI 1.32–4.71), lower level of education (AOR of 2.01, 95%CI 1.10–3.66) and small social network size (AOR of 1.75, 95%CI 1.09–2.80) were more likely to be associated with higher odds of LTFU. Conclusion To improve retention in the programs for HIV control, counseling and testing among MSM in Nanjing, focused intensified intervention targeting those who were more likely to be LTFU, especially the young, less educated, unofficial residents of Nanjing who had smaller social network size, might be helpful. PMID:25559678

  9. Factors influencing participation in weekly support groups among women completing an HIV/STD intervention program.

    PubMed

    VanDevanter, N; Parikh, N S; Cohall, R M; Merzel, C; Faber, N; Litwak, E; Gonzales, V; Kahn-Krieger, S; Messeri, P; Weinberg, G; Greenberg, J

    1999-01-01

    Over the past three decades, the influence and importance of social support has been well documented and the findings have suggested a beneficial effect on stress-related situations, mental and physical health, and social functioning. More recently, small group/skills training behavioral interventions have demonstrated success in changing behaviors which affect the transmission of sexually transmitted diseases, including HIV among populations at risk for these diseases. Studies of support groups to date have been conducted exclusively in research settings where women are offered financial incentives for participation. Little is known about the willingness of women to participate in ongoing support groups after successfully completing a skills training intervention. The present study examines the factors that may influence participation among women in a weekly support group after completing a structured, six session HIV/STD intervention. Both quantitative and qualitative data are collected from 265 women in the intervention arm of a multi-site randomized controlled behavioral intervention trial. Results reveal that less than a quarter (22%) of women participated in at least one support group. Participation varied significantly by site, ranging from 34% to 15% (p = .008). Participation was also strongly linked to recent use of domestic violence services. Qualitative data indicated that although monetary incentives play some role in the woman's decision to participate, other factors are also important. These include program outreach, support group size, salience of the group content, consistency of group leadership from the intervention to the support group, and use of peer leaders along with professional facilitators. Implications for design of post-intervention support groups programs are discussed. PMID:10813265

  10. Mediation of an efficacious HIV risk reduction intervention for South African men.

    PubMed

    O'Leary, Ann; Jemmott, John B; Jemmott, Loretta S; Bellamy, Scarlett; Icard, Larry D; Ngwane, Zolani

    2015-10-01

    "Men, Together Making a Difference!" is an HIV/STD risk-reduction intervention that significantly increased self-reported consistent condom use during vaginal intercourse compared with a health-promotion attention-control intervention among men (N = 1181) in Eastern Cape Province, South Africa. The present analyses were designed to identify mediators of the intervention's efficacy. The potential mediators were Social Cognitive Theory (SCT) constructs that the intervention targeted, including several aspects of condom-use self-efficacy, outcome expectancies, and knowledge. Mediation was assessed using a product-of-coefficients approach where an α path (the intervention's effect on the potential mediator) and a β path (the potential mediator's effect on the outcome of interest, adjusting for intervention) were estimated independently in a generalized estimating equations framework. Condom-use negotiation self-efficacy, technical-skill self-efficacy, and impulse-control self-efficacy were significant mediators. Although not mediators, descriptive norm and expected friends' approval of condom use predicted subsequent self-reported condom use, whereas the expected approval of sexual partner did not. The present results suggest that HIV/STD risk-reduction interventions that draw upon SCT and that address self-efficacy to negotiate condom use, to apply condoms correctly, and to exercise sufficient control when sexually aroused to use condoms may contribute to efforts to reduce sexual risk behavior among South African men. Future research must examine whether approaches that build normative support for condom use among men's friends are also efficacious. PMID:25969177

  11. Nothing as Practical as a Good Theory? The Theoretical Basis of HIV Prevention Interventions for Young People in Sub-Saharan Africa: A Systematic Review

    PubMed Central

    Michielsen, Kristien; Chersich, Matthew; Temmerman, Marleen; Dooms, Tessa; Van Rossem, Ronan

    2012-01-01

    This paper assesses the extent to which HIV prevention interventions for young people in sub-Saharan Africa are grounded in theory and if theory-based interventions are more effective. Three databases were searched for evaluation studies of HIV prevention interventions for youth. Additional articles were identified on websites of international organisations and through searching references. 34 interventions were included; 25 mentioned the use of theory. Social Cognitive Theory was most prominent (n = 13), followed by Health Belief Model (n = 7), and Theory of Reasoned Action/Planned Behaviour (n = 6). These cognitive behavioural theories assume that cognitions drive sexual behaviour. Reporting on choice and use of theory was low. Only three articles provided information about why a particular theory was selected. Interventions used theory to inform content (n = 13), for evaluation purposes (n = 4) or both (n = 7). No patterns of differential effectiveness could be detected between studies using and not using theory, or according to whether a theory informed content, and/or evaluation. We discuss characteristics of the theories that might account for the limited effectiveness observed, including overreliance on cognitions that likely vary according to type of sexual behaviour and other personal factors, inadequately address interpersonal factors, and failure to account for contextual factors. PMID:22900155

  12. The MyPEEPS randomized controlled trial: A pilot of preliminary efficacy, feasibility, and acceptability of a group-level, HIV risk reduction intervention for young men who have sex with men

    PubMed Central

    Hidalgo, Marco A.; Kuhns, Lisa M.; Hotton, Anna L.; Johnson, Amy K.; Mustanski, Brian; Garofalo, Robert

    2015-01-01

    An exigent need exists for HIV prevention intervention research targeting young men who have sex with men (MSM) – a group of young adults that, despite composing the highest and most racially disproportionate rates of HIV incidence, has been least often the focus of behavioral intervention research. This pilot study tested a group-based HIV primary prevention intervention for young MSM to evaluate its initial efficacy, feasibility, and acceptability. Participants were randomized (N=101; aged 16-20 years) to one of two group-level, HIV and STI education programs: controls participated in a non-interactive, lecture-based program while intervention participants took part in a highly interactive program tailored to young MSM aged 16-20. Sexual risk and social cognitive outcomes were assessed at baseline, and 6- and 12 weeks post-intervention. Over the entire follow-up period, intervention participants were less likely than controls to engage in any sexual behavior while under the influence of substances (p<0.05), and also observed in this group was a decreasing trend of unprotected anal sex while under the influence of substances (p=.08). Follow-up differences between groups on social cognitive outcomes favored the intervention group, though these differences were non-significant. Acceptability ratings were modest. A 6-session behavioral intervention tailored to young MSM, aged 16-20, is feasible, acceptable, and demonstrates evidence of preliminary efficacy in reducing sexual risk, specifically sexual risk while under the influence of substances. PMID:25135064

  13. Using Randomized Controlled Trials to Evaluate Interventions for Releasing Prisoners

    ERIC Educational Resources Information Center

    Pettus-Davis, Carrie; Howard, Matthew Owen; Dunnigan, Allison; Scheyett, Anna M.; Roberts-Lewis, Amelia

    2016-01-01

    Randomized controlled trials (RCTs) are rarely used to evaluate social and behavioral interventions designed for releasing prisoners. Objective: We use a pilot RCT of a social support intervention (Support Matters) as a case example to discuss obstacles and strategies for conducting RCT intervention evaluations that span prison and community…

  14. Measuring the potential role of frailty in apparent declining efficacy of HIV interventions

    PubMed Central

    Hardnett, Felicia P.; Rose, Charles E.

    2015-01-01

    Objective:In recent HIV intervention trials, intervention efficacies appear to decline over time. Researchers have attributed this to “waning,” or a loss of intervention efficacy. Another possible reason is heterogeneity in infection risk or “frailty.” We propose an approach to assessing the impact of frailty and waning on measures of intervention efficacy and statistical power in randomized-controlled trials. Methods:Using multiplicative risk reduction, we developed a mathematical formulation for computing disease incidence and the incidence rate ratio (IRR) as a function of frailty and waning. We designed study scenarios, which held study-related factors constant, varied waning and frailty parameters and measured the change in disease incidence, IRR, and statistical power. Results:We found that frailty alone can impact disease incidence over time. However, frailty has minimal impact on the IRR. The factor that has the greatest influence on the IRR is intervention efficacy and the degree to which it is projected to wane. We also found that even moderate waning can cause an unacceptable decrease in statistical power while the impact of frailty on statistical power is minimal. Discussion:We conclude that frailty has minimal impact on trial results relative to intervention efficacy. Study resources would, therefore, be better spent on efforts to keep the intervention efficacy constant throughout the trial (e.g., enhancing the vaccine schedule or promoting treatment adherence). PMID:26728574

  15. Context and group dynamics in a CBPR-developed HIV prevention intervention.

    PubMed

    Dickson-Gomez, Julia; Corbett, A Michelle; Bodnar, Gloria; Zuniga, Maria Ofelia; Guevara, Carmen Eugenia; Rodriguez, Karla; Navas, Verónica

    2016-03-01

    This paper will explore in detail the effects of context and group dynamics on the development of a multi-level community-based HIV prevention intervention for crack cocaine users in the San Salvador Metropolitan Area, El Salvador. Community partners included residents from marginal communities, service providers from the historic center of San Salvador and research staff from a non-profit organization. The community contexts from which partners came varied considerably and affected structural group dynamics, i.e. who was identified as community partners, their research and organizational capacity, and their ability to represent their communities, with participants from marginal communities most likely to hold community leadership positions and be residents, and those from the center of San Salvador most likely to work in religious organizations dedicated to HIV prevention or feeding indigent drug users. These differences also affected the intervention priorities of different partners. The context of communities changed over time, particularly levels of violence, and affected group dynamics and the intervention developed. Finally, strategies were needed to elicit input from stakeholders under-represented in the community advisory board, in particular active crack users, in order to check the feasibility of the proposed intervention and revise it as necessary. Because El Salvador is a very different context than that in which most CBPR studies have been conducted, our results reveal important contextual factors and their effects on partnerships not often considered in the literature. PMID:25070835

  16. The Past, Present, and Future of HIV Prevention: Integrating Behavioral, Biomedical, and Structural Intervention Strategies for the Next Generation of HIV Prevention

    PubMed Central

    Rotheram-Borus, Mary Jane; Swendeman, Dallas; Chovnick, Gary

    2010-01-01

    In the past 25 years, the field of HIV prevention research has been transformed repeatedly. Today, effective HIV prevention requires a combination of behavioral, biomedical, and structural intervention strategies. Risk of transmitting or acquiring HIV is reduced by consistent male and female-condom use, reductions in concurrent and/or sequential sexual and needle-sharing partners, male circumcision, and treatment with antiretroviral medications. At least 144 behavioral prevention programs have been found effective in reducing HIV transmission acts; however, scale up of these programs has not occurred outside of the United States. A series of recent failures of HIV-prevention efficacy trials for biomedical innovations such as HIV vaccines, treating herpes simplex 2 and other sexually transmitted infections, and diaphragm and microbicide barriers highlights the need for behavioral strategies to accompany biomedical strategies. This challenges prevention researchers to reconceptualize how cost-effective, useful, realistic, and sustainable prevention programs will be designed, delivered, tested, and diffused. The next generation of HIV prevention science must draw from the successes of existing evidence-based interventions and the expertise of the market sector to integrate preventive innovations and behaviors into everyday routines. PMID:19327028

  17. Abriendo Puertas: Feasibility and Effectiveness a Multi-Level Intervention to Improve HIV Outcomes Among Female Sex Workers Living with HIV in the Dominican Republic.

    PubMed

    Kerrigan, Deanna; Barrington, Clare; Donastorg, Yeycy; Perez, Martha; Galai, Noya

    2016-09-01

    Female sex workers (FSW) are disproportionately affected by HIV. Yet, few interventions address the needs of FSW living with HIV. We developed a multi-level intervention, Abriendo Puertas (Opening Doors), and assessed its feasibility and effectiveness among a cohort of 250 FSW living with HIV in the Dominican Republic. We conducted socio-behavioral surveys and sexually transmitted infection and viral load testing at baseline and 10-month follow-up. We assessed changes in protected sex and adherence to antiretroviral therapy (ART) with logistic regression using generalized estimating equations. Significant pre-post intervention changes were documented for adherence (72-89 %; p < 0.001) and protected sex (71-81 %; p < 0.002). Higher intervention exposure was significantly associated with changes in adherence (AOR 2.42; 95 % CI 1.23-4.51) and protected sex (AOR 1.76; 95 % CI 1.09-2.84). Illicit drug use was negatively associated with both ART adherence and protected sex. Abriendo Puertas is feasible and effective in improving behavioral HIV outcomes in FSW living with HIV. PMID:27016102

  18. Effects of a Theory-Based Audio HIV/AIDS Intervention for Illiterate Rural Females in Amhara, Ethiopia

    ERIC Educational Resources Information Center

    Bogale, Gebeyehu W.; Boer, Henk; Seydel, Erwin R.

    2011-01-01

    In Ethiopia the level of illiteracy in rural areas is very high. In this study, we investigated the effects of an audio HIV/AIDS prevention intervention targeted at rural illiterate females. In the intervention we used social-oriented presentation formats, such as discussion between similar females and role-play. In a pretest and posttest…

  19. Effectiveness of a Peer-Assisted Multicomponent Behavioral Intervention in HIV Risk Reduction Among Female Entertainment Workers in China.

    PubMed

    Yang, Xiushi; Xia, Guomei

    2015-10-01

    This study examined the effectiveness of a behavioral intervention that combined cognitive and social influence approaches. The intervention consisted of small group sessions targeting HIV knowledge, protection motivation, behavioral skills, and social influences of risk reduction. The control was an attention-controlled HIV/STI health education and counseling. Two-group comparisons were conducted to assess the effectiveness of the intervention; risk reduction over time was analyzed to determine the sustainability of the effectiveness. The analyses revealed that the intervention was effective in reducing/increasing HIV risk/protective behaviors and the effect was sustainable. While participants in the control reported a greater reduction/increase in risk/protective behaviors 3-month post-intervention, the initial strong effect quickly faded and completely disappeared 12-month post-intervention. By contrast, the moderate initial effect of the intervention was not only sustained but actually strengthened over time. The intervention was well received by participants and holds promise for HIV risk reduction behavior change among female entertainment workers in China. PMID:26485234

  20. Taxonomy for Strengthening the Identification of Core Elements for Evidence-Based Behavioral Interventions for HIV/AIDS Prevention

    ERIC Educational Resources Information Center

    Galbraith, Jennifer S.; Herbst, Jeffrey H.; Whittier, David K.; Jones, Patricia L.; Smith, Bryce D.; Uhl, Gary; Fisher, Holly H.

    2011-01-01

    The concept of core elements was developed to denote characteristics of an intervention, such as activities or delivery methods, presumed to be responsible for the efficacy of evidence-based behavioral interventions (EBIs) for HIV/AIDS prevention. This paper describes the development of a taxonomy of core elements based on a literature review of…

  1. Trials of Intervention Principles: Evaluation Methods for Evolving Behavioral Intervention Technologies

    PubMed Central

    Schueller, Stephen M; Riley, William T; Brown, C Hendricks; Cuijpers, Pim; Duan, Naihua; Kwasny, Mary J; Stiles-Shields, Colleen; Cheung, Ken

    2015-01-01

    In recent years, there has been increasing discussion of the limitations of traditional randomized controlled trial (RCT) methodologies for the evaluation of eHealth and mHealth interventions, and in particular, the requirement that these interventions be locked down during evaluation. Locking down these interventions locks in defects and eliminates the opportunities for quality improvement and adaptation to the changing technological environment, often leading to validation of tools that are outdated by the time that trial results are published. Furthermore, because behavioral intervention technologies change frequently during real-world deployment, even if a tested intervention were deployed in the real world, its shelf life would be limited. We argue that RCTs will have greater scientific and public health value if they focus on the evaluation of intervention principles (rather than a specific locked-down version of the intervention), allowing for ongoing quality improvement modifications to the behavioral intervention technology based on the core intervention principles, while continuously improving the functionality and maintaining technological currency. This paper is an initial proposal of a framework and methodology for the conduct of trials of intervention principles (TIPs) aimed at minimizing the risks of in-trial changes to intervention technologies and maximizing the potential for knowledge acquisition. The focus on evaluation of intervention principles using clinical and usage outcomes has the potential to provide more generalizable and durable information than trials focused on a single intervention technology. PMID:26155878

  2. A Controlled Pre-Post Evaluation of a Computer-based HIV/AIDS Education on Students' Sexual Behaviors, Knowledge and Attitudes.

    PubMed

    Musiimenta, Angella

    2012-01-01

    Unlike traditional approaches to sexuality and HIV education which can be constrained by the sensitive nature of the subject, Information Technology (IT) can be an innovative teaching tool that can be used to educate people about HIV. This is especially relevant to interventions targeting young people; the population group fond of using IT, and the same group that is more vulnerable to HIV/AIDS. Yet, there are significantly few empirical studies that rigorously evaluated computer-assisted school-based HIV/AIDS interventions in developing countries. The modest studies conducted in this area have largely been conducted in developed countries, leaving little known about the effectiveness of such interventions in low resource settings, which moreover host the majority of HIV/AIDS infections. This research addresses this gap by conducting a controlled pre-post intervention evaluation of the impacts of the World Starts With Me (WSWM), a computer-assisted HIV/AIDS intervention implemented in schools in Uganda. The research question was: did the WSWM intervention significantly influence students' sexual behaviors, HIV/AIDS knowledge, attitudes and self-efficacy? To address this question, questionnaires were simultaneously administering to 146 students in an intervention group (the group receiving the WSWM intervention) and 146 students in a comparison group (the group who did not receive the WSWM intervention), before (February 2009) and after the intervention (December 2009). Findings indicate that the intervention significantly improved students' HIV/AIDS knowledge, attitudes self-efficacy, sex abstinence and fidelity, but had no significant impact on condom use. The major reason for non-use of condoms was lack of knowledge about condom use which can be attributed to teachers' failure and inabilities to demonstrate condom use in class. To address this challenge, intervention teachers should be continuously trained in skills-based and interactive sexuality education. This

  3. Stigma reduction in adolescents and young adults newly diagnosed with HIV: findings from the Project ACCEPT intervention.

    PubMed

    Harper, Gary W; Lemos, Diana; Hosek, Sybil G

    2014-10-01

    This article describes the influence of a group-based behavioral intervention for adolescents and young adults newly diagnosed with HIV (Project ACCEPT) on four dimensions of HIV-related stigma-personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes about people with HIV-as measured by the Berger HIV Stigma Scale. Stigma was addressed in a holistic manner during the intervention by providing HIV/AIDS-related information, facilitating the acquisition of coping skills, and providing contact with other youth living with HIV in order to improve social support. Fifty youth (28 male, 22 female; mean age=19.24 years) newly diagnosed with HIV from four geographically diverse clinics participated in a one-group pretest-posttest design study whereby they received the intervention over a 12-week period, and completed assessments at baseline, post-intervention, and 3-month follow-up. Results from the combined sample (males and females) revealed overall reductions in stigma in three dimensions: personalized stigma, disclosure concerns, and negative self-image, although only the combined-sample effects for negative self-image were maintained at 3-month follow-up. Gender-specific analyses revealed that the intervention reduced stigma for males across all four dimensions of stigma, with all effects being maintained to some degree at the 3-month follow-up. Only personalized stigma demonstrated a decrease for females, although this effect was not maintained at the 3-month follow-up; while the other three types of stigma increased at post-intervention and 3-month follow-up. Findings are discussed in terms of gender specific outcomes and the need for a different type of intervention to reduce stigma for young women. PMID:25216106

  4. Integrating Prevention Interventions for People Living With HIV Into Care and Treatment Programs: A Systematic Review of the Evidence

    PubMed Central

    Medley, Amy; Bachanas, Pamela; Grillo, Michael; Hasen, Nina; Amanyeiwe, Ugochukwu

    2015-01-01

    Introduction This review assesses the impact of prevention interventions for people living with HIV on HIV-related mortality, morbidity, retention in care, quality of life, and prevention of ongoing HIV transmission in resource-limited settings (RLSs). Methods We conducted a systematic review of studies reporting the results of prevention interventions for people living with HIV in RLS published between January 2000 and August 2014. Standardized methods of searching and data abstraction were used. Results Ninety-two studies met the eligibility criteria: 24 articles related to adherence counseling and support, 13 on risk reduction education and condom provision, 19 on partner HIV testing and counseling, 14 on provision of family planning services, and 22 on assessment and treatment of other sexually transmitted infections. Findings indicate good evidence that adherence counseling and sexually transmitted infection treatment can have a high impact on morbidity, whereas risk reduction education, partner HIV testing and counseling, and family planning counseling can prevent transmission of HIV. More limited evidence was found to support the impact of these interventions on retention in care and quality of life. Most studies did not report cost information, making it difficult to draw conclusions about the cost-effectiveness of these interventions. Conclusions This evidence suggests that these prevention interventions, if brought to sufficient scale and coverage, can help support and optimize the impact of core treatment and prevention interventions in RLS. Further operational research with more rigorous study designs, and ideally with biomarkers and costing information, is needed to determine the best model for providing these interventions in RLS. PMID:25768868

  5. Cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS (PLWHA) in China

    PubMed Central

    Williams, Ann B.; Wang, Honghong; Burgess, Jane; Li, Xianhong; Danvers, Karina

    2012-01-01

    BACKGROUND Adapting nursing interventions to suit the needs and culture of a new population (cultural adaptation) is an important early step in the process of implementation and dissemination. While the need for cultural adaptation is widely accepted, research-based strategies for doing so are not well articulated. Non-adherence to medications for chronic disease is a global problem and cultural adaptation of existing evidence-based interventions could be useful. OBJECTIVES This paper aims to describe the cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS and to offer recommendations for adaptation of interventions across cultures and borders. SITE The intervention, which demonstrated efficacy in a randomized controlled trial in North America, was adapted for the cultural and social context of Hunan Province, in south central China. SOURCES OF DATA The adaptation process was undertaken by intervention stakeholders including the original intervention study team, the proposed adaptation team, and members of a Community Advisory Board, including people living with HIV/AIDS, family members, and health care workers at the target clinical sites. PROCEDURES The adaptation process was driven by quantitative and qualitative data describing the new population and context and was guided by principles for cultural adaptation drawn from prevention science research. RESULTS The primary adaptation to the intervention was the inclusion of family members in intervention activities, in response to the cultural and social importance of the family in rural China. In a pilot test of the adapted intervention, self-reported medication adherence improved significantly in the group receiving the intervention compared to the control group (p=0.01). Recommendations for cultural adaptation of nursing interventions include 1) involve stakeholders from the beginning; 2) assess the population, need, and context; 3

  6. Cultural Factors and Family-Based HIV Prevention Intervention for Latino Youth

    PubMed Central

    Brown, Larry K.; Raffaelli, Marcela; Lima, Lori-Ann

    2009-01-01

    Latino youth are the fastest growing ethnic group in the United States and are at considerable risk for HIV and other sexually transmitted infections (STIs), given that they have an earlier onset of sexual activity and use condoms less consistently than European American adolescents. Theorists and scholars have emphasized the importance of taking culture into account in sexuality interventions with Latino adolescents, yet few culturally tailored interventions have been developed for this population. Given the emphasis on familismo and collectivism among Latinos, family-based programs are likely to be well received and could contribute to long-term maintenance of adolescent safety. In this synthesis of the relevant literature, cultural factors that have been identified as relevant to Latino sexuality are reviewed and implications for family-based intervention with Latinos are addressed. PMID:19181820

  7. An Individually Tailored Intervention for HIV Prevention: Baseline Data From the EXPLORE Study

    PubMed Central

    Chesney, Margaret A.; Koblin, Beryl A.; Barresi, Patrick J.; Husnik, Marla J.; Celum, Connie L.; Colfax, Grant; Mayer, Kenneth; McKirnan, David; Judson, Franklyn N.; Huang, Yijian; Coates, Thomas J.

    2003-01-01

    Objectives. We describe the intervention tested in EXPLORE, an HIV prevention trial aimed at men who have sex with men (MSM), and test the empirical basis of the individually tailored intervention. Methods. Data on participants’ self-efficacy, communication skills, social norms, and enjoyment of unprotected anal intercourse were examined in relation to sexual risk. Combinations of these factors, together with alcohol use and noninjection drug use, were also examined. Results. The individual factors examined were associated with sexual risk behavior. The cohort was shown to be heterogeneous in regard to the presence of combinations of these risk-related factors. Conclusions. Baseline data from the EXPLORE study support the efficacy of the individually tailored intervention used. PMID:12773358

  8. A test of motivational plus nicotine replacement interventions for HIV positive smokers.

    PubMed

    Ingersoll, Karen S; Cropsey, Karen L; Heckman, Carolyn J

    2009-06-01

    The purpose of this study was to test two combination motivational plus pharmacological interventions for smoking cessation among HIV positive smokers. Participants were 40 adults receiving HIV care who smoked daily reporting interest in smoking reduction. Measures were administered at baseline, 1-month, and 3-month follow-ups. Participants were randomly assigned to self-guided reading plus nicotine patch (n = 18) or motivational interviewing plus nicotine patch (n = 22). Groups did not differ at 3 months on biochemically-verified abstinence. The sample reduced cigarettes per day by half a pack and the percent of smoking days by 41%, and 22% were abstinent at 3-month follow-up. Compliance with the nicotine patch was poor and declined over time, but patch use was unrelated to carbon monoxide level at 3-month follow-up. Smoking cessation interventions for people with HIV can be helpful and should include components that encourage some smoke-free days, increase self-efficacy, and attend to adherence to nicotine replacement treatment. PMID:18066659

  9. Religious communities and HIV prevention: an intervention-study using a human rights-based approach

    PubMed Central

    Paiva, V.; Garcia, J.; Rios, L.F.; Santos, A.O.; Terto, V.; Munõz-Laboy, M.

    2011-01-01

    Religious communities have been a challenge to HIV prevention globally. Focusing on the acceptability component of the right to health, this intervention study examined how local Catholic, Evangelical and Afro-Brazilian religious communities can collaborate to foster young people’s sexual health and ensure their access to comprehensive HIV prevention in their communities in Brazil. This article describes the process of a three-stage sexual health promotion and HIV prevention initiative that used a multicultural human rights approach to intervention. Methods included 27 in-depth interviews with religious authorities on sexuality, AIDS prevention and human rights, and training 18 young people as research-agents, who surveyed 177 youth on the same issues using self-administered questionnaires. The results, analysed using a rights-based perspective on health and the vulnerability framework, were discussed in daylong interfaith workshops. Emblematic of the collaborative process, workshops are the focus of the analysis. Our findings suggest that this human rights framework is effective in increasing inter-religious tolerance and in providing a collective understanding of the sexuality and prevention needs of youth from different religious communities, and also serves as a platform for the expansion of state AIDS programmes based on laical principles. PMID:20373192

  10. An HIV Prevention Intervention for Ethnically Diverse Men in Substance Abuse Treatment: Pilot Study Findings

    PubMed Central

    Burlew, A. Kathleen; Hatch-Maillette, Mary A.; Beadnell, Blair; Wright, Lynette; Wilson, Jerika

    2013-01-01

    Objectives. We determined the acceptability, participants' receptivity, and effectiveness of a culturally adapted version of Real Men Are Safe (REMAS-CA), an HIV prevention intervention for men in substance abuse treatment. Methods. In 2010 and 2011, we compared participants who attended at least 1 (of 5) REMAS-CA session (n = 66) with participants in the original REMAS study (n = 136). Participants completed an assessment battery at baseline and at 3-month follow-up with measures of substance abuse, HIV risk behaviors, perceived condom barriers, and demographics. We conducted postintervention focus groups at each clinic. Results. Minority REMAS-CA participants were more likely to have attended 3 or more sessions (87.0%), meeting our definition of intervention completion, than were minority participants in the REMAS study (75.1%; odds ratio = 2.1). For REMAS-CA participants with casual partners (n = 25), the number of unprotected sexual occasions in the past 90 days declined (6.2 vs 1.6). Among minority men in the REMAS study (n = 36), the number of unprotected sexual occasions with casual partners changed little (9.4 vs 8.4; relative risk = 4.56). Conclusions. REMAS-CA was effective across ethnic groups, a benefit for HIV risk reduction programs that serve a diverse clientele. PMID:23488494

  11. The Mpowerment Project: a community-level HIV prevention intervention for young gay men.

    PubMed Central

    Kegeles, S M; Hays, R B; Coates, T J

    1996-01-01

    OBJECTIVES. Since young gay men are engaging in alarmingly high rates of unsafe sex and few seek help for changing risky behaviors, community-level programs to prevent infection with the human immunodeficiency virus (HIV) among them are urgently needed. METHODS. We developed and implemented a community-level HIV prevention program in a midsized Oregon community. The peer-led program had three components: out-reach, small groups, and a publicity campaign. Independently from the prevention program, a cohort of young gay men (n = 300) was surveyed in this and in a similar comparison community pre- and postintervention. RESULTS. Following intervention, the proportion of men engaging in any unprotected anal intercourse decreased from 41.0% to 30.0% (-27% from baseline), decreased from 20.2% to 11.1% (-45% from baseline) with nonprimary partners, and decreased from 58.9% to 44.7% (-24% from baseline) with boyfriends. No significant changes occurred in the comparison community over the same period. CONCLUSIONS. This prevention approach effectively led to HIV risk reduction. To reach risk-taking young gay men, HIV prevention activities must be embedded in social activities and community life. PMID:8712273

  12. Integration of health systems and priority health interventions: a case study of the integration of HIV and TB control programmes into the general health system in Vietnam.

    PubMed

    Conseil, Alexandra; Mounier-Jack, Sandra; Coker, Richard

    2010-11-01

    This case study on Vietnam aims to generate empirical evidence on the relative merits of integration of two priority health interventions, HIV/AIDS and tuberculosis (TB), into six functions of the wider health system: stewardship and governance, service delivery, demand generation, monitoring and evaluation, planning, and financing. Selective documentary reviews and 25 qualitative, semi-structured interviews were conducted in early 2009 in Hanoi, Hai Duong province, Chih Linh district and Hoang Tien commune with informants from international, national and sub-national agencies steering or managing the HIV/AIDS and TB programmes and from health facilities providing HIV/AIDS and TB services. Data collected were collated and evaluated against 25 elements of integration. Each element of integration was ultimately classified as being 'fully/predominantly integrated', 'partially integrated', 'not or predominantly not integrated'. The results showed that none of the six programme functions was fully integrated into the general health care system as a whole. They were established either in parallel, notably at higher administrative levels, or were partially integrated. The study findings also revealed that little integration across all functional levels has occurred between the two programmes. Generally international agencies and sub-national domestic stakeholders supported more integration between vertical programmes (HIV and TB) and the general health systems, while national bodies responsible for HIV and TB favoured reinforcing a more vertical and thus less integrated approach. In the absence of shared assumptions and goals, this polarization of views may result in sub-optimal effectiveness and efficiency of each of the disease programmes as well as of HIV/TB interventions. PMID:20966106

  13. Major Factors Influencing HIV/AIDS Project Evaluation

    ERIC Educational Resources Information Center

    Niba, Mercy Bi; Green, J. Maryann

    2005-01-01

    This article aimed at finding out if participatory processes (group discussions, enactments, and others) do make a valuable contribution in communication-based project implementation/evaluation and the fight against HIV/AIDS. A case study backed by documentary analysis of evaluation reports and occasional insights from interviews stood as the main…

  14. An Assessment of Health Interventions Required to Prevent the Transmission of HIV Infection Among Men Having Sex with Men in Bujumbura, Burundi.

    PubMed

    Coulaud, Pierre-Julien; Mujimbere, Gabriel; Nitunga, Arsène; Kayonde, Candide; Trenado, Emmanuel; Spire, Bruno; Bernier, Adeline

    2016-10-01

    Data regarding HIV among men having sex with men (MSM) in Burundi are scarce. In a context where same-sex practices are illegal, national recommendations including MSM have been issued in 2012. However, no study has been conducted to evaluate MSM's health needs, which would be useful to adapt recommendations and implement evidence-based interventions. This study aimed at identifying health needs expressed by MSM. A cross-sectional study was conducted in Bujumbura in 2014, in collaboration with the National Association for HIV positive people and AIDS patients. Fifty-one MSM, recruited during HIV prevention activities, self-completed a questionnaire. A descriptive analysis was conducted. Participants had a median age of 23 years, over 60 % declared being a member of an LGBT organisation and 76 % lived their homosexuality secretly or discretely. Over the last month, 67 % declared having had sex with a man and 32 % with a woman. In the previous 6 months, 40 % declared having systematically used a condom during sexual intercourse. In terms of health needs, 22 % did not use the services offered by HIV providers. Participants expressed needs in terms of prevention (access to rapid HIV tests, in a confidential setting, with counselling) and care (listening centre, free treatment, confidentiality). Medical expertise and being a good listener were the predominant healthcare staff qualities desired by participants. Results suggest that Burundian MSM represent an at-risk population, with low access to HIV services, in need of a comprehensive approach for HIV prevention, with community-based activities (HIV testing, counselling, prevention tools), psychological and social support. PMID:27020779

  15. Community Wise: A formative evaluation of a community based health intervention

    PubMed Central

    Windsor, Liliane Cambraia; Jessell, Lauren; Lassiter, Teri; Benoit, Ellen

    2015-01-01

    Individuals with histories of incarceration and substance abuse residing in distressed communities often receive suboptimal services partly due to a lack of empirically supported substance abuse treatments targeting this population. Grounded in community-engaged research, we developed Community Wise, a manualized, 12-week, group behavioral intervention. The intervention aims to reduce substance use frequency, HIV/HCV risk behaviors, and reoffending among individuals with histories of substance abuse and incarceration. Thirty six individuals were recruited to participate in a formative evaluation of Community Wise processes and outcomes. Analysis showed significantly lower post-intervention number of cigarettes smoked per day, days using an illicit drug, money spent on illegal drugs, and rearrests. Based on the evaluation, the research team made the following changes: 1) added a session on sexuality; 2) increased the number of sessions from 12 to 15; and 3) modified strategies to help participants develop and implement capacity building projects. PMID:26594312

  16. Performance evaluation of a new fourth-generation HIV Ag/Ab combination electrochemiluminescence immunoassay - evaluation of a new HIV assay.

    PubMed

    Wang, Tingting; Li, Dongdong; Yan, Kening; Yuan, Yu; Yang, Tingfu; Du, Xiaoqing; Yan, Xuedan; Tao, Chuanmin; Wang, Lanlan

    2014-03-01

    A new fourth-generation HIV Ag/Ab electrochemiluminescence immunoassay for screening of HIV infection, the Elecsys HIV Combi PT (Roche Diagnostics, Penzberg, Germany) assay, is going to be commercially available in clinical laboratories in China. This assay was evaluated and compared with two commonly used assays: Elecsys HIV Combi assay and the Livzon anti-HIV-1/2 ELISA. Commercially available panels and 30 established HIV infection samples were tested to evaluate the sensitivity. In addition, a total of 675 routine clinical samples were collected and tested in West China Hospital to compare the specificity. Any reactive result from a screening test was retested and all reactive retested samples were confirmed with Western blot assay, Elecsys HIV Ag test, Elecsys HIV Ag confirmatory test or HIV-1 RNA NAT testing. According to the results of the HIV seroconversion panels, the Elecsys HIV Combi PT could detect seroconversion at the same bleed or at least one bleed earlier compared to the other two assays. Among the 675 clinical samples, most results were consistent except for one specimen with a false-negative result using Elecsys HIV Combi assay. In conclusion, the Elecsys HIV Combi PT has shown satisfactory sensitivity and specificity to be a screening test for HIV infection. PMID:23970655

  17. Respecting the circle of life: one year outcomes from a randomized controlled comparison of an HIV risk reduction intervention for American Indian adolescents.

    PubMed

    Tingey, Lauren; Mullany, Britta; Chambers, Rachel; Hastings, Ranelda; Lee, Angelita; Parker, Anthony; Barlow, Allison; Rompalo, Anne

    2015-01-01

    Potential for widespread transmission of HIV/AIDS among American Indian (AI) adolescents exists, yet no evidence-based interventions (EBIs) have been adapted and evaluated with this population. Intensive psychoeducation may improve knowledge and decision-making which could potentially translate to reductions in HIV risk behaviors. A peer group randomized controlled comparison of an adapted EBI vs. control was delivered over an eight-day summer basketball camp in one reservation-based tribal community to adolescents ages 13-19. Outcome data were gathered immediately post-camp and at 6 and 12 months follow-up. Self-selected peer groups were randomized to intervention (n = 138) or control (n = 129) conditions for a total sample of 267 participants (56.2% female), mean age 15.1 years (SD = 1.7). Intervention participants had better condom use self-efficacy post-camp (Adjusted Mean Difference [AMD] = -0.75, p < 0.005) and at 6 (AMD = -0.44, p < 0.005) and 12 months (AMD = -0.23, p < 0.05) follow-up. Intervention participants also had higher HIV prevention and transmission knowledge (post-camp: AMD = 0.07, p < 0.01; 6 months: AMD = 0.06, p < 0.01) were more likely to believe condoms prevent sexually transmitted infections (post-camp: RR = 1.41, p < 0.005; 6 months: RR = 1.34, p < 0.05), to talk with an adult about HIV/AIDS (post-camp: RR=1.78, p < 0.005; 6 months: RR = 1.14, p < 0.005), had higher partner negotiation efficacy related to substance use during sex (post-camp: AMD = 0.37, p < 0.01), and were more likely to intend to use a condom (post-camp: RR = 1.39, p < 0.01). The adapted intervention had short- and medium-term impacts on AI adolescent risk for HIV/AIDS, but attenuated at 12 months. Intervention delivery through a community-based camp is feasible and acceptable with strong retention. Additional study is needed to evaluate the adapted intervention's impact on sexual risk behaviors and if booster sessions and parent involvement translate to long-term impacts

  18. Resources and obstacles to developing and implementing a structural intervention to prevent HIV in San Salvador, El Salvador.

    PubMed

    Dickson-Gomez, Julia; Corbett, A Michelle; Bodnar, Gloria; Rodriguez, Karla; Guevara, Carmen E

    2010-02-01

    HIV prevention researchers have increasingly advocated structural interventions that address factors in the social, political and economic context to reduce disparities of HIV/AIDS among disadvantaged populations. This paper draws on data collected in three different types of low-income communities (n=6) in the San Salvador metropolitan area in El Salvador. Nine focus group discussions were conducted between January 2006 and July 2007, 6 with community leaders, and 3 with crack cocaine users, as well as in-depth interviews with 20 crack users and crack dealers. We explore opportunities and barriers to the implementation of a community-level, structural intervention. We first analyze the different forms of leadership, and other community resources including existing HIV prevention activities that could potentially be used to address the related problems of crack use and HIV in the communities, and the structural factors that may act as barriers to capitalizing on communities' strengths in interventions. Each of the communities studied demonstrated different resources that stem from each community's unique history and geographic location. HIV testing and prevention resources varied widely among the communities, with resources concentrated in one Older Central community despite a strong need in all communities. In many communities, fear of gang violence and non-responsiveness by government agencies to communities' needs have discouraged community organizing. In the discussion, we offer concrete suggestions for developing and implementing structural interventions to reduce HIV risks that use communities' different but complementary resources. PMID:19910099

  19. Resources and obstacles to developing and implementing a structural intervention to prevent HIV in San Salvador, El Salvador

    PubMed Central

    Corbett, A. Michelle; Bodnar, Gloria; Rodriguez, Karla; Guevara, Carmen E

    2009-01-01

    HIV prevention researchers have increasingly advocated structural interventions that address factors in the social, political and economic context to reduce disparities of HIV/AIDS among disadvantaged populations. This paper draws on data collected in three different types of low-income communities (n=6) in the San Salvador metropolitan area in El Salvador. Nine focus group discussions were conducted between January 2006 - July 2007, six with community leaders, and three with crack cocaine users, as well as in-depth interviews with 20 crack users and crack dealers. We explore opportunities and barriers to the implementation of a community-level, structural intervention. We first analyze the different forms of leadership, and other community resources including existing HIV prevention activities that could potentially be used to address the related problems of crack use and HIV in the communities, and the structural factors that may act as barriers to capitalizing on communities’ strengths in interventions. Each of the communities studied demonstrated different resources that stem from each community's unique history and geographic location. HIV testing and prevention resources varied widely among the communities, with resources concentrated in one Older Central community despite a strong need in all communities. In many communities, fear of gang violence and non-responsiveness by government agencies to communities’ needs have discouraged community organizing. In the discussion, we offer concrete suggestions for developing and implementing structural interventions to reduce HIV risks that use communities’ different but complementary resources. PMID:19910099

  20. Results of the NIMH Collaborative HIV/STD Prevention Trial of a Community Popular Opinion Leader Intervention

    PubMed Central

    2010-01-01

    Objective To determine whether community populations in Community Popular Opinion Leader (C-POL) intervention venues showed greater reductions in sexual risk practices and lower HIV/STD incidence than those in comparison venues. Methods A 5-country group-randomized trial, conducted from 2002 to 2007, enrolled cohorts from 20 to 40 venues in each country. Venues, matched within country on sexual risk and other factors, were randomly assigned within matched pairs to the C-POL community intervention or an AIDS education comparison. All participants had access to condoms and were assessed with repeated in-depth sexual behavior interviews, STD/HIV testing and treatment, and HIV/STD risk reduction counseling. Sexual behavior change and HIV/STD incidence were measured over two years. Results Both intervention and comparison conditions showed declines of approximately 33% in risk behavior prevalence and had comparable disease incidence within and across countries, target populations, and types of venues. Conclusions The community-level intervention did not produce greater behavioral risk and disease incidence reduction than the comparison condition, perhaps due to the intensive prevention services received by all participants during the assessment. Repeated, detailed self-review of risk behavior practices coupled with HIV/STD testing, treatment, HIV risk reduction counseling, and condom access can themselves substantially change behavior and disease acquisition. PMID:20354444

  1. Adapting the VOICES HIV behavioral intervention for Latino men who have sex with men.

    PubMed

    O'Donnell, Lydia; Stueve, Ann; Joseph, Heather A; Flores, Stephen

    2014-04-01

    Latino men who have sex with men (MSM) are disproportionately impacted by HIV/AIDS, but few behavioral interventions address their prevention needs. Adaptation of evidence-based interventions is a pragmatic strategy that builds upon lessons learned and has the potential to fill gaps in prevention programming. Yet there are few reports of how transfers are executed and whether effectiveness is achieved. This research reports on the adaptation of VOICES/VOICES, a single-session intervention designed for heterosexual adults, into No Excuses/Sin buscar excuses for Latino MSM. To test the adapted intervention, 370 at-risk Latino MSM were enrolled in a randomized trial. At a three-month follow-up, there was a sharper decrease in unprotected intercourse in the intervention group compared to controls (59 % vs. 39 %, ANOVA p < 0.05, F = 4.10). Intervention participants also reported more condom use at last intercourse (AOR = 1.69; 95 % CI 1.02-2.81, p < 02). Findings support use of adapted models for meeting prevention needs of high-priority populations. PMID:24419993

  2. Implementing for results: program analysis of the HIV/STI interventions for sex workers in Benin.

    PubMed

    Semini, Iris; Batona, Georges; Lafrance, Christian; Kessou, Léon; Gbedji, Eugène; Anani, Hubert; Alary, Michel

    2013-01-01

    HIV response has entered a new era shaped by evidence that the combination of interventions impacts the trajectory of the epidemic. Even proven interventions, however, can be ineffective if not to scale, appropriately implemented, and with the right combination. Benin is among the pioneering countries that prioritized HIV prevention for sex workers and clients early on. Effective implementation up to 2006 resulted in consistent condom use among sex workers increasing from 39% to 86.2% and a decline in prevalence of gonorrhea from 5.4% to 1.6%. This study responds to the growing concern that, although proven interventions for female sex workers (FSWs) were expanded in Benin since 2008, indicators of coverage and behaviors are far from satisfactory. The quest to better understand implementation and how to render service delivery efficient and effective resonates with increased emphasis in the international arena on return for investments. Quantitative and qualitative methods were utilized to collect data. The output measured is the number of sex workers seeking Sexually Transmitted Infection (STI) care at user-friendly STI Clinics (SCs). Data were collected for 2010-2011 in nine regions of Benin. While recognizing that commitment to scale up is commendable, the study revealed deficiencies in program design and implementation that undermine outcomes. The selected mix of interventions is not optimal. Allocation of funds is not proportionate to the needs of FSW across regions. Only 5 of 41 SCs were fully functional at time of study. Free distribution of condoms covers only 10% of needs of FSWs. Funding and financing gaps resulted in extended interruptions of services. Successful HIV prevention in Benin will depend on the effective and efficient implementation of well-funded programs in sex work setting. Resources should be aligned to local sex work typology and presence in communities. A national framework defining an appropriate mix of interventions, management

  3. The Positive Outlook Study: A Randomised Controlled Trial Evaluating Online Self-Management for HIV Positive Gay Men.

    PubMed

    Millard, Tanya; Agius, Paul A; McDonald, Karalyn; Slavin, Sean; Girdler, Sonya; Elliott, Julian H

    2016-09-01

    The aim of this paper was to evaluate the effectiveness of an online self-management program in improving health outcomes and well-being for gay men living with HIV in Australia. The online Positive Outlook Program was based on self-efficacy theory and used a self-management approach to enhance HIV-positive gay men's skills, confidence and abilities to manage the psychosocial issues associated with HIV in daily life. The 7-week program was delivered in closed groups and comprised information modules, action-planning activities, moderated discussion boards, and weekly peer-facilitated 'live chats'. A randomised controlled trial was conducted to establish the effectiveness of the Positive Outlook program compared to a 'usual care' control. Participants were HIV-positive gay men 18 years or older living in Australia. Primary outcomes were evaluated at three time-points (baseline, post-intervention and 12-week's post-intervention follow-up) and included HIV-related quality of life (PROQOL-HIV), outcomes of health education (HeiQ) and HIV specific self-efficacy (Positive Outlook Self-Efficacy Scale). A total of 132 gay men with HIV in Australia were randomly allocated to the intervention (n = 68) or usual care control (n = 64) groups. Maximum likelihood marginal-linear modelling indicated significant improvement in the intervention group on the PROQOL-HIV subscales of body change (p = 0.036), social relationships (p = 0.035) and emotional distress (p = 0.031); the HeiQ subscales of health-directed activity (p = 0.048); constructive attitudes and approaches (p = 0.015); skill and technique acquisition (p = 0.046) and health service navigation (p = 0.008); and the Positive Outlook Self-Efficacy Scale on the subscales of relationships (p = 0.019); social participation (p = 0.006); and emotions (p = 0.041). Online delivery of self-management programs is feasible and has the potential to improve quality of life, self-management skills and domain

  4. Peer-delivered interventions reduce HIV risk behaviors among out-of-treatment drug abusers.

    PubMed Central

    Cottler, L B; Compton, W M; Ben Abdallah, A; Cunningham-Williams, R; Abram, F; Fichtenbaum, C; Dotson, W

    1998-01-01

    OBJECTIVE: The purpose of this chapter is to describe the results of a randomized study (funded by the National Institute on Drug Abuse [NIDA]) comparing a peer-delivered enhanced intervention to the NIDA standard intervention for reducing human immunodeficiency virus (HIV) risk behaviors. METHODS: Data come from the ongoing St. Louis Each One Teach One (EOTO) study on HIV risk behaviors among out-of-treatment crack cocaine users and injecting drug users (IDUs). The study has a randomized prospective design, and for this chapter, three risk behaviors were analyzed--the frequency of crack cocaine use and the number of sex partners and condom use over the past 30-day period. We report the level of risk at baseline and at the three-month follow-up period to determine the proportion of individuals improving or worsening based on a dichotomous outcome in which remaining at low risk or decreasing moderate or high risk behaviors is considered "improving" and increasing risk behavior or remaining at moderate or high risk is considered "worsening". RESULTS: Overall, 80% of the sample "improved" their crack cocaine use, meaning they maintained at low level or reduced their use. Although both the standard and enhanced intervention groups made substantial improvement in their crack cocaine use, individuals in the enhanced intervention group were statistically more likely to reduce their risk than those assigned to the standard intervention (83% vs. 75%, P < 0.05). As for the number of sex partners, 75% of the overall sample improved; that is, they reduced the number of sex partners or remained abstinent or in a one-partner relationship at baseline and follow-up. There was no statistically significant difference between the enhanced and standard groups (76% vs 73%). Stratified by gender, the results showed a trend toward improvement among women assigned to the enhanced intervention compared with those assigned to the standard. In terms of condom use, the overall sample worsened

  5. Inhibition of the HIV Rev transactivator : a new target for therapeutic intervention.

    PubMed

    Heguy, A

    1997-01-01

    The viral transactivator Rev is essential for HIV replication, since it allows the nuclear export of unspliced and partially spliced viral mRNAs that encode the structural proteins. Rev is an RNA binding protein that interacts with a highly structured RNA element, the RRE, found within the envelope sequences. This viral protein also interacts with cellular proteins, termed nucleoporins, and acts as an adaptor between the viral mRNAs and the cellular nuclear export machinery. Both interactions are specific, and required for Rev function. Because of its crucial role in the HIV replication cycle, and its novel mechanism of action, Rev represents an ideal target for therapeutic intervention. This review describes the efforts towards Rev inhibition. Gene therapy approaches, including the expression of trans-dominant mutants and RNA decoys, as well as antisense therapies and small molecule inhibitors of Rev-RRE binding or Rev interaction with the cellular machinery will be discussed PMID:9206979

  6. Evaluation and Diagnosis of HIV-Associated Lung Disease.

    PubMed

    Maximous, Stephanie; Huang, Laurence; Morris, Alison

    2016-04-01

    There are myriad pulmonary conditions associated with HIV, ranging from acute infections to chronic noncommunicable diseases. The epidemiology of these diseases has changed significantly in the era of widespread antiretroviral therapy. Evaluation of the HIV-infected patient involves assessment of the severity of illness and a thorough yet efficient pursuit of definitive diagnosis, which may involve multiple etiologies simultaneously. Important clues to a diagnosis include medical and social history, demographic details such as travel and geography of residence, substance use, sexual practices, and domiciliary and incarceration status. CD4 cell count is a tremendously useful measure of immune function and risk for HIV-related diseases, and helps narrow down the differential. Careful history of current symptoms and physical examination with particular attention to extrapulmonary signs are crucial early steps. Many adjunctive laboratory studies can suggest or rule out particular diagnoses. Pulmonary function testing (PFT) may aid in characterization of several chronic noninfectious illnesses accelerated by HIV. Chest radiograph and computed tomography (CT) scan allow for classification of diseases by pathognomonic imaging patterns, although many infectious conditions present atypically, particularly with lower CD4 counts. Ultimately, definitive diagnosis with sputum, bronchoscopy with bronchoalveolar lavage, or lung tissue is often needed. It is of utmost importance to maintain a high degree of suspicion for HIV in otherwise undiagnosed patients, as the first presentation of HIV may be via an acute pulmonary illness. PMID:26974298

  7. Children affected by maternal HIV/AIDS: feasibility and acceptability trial of the Children United with Buddies (CUB) intervention.

    PubMed

    Murphy, Debra A; Marelich, William D; Graham, Jamie; Payne, Diana L

    2015-01-01

    Past research has shown that young children affected by maternal HIV present with elevated stress/anxiety and negative well-being. This pilot intervention for children aged 7-14 affected by maternal HIV targeted improving positive child-mother communication, improving HIV/AIDS knowledge and reducing anxiety (especially related to transmission), and lessening feelings of stigma. Each of the three child intervention sessions included behavioral skills training and a themed craft exercise; mothers attended an open discussion group while the children attended their sessions. Study participants were 37 child-mother pairs. The study design was a randomized two-group pretest-posttest experimental design. The intervention sessions were audiotaped for transcription. Results showed significant decreases in anxiety and worry for children in the intervention group, and increases in happiness and knowledge regarding HIV/AIDS transmission. Intervention group mothers reported greater social support. Qualitative findings for the intervention group children and mothers also support these findings. Early intervention reduces child stress, and may affect longer-term outcomes. PMID:23946295

  8. Adolescent HIV Risk Reduction in the Bahamas: Results from Two Randomized Controlled Intervention Trials Spanning Elementary School Through High School.

    PubMed

    Stanton, Bonita; Dinaj-Koci, Veronica; Wang, Bo; Deveaux, Lynette; Lunn, Sonja; Li, Xiaoming; Rolle, Glenda; Brathwaite, Nanika; Marshall, Sharon; Gomez, Perez

    2016-06-01

    To address global questions regarding the timing of HIV-prevention efforts targeting youth and the possible additional benefits of parental participation, researchers from the USA and The Bahamas conducted two sequential longitudinal, randomized trials of an evidence-based intervention spanning the adolescent years. The first trial involved 1360 grade-6 students and their parents with three years of follow-up and the second 2564 grade-10 students and their parents with two years of follow-up. Through grade-12, involvement in the combined child and parent-child HIV-risk reduction interventions resulted in increased consistent condom-use, abstinence/protected sex, condom-use skills and parent-child communication about sex. Receipt of the grade-6 HIV-prevention intervention conferred lasting benefits regarding condom-use skills and self-efficacy. Youth who had not received the grade-six intervention experienced significantly greater improvement over baseline as a result of the grade-10 intervention. The HIV-risk reduction intervention delivered in either or both grade-6 and grade-10 conferred sustained benefits; receipt of both interventions appears to confer additional benefits. PMID:26499123

  9. Environmental–Structural Interventions to Reduce HIV/STI Risk Among Female Sex Workers in the Dominican Republic

    PubMed Central

    Kerrigan, Deanna; Moreno, Luis; Rosario, Santo; Gomez, Bayardo; Jerez, Hector; Barrington, Clare; Weiss, Ellen; Sweat, Michael

    2006-01-01

    Objectives. We assessed the effectiveness of 2 environmental–structural interventions in reducing risks of HIV and sexually transmitted infections (STIs) among female sex workers in the Dominican Republic. Methods. Two intervention models were implemented over a 1-year period: community solidarity in Santo Domingo and solidarity combined with government policy in Puerto Plata. Both were evaluated via preintervention–postintervention cross-sectional behavioral surveys, STI testing and participant observations, and serial cross-sectional STI screenings. Results. Significant increases in condom use with new clients (75.3%–93.8%; odds ratio [OR]=4.21; 95% confidence interval [CI]=1.55, 11.43) were documented in Santo Domingo. In Puerto Plata, significant increases in condom use with regular partners (13.0%–28.8%; OR=2.97; 95% CI=1.33, 6.66) and reductions in STI prevalence (28.8%–16.3%; OR = 0.50; 95% CI = 0.32, 0.78) were documented, as were significant increases in sex workers’ verbal rejections of unsafe sex (50.0%–79.4%; OR=3.86; 95% CI=1.96, 7.58) and participating sex establishments’ ability to achieve the goal of no STIs in routine monthly screenings of sex workers (OR=1.17; 95% CI=1.12, 1.22). Conclusions. Interventions that combine community solidarity and government policy show positive initial effects on HIV and STI risk reduction among female sex workers. PMID:16317215

  10. Developing Content for a mHealth Intervention to Promote Postpartum Retention in Prevention of Mother-To-Child HIV Transmission Programs and Early Infant Diagnosis of HIV: A Qualitative Study

    PubMed Central

    Odeny, Thomas A.; Newman, Maya; Bukusi, Elizabeth A.; McClelland, R. Scott; Cohen, Craig R.; Camlin, Carol S.

    2014-01-01

    Background Maternal attendance at postnatal clinic visits and timely diagnosis of infant HIV infection are important steps for prevention of mother-to-child transmission (PMTCT) of HIV. We aimed to use theory-informed methods to develop text messages targeted at facilitating these steps. Methods We conducted five focus group discussions with health workers and women attending antenatal, postnatal, and PMTCT clinics to explore aspects of women's engagement in postnatal HIV care and infant testing. Discussion topics were informed by constructs of the Health Belief Model (HBM) and prior empirical research. Qualitative data were coded and analyzed according to the construct of the HBM to which they related. Themes were extracted and used to draft intervention messages. We carried out two stages of further messaging development: messages were presented in a follow-up focus group in order to develop optimal phrasing in local languages. We then further refined the messages, pretested them in individual cognitive interviews with selected health workers, and finalized the messages for the intervention. Results Findings indicated that brief, personalized, caring, polite, encouraging, and educational text messages would facilitate women bringing their children to clinic after delivery, suggesting that text messages may serve as an important “cue to action.” Participants emphasized that messages should not mention HIV due to fear of HIV testing and disclosure. Participants also noted that text messages could capitalize on women's motivation to attend clinic for childhood immunizations. Conclusions Applying a multi-stage content development approach to crafting text messages – informed by behavioral theory – resulted in message content that was consistent across different focus groups. This approach could help answer “why” and “how” text messaging may be a useful tool to support maternal and child health. We are evaluating the effect of these messages on

  11. Effect of an STD/HIV Behavioral Intervention on Women's Use of the Female Condom

    PubMed Central

    Van Devanter, Nancy; Gonzales, Virginia; Merzel, Cheryl; Parikh, Nina S.; Celantano, David; Greenberg, Judith

    2002-01-01

    Objectives. This study assessed the effectiveness of a sexually transmitted disease (STD)/HIV behavior change intervention in increasing women's use of the female condom. Methods. A total of 604 women at high risk for STDs and HIV in New York City, Baltimore, Md, and Seattle, Wash, enrolled in a randomized controlled trial of a small-group, skills-training intervention that included information and skills training in the use of the female condom. Results. In a logistic regression, the strongest predictors of use were exposure to the intervention (odds ratio [OR] = 5.5; 95% confidence interval [CI] = 2.8, 10.7), intention to use the female condom in the future (OR = 4.5; 95% CI = 2.4, 8.5), having asked a partner to use a condom in the past 30 days (OR = 2.3; 95% CI = 1.3, 3.9), and confidence in asking a partner to use a condom (OR = 1.9; 95% CI = 1.1, 3.5). Conclusions. Clinicians counseling women in the use of the female condom need to provide information, demonstrate its correct use with their clients, and provide an opportunity for their clients to practice skills themselves. PMID:11772772

  12. Harm reduction interventions in HIV care: a qualitative exploration of patient and provider perspectives

    PubMed Central

    2016-01-01

    Background. A culture of stringent drug policy, one-size-fits-all treatment approaches, and drug-related stigma has clouded clinical HIV practice in the United States. The result is a series of missed opportunities in the HIV care environment. An approach which may address the broken relationship between patient and provider is harm reduction—which removes judgment and operates at the patient’s stage of readiness. Harm reduction is not a routine part of care; rather, it exists outside clinic walls, exacerbating the divide between compassionate, stigma-free services and the medical system. Methods. Qualitative, phenomenological, semi-structured, individual interviews with patients and providers were conducted in three publicly-funded clinics in Chicago, located in areas of high HIV prevalence and drug use and serving African-American patients (N = 38). A deductive thematic analysis guided the process, including: the creation of an index code list, transcription and verification of interviews, manual coding, notation of emerging themes and refinement of code definitions, two more rounds of coding within AtlasTi, calculation of Cohen’s Kappa for interrater reliability, queries of major codes and analysis of additional common themes. Results. Thematic analysis of findings indicated that the majority of patients felt receptive to harm reduction interventions (safer injection counseling, safer stimulant use counseling, overdose prevention information, supply provision) from their provider, and expressed anticipated gratitude for harm reduction information and/or supplies within the HIV care visit, although some were reluctant to talk openly about their drug use. Provider results were mixed, with more receptivity reported by advanced practice nurses, and more barriers cited by physicians. Notable barriers included: role-perceptions, limited time, inadequate training, and the patients themselves. Discussion. Patients are willing to receive harm reduction

  13. Harm reduction interventions in HIV care: a qualitative exploration of patient and provider perspectives.

    PubMed

    Carlberg-Racich, Suzanne

    2016-01-01

    Background. A culture of stringent drug policy, one-size-fits-all treatment approaches, and drug-related stigma has clouded clinical HIV practice in the United States. The result is a series of missed opportunities in the HIV care environment. An approach which may address the broken relationship between patient and provider is harm reduction-which removes judgment and operates at the patient's stage of readiness. Harm reduction is not a routine part of care; rather, it exists outside clinic walls, exacerbating the divide between compassionate, stigma-free services and the medical system. Methods. Qualitative, phenomenological, semi-structured, individual interviews with patients and providers were conducted in three publicly-funded clinics in Chicago, located in areas of high HIV prevalence and drug use and serving African-American patients (N = 38). A deductive thematic analysis guided the process, including: the creation of an index code list, transcription and verification of interviews, manual coding, notation of emerging themes and refinement of code definitions, two more rounds of coding within AtlasTi, calculation of Cohen's Kappa for interrater reliability, queries of major codes and analysis of additional common themes. Results. Thematic analysis of findings indicated that the majority of patients felt receptive to harm reduction interventions (safer injection counseling, safer stimulant use counseling, overdose prevention information, supply provision) from their provider, and expressed anticipated gratitude for harm reduction information and/or supplies within the HIV care visit, although some were reluctant to talk openly about their drug use. Provider results were mixed, with more receptivity reported by advanced practice nurses, and more barriers cited by physicians. Notable barriers included: role-perceptions, limited time, inadequate training, and the patients themselves. Discussion. Patients are willing to receive harm reduction interventions from

  14. A randomized controlled trial of a tailored group smoking cessation intervention for HIV-infected smokers

    PubMed Central

    Moadel, Alyson B.; Bernstein, Steven L.; Mermelstein, Robin J.; Arnsten, Julia H.; Dolce, Eileen H.; Shuter, Jonathan

    2013-01-01

    Background More than half of persons living with HIV (PLWH) in the US smoke cigarettes, and tobacco use is responsible for considerable morbidity and mortality in this group. Little is known about the efficacy of tobacco treatment strategies in PLWH. Design Randomized controlled trial comparing Positively Smoke Free (PSF), an intensive group therapy intervention targeting HIV-infected smokers, to standard care. Methods A cohort of 145 PLWH smokers, recruited from an HIV-care center in the Bronx, New York, were randomized 1:1 into the PSF program or standard care. All were offered a 3-month supply of nicotine replacement therapy. PSF is an eight session program tailored to address the needs and concerns of HIV-infected smokers. Sessions were co-facilitated by a graduate student and an HIV-infected peer. The primary outcome was biochemically-confirmed, seven-day point-prevalence abstinence at three months. Results In the intention to treat analysis, PSF condition subjects had nearly double the quit rate of controls (19.2% vs 9.7%, P=0.11). In the complete case, as-treated analysis, assignment to PSF was associated with increased odds of quitting (ORadj 3.55, 95% CI: 1.04– 12.0). Latino ethnicity and lower loneliness score were predictive of abstinence. Subjects in the PSF condition exhibited significant decreases in daily cigarette consumption and significant increases in self-efficacy and in motivation to quit. Attendance of ≥7 sessions was associated with higher quit rates. Conclusions These findings suggest a positive effect of PSF on cessation rates in PLWH smokers. Loneliness and self-efficacy are influential factors in the smoking behaviors of PLWH. PMID:22732470

  15. Sibanye Methods for Prevention Packages Program Project Protocol: Pilot Study of HIV Prevention Interventions for Men Who Have Sex With Men in South Africa

    PubMed Central

    Kearns, Rachel; Siegler, Aaron J; Phaswana-Mafuya, Nancy; Bekker, Linda-Gail; Stephenson, Rob; Baral, Stefan D; Brookmeyer, Ron; Yah, Clarence S; Lambert, Andrew J; Brown, Benjamin; Rosenberg, Eli; Blalock Tharp, Mondie; de Voux, Alex; Beyrer, Chris; Sullivan, Patrick S

    2014-01-01

    Background Human immunodeficiency virus (HIV) prevention intervention programs and related research for men who have sex with men (MSM) in the southern African region remain limited, despite the emergence of a severe epidemic among this group. With a lack of understanding of their social and sexual lives and HIV risks, and with MSM being a hidden and stigmatized group in the region, optimized HIV prevention packages for southern African MSM are an urgent public health and research priority. Objective The objective of the Sibanye Health Project is to develop and evaluate a combination package of biomedical, behavioral, and community-level HIV prevention interventions and services for MSM in South Africa. Methods The project consists of three phases: (1) a comprehensive literature review and summary of current HIV prevention interventions (Phase I), (2) agent-based mathematical modeling of HIV transmission in southern African MSM (Phase II), and (3) formative and stigma-related qualitative research, community engagement, training on providing health care to MSM, and the pilot study (Phase III). The pilot study is a prospective one-year study of 200 men in Cape Town and Port Elizabeth, South Africa. The study will assess a package of HIV prevention services, including condom and condom-compatible lubricant choices, risk-reduction counseling, couples HIV testing and counseling, pre-exposure prophylaxis (PrEP) for eligible men, and non-occupational post-exposure prophylaxis for men with a high risk exposure. The pilot study will begin in October 2014. Results Preliminary results from all components but the pilot study are available. We developed a literature review database with meta-data extracted from 3800 documents from 67 countries. Modeling results indicate that regular HIV testing and promotion of condom use can significantly impact new HIV infections among South African MSM, even in the context of high coverage of early treatment of HIV-positive men and high

  16. Prevalence and drivers of HIV stigma among health providers in urban India: implications for interventions

    PubMed Central

    Ekstrand, Maria L; Ramakrishna, Jayashree; Bharat, Shalini; Heylen, Elsa

    2013-01-01

    Introduction HIV stigma inflicts hardship and suffering on people living with HIV (PLHIV) and interferes with both prevention and treatment efforts. Health professionals are often named by PLHIV as an important source of stigma. This study was designed to examine rates and drivers of stigma and discrimination among doctors, nurses and ward staff in different urban healthcare settings in high HIV prevalence states in India. Methods This cross-sectional study enrolled 305 doctors, 369 nurses and 346 ward staff in both governmental and non-governmental healthcare settings in Mumbai and Bengaluru, India. The approximately one-hour long interviews focused on knowledge related to HIV transmission, personal and professional experiences with PLHIV, instrumental and symbolic stigma, endorsement of coercive policies, and intent to discriminate in professional and personal situations that involve high and low risk of fluid exposure. Results High levels of stigma were reported by all groups. This included a willingness to prohibit female PLHIV from having children (55 to 80%), endorsement of mandatory testing for female sex workers (94 to 97%) and surgery patients (90 to 99%), and stating that people who acquired HIV through sex or drugs “got what they deserved” (50 to 83%). In addition, 89% of doctors, 88% of nurses and 73% of ward staff stated that they would discriminate against PLHIV in professional situations that involved high likelihood of fluid exposure, and 57% doctors, 40% nurses and 71% ward staff stated that they would do so in low-risk situations as well. Significant and modifiable drivers of stigma and discrimination included having less frequent contact with PLHIV, and a greater number of transmission misconceptions, blame, instrumental and symbolic stigma. Participants in all three groups reported high rates of endorsement of coercive measures and intent to discriminate against PLHIV. Stigma and discrimination were associated with multiple modifiable

  17. weCARE: A Social Media-Based Intervention Designed to Increase HIV Care Linkage, Retention, and Health Outcomes for Racially and Ethnically Diverse Young MSM.

    PubMed

    Tanner, Amanda E; Mann, Lilli; Song, Eunyoung; Alonzo, Jorge; Schafer, Katherine; Arellano, Elías; Garcia, Jesus M; Rhodes, Scott D

    2016-06-01

    Estimates suggest that only about 30% of all individuals living with HIV in the U.S. have achieved viral suppression. Men who have sex with men (MSM), particularly racial/ethnic minority young MSM, are at increased risk for HIV infection and may have even lower viral suppression rates. HIV testing rates among MSM are low, and when tested, racial/ethnic minority young MSM have disproportionately lower rates of retention in care and viral suppression compared to other subgroups. This article describes the design and development of weCare, our social media-based intervention to improve care linkage and retention and health outcomes among racially and ethnically diverse MSM, ages 13-34, living with HIV that will be implemented and evaluated beginning in late 2016. The intervention harnesses established social media that MSM between these ages commonly use, including Facebook, text messaging, and established GPS-based mobile applications (apps). We are using community-based participatory research (CBPR) to enhance the quality and validity of weCare, equitably involving community members, organization representatives, healthcare providers, clinic staff, and academic researchers. PMID:27244190

  18. HIV/AIDS Risk Reduction Intervention for Women who have Experienced Intimate Partner Violence

    PubMed Central

    Rountree, Michele A.

    2010-01-01

    A growing body of literature highlights the association between women who have experienced intimate partner abuse (IPA) and their heightened risk for HIV/AIDS (human immune deficiency syndrome/ acquired immune deficiency syndrome) infection. Finding HIV risk reduction strategies that are contextually relevant for this population is an important public policy priority. This qualitative study researched women who have experienced intimate partner abuse in order to develop a HIV/AIDS risk reduction intervention unique to their circumstances. This pilot study explored the critical components of such an intervention among a racially/ethnically stratified (African-American, Mexican-American and Anglo) sample of women (n=43) who have experienced IPA. Focus groups were conducted and transcribed, and a content analysis was used to identify major themes. In all five focus groups, participants viewed the research as interesting, good, beneficial, and/or important based on their perceptions of risk for infection. Respondents felt that they knew of ways to protect themselves from infection in non-abusive relationships; however, acknowledged the difficulties of doing so given the context of their abusive relationships. Examining the racial/ethnic differences across focus groups showed that the language used by women is quite variable. The ways in which survivors define rape, sexual abuse, and their own experiences are all unique; however, their actual experiences have many similarities. Discussed at length are the topics participants shared as critical in informing the design of an intervention and the relevance of the findings to social work clinical practice is explained. PMID:21170178

  19. Changeover-time in psychosocial wellbeing of people living with HIV and people living close to them after an HIV stigma reduction and wellness enhancement community intervention.

    PubMed

    Chidrawi, H Christa; Greeff, Minrie; Temane, Q Michael; Ellis, Suria

    2015-01-01

    HIV stigma continues to affect the psychosocial wellbeing of people living with HIV (PLWH) and people living close to them (PLC). Literature unequivocally holds the view that HIV stigma and psychosocial wellbeing interact with and have an impact on each other. This study, which is part of a larger research project funded by the South Africa Netherlands research Programme on Alternatives in Development (SANPAD), responds to the lack of interventions mitigating the impactful interaction of HIV stigma and psychosocial wellbeing and tests one such intervention. The research objectives were to test the changeover-time in the psychosocial wellbeing of PLWH and PLC in an urban and a rural setting, following a comprehensive community-based HIV stigma reduction and wellness enhancement intervention. An experimental quantitative single system research design with a pre- and four repetitive post-tests was used, conducting purposive voluntary sampling for PLWH (n = 18) and snowball sampling for PLC (n = 60). The average age of participants was 34 years old. The five measuring instruments used for both groups were the mental health continuum short-form scale, the patient health questionnaire, the satisfaction with life scale, the coping self-efficacy scale and the spirituality wellbeing scale. No significant differences were found between the urban-rural settings and data were pooled for analysis. The findings show that initial psychosocial wellbeing changes after the intervention were better sustained (over time) by the PLC than by the PLWH and seemed to be strengthened by interpersonal interaction. Recommendations included that the intervention should be re-utilised and that its tenets, content and activities be retained. A second intervention three to six months after the first should be included to achieve more sustainability and to add focused activities for the enhancement of psychosocial wellbeing. PLWH and PLC are to be encouraged to engage with innovative community

  20. Learning From Successful Interventions: A Culturally Congruent HIV Risk–Reduction Intervention for African American Men Who Have Sex With Men and Women

    PubMed Central

    Ramamurthi, Hema C.; Manago, Cleo; Harawa, Nina T.

    2009-01-01

    Few HIV prevention interventions have been developed for African American men who have sex with men or who have sex with both men and women. Many interventions neglect the historical, structural or institutional, and sociocultural factors that hinder or support risk reduction in this high-risk group. We examined ways to incorporate these factors into Men of African American Legacy Empowering Self, a culturally congruent HIV intervention targeting African American men who have sex with men and women. We also studied how to apply key elements from successful interventions to future efforts. These elements include having gender specificity, a target population, a theoretical foundation, cultural and historical congruence, skill-building components, and well-defined goals. PMID:19372517

  1. The neurobiology of HIV and its impact on cognitive reserve: A review of cognitive interventions for an aging population.

    PubMed

    Cody, Shameka L; Vance, David E

    2016-08-01

    The medications used to treat HIV have reduced the severity of cognitive deficits; yet, nearly half of adults with HIV still exhibit some degree of cognitive deficits, referred to as HIV-associated neurocognitive disorder or HAND. These cognitive deficits interfere with everyday functioning such as emotional regulation, medication adherence, instrumental activities of daily living, and even driving a vehicle. As adults are expected to live a normal lifespan, the process of aging in this clinical population may exacerbate such cognitive deficits. Therefore, it is important to understand the neurobiological mechanisms of HIV on cognitive reserve and develop interventions that are either neuroprotective or compensate for such cognitive deficits. Within the context of cognitive reserve, this article delivers a state of the science perspective on the causes of HAND and provides possible interventions for addressing such cognitive deficits. Suggestions for future research are also provided. PMID:26776767

  2. Stigma Reduction in Adolescents and Young Adults Newly Diagnosed with HIV: Findings from the Project ACCEPT Intervention

    PubMed Central

    Lemos, Diana; Hosek, Sybil G.

    2014-01-01

    Abstract This article describes the influence of a group-based behavioral intervention for adolescents and young adults newly diagnosed with HIV (Project ACCEPT) on four dimensions of HIV-related stigma—personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes about people with HIV—as measured by the Berger HIV Stigma Scale. Stigma was addressed in a holistic manner during the intervention by providing HIV/AIDS-related information, facilitating the acquisition of coping skills, and providing contact with other youth living with HIV in order to improve social support. Fifty youth (28 male, 22 female; mean age=19.24 years) newly diagnosed with HIV from four geographically diverse clinics participated in a one-group pretest-posttest design study whereby they received the intervention over a 12-week period, and completed assessments at baseline, post-intervention, and 3-month follow-up. Results from the combined sample (males and females) revealed overall reductions in stigma in three dimensions: personalized stigma, disclosure concerns, and negative self-image, although only the combined-sample effects for negative self-image were maintained at 3-month follow-up. Gender-specific analyses revealed that the intervention reduced stigma for males across all four dimensions of stigma, with all effects being maintained to some degree at the 3-month follow-up. Only personalized stigma demonstrated a decrease for females, although this effect was not maintained at the 3-month follow-up; while the other three types of stigma increased at post-intervention and 3-month follow-up. Findings are discussed in terms of gender specific outcomes and the need for a different type of intervention to reduce stigma for young women. PMID:25216106

  3. Evaluation of an Abstinence Based Intervention for Middle School Students

    ERIC Educational Resources Information Center

    Rue, Lisa; Chandran, Raj; Pannu, Aman; Bruce, David; Singh, Rana; Traxler, Karen

    2012-01-01

    Outcomes associated with an abstinence education intervention were evaluated using a single group design with a 12-month longitudinal follow-up. The intervention group of adolescents ages 12-14 years (N = 427) were enrolled in an 11.5-hour abstinence education intervention offered during the school day. Significant differences were found in the…

  4. Risk and protective factors for HIV/AIDS in Native Americans: implications for preventive intervention.

    PubMed

    Dennis, Mary Kate

    2009-04-01

    HIV/AIDS has steadily increased in Native American and Alaska Native populations, and despite efforts at control many challenges remain. This article examines historical, biological, social, and behavioral cofactors related to the spread of HIV/AIDS within the context of Native American culture. Special attention is given to vulnerable subgroups and to the need for culturally appropriate efforts at prevention and intervention that respect the unique needs of each group. PMID:19366163

  5. The Development and Feasibility of a Brief Risk Reduction Intervention for Newly HIV-Diagnosed Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Sikkema, Kathleen J.; Hansen, Nathan B.; Kochman, Arlene; Santos, Jonathan; Watt, Melissa H.; Wilson, Patrick A.; DeLorenzo, Allyson; Laudato, Jay; Mayer, Gal

    2011-01-01

    Men who have sex with men (MSM) represent more than half of all new HIV infections in the United States. Utilizing a collaborative, community-based approach, a brief risk reduction intervention was developed and pilot tested among newly HIV-diagnosed MSM receiving HIV care in a primary care setting. Sixty-five men, within 3 months of diagnosis,…

  6. The Effect of HIV/AIDS Prevention Intervention for Israeli Adolescents in Residential Centers: Results at 12-Month Follow-Up.

    ERIC Educational Resources Information Center

    Slonim-Nevo, Vered

    2001-01-01

    Assessed effect of cognitive-behavioral program to prevent HIV/AIDS among 139 adolescents. Self-report instruments were used to assess participants' knowledge and behavior about HIV/AIDS. Intervention was found to have significant effect on knowledge about HIV/AIDS, attitudes toward prevention, and coping with high-risk situations. Changes were…

  7. A Multimodal Behavioral Intervention to Impact Adherence and Risk Behavior among Perinatally and Behaviorally HIV-Infected Youth: Description, Delivery, and Receptivity of Adolescent Impact

    ERIC Educational Resources Information Center

    Chandwani, Sulachni; Abramowitz, Susan; Koenig, Linda J.; Barnes, William; D'Angelo, Lawrence

    2011-01-01

    Secondary prevention programs are needed to help HIV-positive youth reduce risk behavior and improve adherence to HIV medications. This article provides an overview of Adolescent Impact, a secondary HIV prevention intervention, including its description, delivery, and receptivity among the two unique groups of participants. Adolescent Impact, a…

  8. 'Whose failure counts?' A critical reflection on definitions of failure for community health volunteers providing HIV self-testing in a community-based HIV/TB intervention study in urban Malawi.

    PubMed

    Sambakunsi, Rodrick; Kumwenda, Moses; Choko, Augustine; Corbett, Elizabeth L; Desmond, Nicola Ann

    2015-12-01

    The category of community health worker applied within the context of health intervention trials has been promoted as a cost-effective approach to meeting study objectives across large populations, relying on the promotion of the concept of 'community belonging' to encourage altruistic volunteerism from community members to promote health. This community-based category of individuals is recruited to facilitate externally driven priorities defined by large research teams, outside of the target research environment. An externally defined intervention is then 'brought to' the community through locally recruited community volunteers who form a bridge between the researchers and participants. The specific role of these workers is context-driven and responsive to the needs of the intervention. This paper is based on the findings from an annual evaluation of community health worker performance employed as community counsellors to deliver semi-supervised HIV self-testing (HIVST) at community level of a large HIV/TB intervention trial conducted in urban Blantyre, Malawi. A performance evaluation was conducted to appraise individual service delivery and assess achievements in meeting pre-defined targets for uptake of HIVST with the aim of improving overall uptake of HIVST. Through an empirical 'evaluation of the evaluation' this paper critically reflects on the position of the community volunteer through the analytical lens of 'failure', exploring the tensions in communication and interpretation of intervention delivery between researchers and community volunteers and the differing perspectives on defining failure. It is concluded that community interventions should be developed in collaboration with the population and that information guiding success should be clearly defined. PMID:26762610

  9. Evaluation of a HIV Voluntary Opt-Out Screening Program in a Singapore Hospital

    PubMed Central

    Tan, Xin Quan; Goh, Wei-Ping; Venkatachalam, Indumathi; Goh, Diana; Sridhar, Revathi; Chan, Hwang Ching; Archuleta, Sophia

    2015-01-01

    Background Early diagnosis of human immunodeficiency virus (HIV) allows for appropriately timed interventions with improved outcomes, but HIV screening among asymptomatic persons and the general population in Singapore remains low. In 2008, Singapore’s Ministry of Health implemented HIV voluntary opt-out screening (VOS) for hospitalised adults. We evaluated the outcome of VOS and surveyed reasons for its low uptake in our institution. Methods We assessed the outcomes of the VOS programme from January 2010 to December 2013 at National University Hospital, a 1081-bed tertiary hospital in Singapore. We also examined reasons for opting-in and opting-out using an interviewer–administered structured questionnaire in a representative sample in January 2013. Results 107,523 patients fulfilled VOS criteria and were offered HIV screening, of which 5215 (4.9%) agreed to testing. 4850 (93.1%) of those who opted-in had an HIV test done. Three (0.06%) tested positive for HIV. 238 patients (14.2%) were surveyed regarding reasons for opting-in or out of VOS. 21 (8.8%) had opted-in. Patients who opted-in were likely to be younger, more educated and reported having more regular sexual partners. Type of housing, number of casual sexual partners, sexual orientation, intravenous drug use, condom use and previous sexually transmitted infection were not associated with deciding to opt-in/out. Patients’ most common reasons for opting-out were: belief that they were at low risk (50.2%), belief that they were too old (26.8%), cost (6.9%) and aversion to venepuncture (6.5%). The most common reason for opting-in was desire to know their HIV status (47.6%). Conclusion The success of an HIV-VOS program is largely determined by test uptake. Our study showed that the majority of eligible VOS patients opted-out of HIV screening. Given the considerable cost and low yield of this programme, more needs to be done to better equip patients in self-risk assessment and opting in to testing. PMID

  10. Testing experiences of HIV positive refugees in Nakivale Refugee Settlement in Uganda: informing interventions to encourage priority shifting

    PubMed Central

    2013-01-01

    Background Recent initiatives by international health and humanitarian aid organizations have focused increased attention on making HIV testing services more widely available to vulnerable populations. To realize potential health benefits from new services, they must be utilized. This research addresses the question of how utilization of testing services might be encouraged and increased for refugees displaced by conflict, to make better use of existing resources. Methods Open-ended interviews were conducted with HIV-infected refugees (N=73) who had tested for HIV and with HIV clinic staff (N=4) in Nakivale Refugee Settlement in southwest Uganda. Interviews focused on accessibility of HIV/AIDS-related testing and care and perspectives on how to improve utilization of testing services. Data collection took place at the Nakivale HIV/AIDS Clinic from March to July of 2011. An inductive approach to data analysis was used to identify factors related to utilization. Results In general, interviewees report focusing daily effort on tasks aimed at meeting survival needs. HIV testing is not prioritized over these responsibilities. Under some circumstances, however, HIV testing occurs. This happens when: (a) circumstances realign to trigger a temporary shift in priorities away from daily survival-related tasks; (b) survival needs are temporarily met; and/or (c) conditions shift to alleviate barriers to HIV testing. Conclusion HIV testing services provided for refugees must be not just available, but also utilized. Understanding what makes HIV testing possible for refugees who have tested can inform interventions to increase testing in this population. Intervening by encouraging priority shifts toward HIV testing, by helping ensure survival needs are met, and by eliminating barriers to testing, may result in refugees making better use of existing testing services. PMID:23409807

  11. Impact of an intervention on HIV, sexually transmitted diseases, and condom use among sex workers in Bombay, India.

    PubMed

    Bhave, G; Lindan, C P; Hudes, E S; Desai, S; Wagle, U; Tripathi, S P; Mandel, J S

    1995-07-01

    The objective was to develop and test an HIV intervention targeting sex workers and madams in the brothels of Bombay. In a controlled intervention trial, with measurements before and after the intervention, 334 sex workers and 20 madams were recruited from an intervention site, and 207 and 17, respectively, from a similar control site, both in red-light areas of Bombay. All sex workers were tested for antibodies to HIV and syphilis, and for hepatitis B surface antigen. Information on sexual practices, condom use, and knowledge of HIV was collected by questionnaires. All subjects in the intervention group underwent a 6-month program of educational videos, small group discussions and pictorial educational materials; free condoms were also distributed. The blood tests and the questionnaire were readministered to all subjects at both sites immediately after the intervention. Both groups were followed for approximately 1 year. The baseline prevalence of HIV antibodies was 47% in the intervention group and 41% in the control group (p = 0.17). The incidence densities for HIV and sexually transmitted diseases were significantly different in the 2 groups (all p 0.005): 0.05 and 0.16 per person-year of follow-up for HIV, 0.08 and 0.22 per person-year for antibodies to syphilis, and 0.04 and 0.12 per person-year for hepatitis B surface antigen in the intervention and control women, respectively. Following the intervention, there was a significant increase in knowledge of modes of HIV transmission in the intervention group (n = 334) compared to the control group (n = 190) (60% vs. 99% compared to 56% vs. 26%, p 0.001). In addition, women reported increased levels of condom use and some (41%) said they were willing to refuse clients who would not use them. However, both the sex workers and 100% of the madams were concerned about losing business if condom use was insisted upon. Intervention programs of longer duration that target madams and clients and make condoms easily

  12. Virtual Nursing Intervention Adjunctive to Conventional Care: The Experience of Persons Living With HIV

    PubMed Central

    Rouleau, Geneviève; Ramirez-Garcia, Pilar; Bourbonnais, Anne

    2015-01-01

    Background Persons living with HIV (PLHIV) must adhere optimally to antiretroviral therapy (ART) on a daily basis and for their lifetime to maintain an undetectable viral load, allowing them to preserve their health. Taking advantage of the opportunity that information and communication technologies provide to broaden intervention modalities and intensify clinical follow-up, a virtual nursing intervention consisting of four interactive computer sessions was developed to empower PLHIV to manage their ART and symptoms optimally. Compared with other types of information and communication technologies-assisted interventions such as text messages, HIV Treatment, Virtual Nursing Assistance and Education (VIH-TAVIE) requires a certain degree of active engagement on the part of the user to develop and strengthen the self-management skills to optimize adherence. After the intervention’s impact on ART adherence was measured quantitatively, a qualitative study was undertaken to describe how users experience the intervention. Understanding how PLHIV perceive being assisted asynchronously by a virtual nurse was of particular interest. Objective The objective of the study was to explore and describe how PLHIV experience VIH-TAVIE, that is, receiving customized asynchronous accompaniment via a virtual nurse. Methods A qualitative study was conducted with 26 PLHIV (20 men, 6 women) who received all four VIH-TAVIE sessions. Participants had been diagnosed with HIV 14 years earlier on average and had been on ART for a mean period of 10 years. The sessions lasted 20-30 minutes each and were received two weeks apart. They are hosted by a virtual nurse who engages the user in a self-management skills-learning process for the purpose of treatment adherence. Semistructured interviews were conducted lasting 30-40 minutes to get participants to share their experience of the intervention through personal stories and what they thought and felt during their participation. Data were analyzed

  13. Systematic validation of disease models for pharmacoeconomic evaluations. Swiss HIV Cohort Study.

    PubMed

    Sendi, P P; Craig, B A; Pfluger, D; Gafni, A; Bucher, H C

    1999-08-01

    Pharmacoeconomic evaluations are often based on computer models which simulate the course of disease with and without medical interventions. The purpose of this study is to propose and illustrate a rigorous approach for validating such disease models. For illustrative purposes, we applied this approach to a computer-based model we developed to mimic the history of HIV-infected subjects at the greatest risk for Mycobacterium avium complex (MAC) infection in Switzerland. The drugs included as a prophylactic intervention against MAC infection were azithromycin and clarithromycin. We used a homogenous Markov chain to describe the progression of an HIV-infected patient through six MAC-free states, one MAC state, and death. Probability estimates were extracted from the Swiss HIV Cohort Study database (1993-95) and randomized controlled trials. The model was validated testing for (1) technical validity (2) predictive validity (3) face validity and (4) modelling process validity. Sensitivity analysis and independent model implementation in DATA (PPS) and self-written Fortran 90 code (BAC) assured technical validity. Agreement between modelled and observed MAC incidence confirmed predictive validity. Modelled MAC prophylaxis at different starting conditions affirmed face validity. Published articles by other authors supported modelling process validity. The proposed validation procedure is a useful approach to improve the validity of the model. PMID:10461580

  14. HIV prevention outreach in commercial gay venues in large cities: evaluation findings from London.

    PubMed

    Bonell, Chris; Strange, V; Allen, E; Barnett-Page, E

    2006-08-01

    Human immunodeficiency virus (HIV) prevention delivered in gay venues in US cities has been found to be effective in reducing HIV transmission in the 1990s but effects might not be generalizable to different times and settings. Doubts have been raised about: outreach's ability to address skills and explore personal behaviour; big-city commercial gay venues being appropriate sites for outreach because of gossip and social surveillance; and acceptability of outreach by professionals rather than 'popular opinion formers'. We evaluated coverage, feasibility, acceptability and perceived impact of venue-based HIV prevention outreach by professionals in London, employing observation, surveys and interviews with venue-users, and focus groups/semi-structured interviews with workers. We found high coverage especially among target groups. Addressing negotiation skills and personal behaviour was feasible but required worker motivation and skill. Social surveillance rarely impeded work. Gay men generally found outreach acceptable and useful, and professionals were not regarded negatively. Impact on knowledge was commonly reported; impacts on negotiation skills and reflection on personal behaviour were more common among men experiencing longer contacts. In conclusion, professional HIV prevention outreach in gay venues in large cities is a feasible and acceptable intervention with significant potential impacts. Workers need to be well briefed and trained to maximize impact. PMID:16306218

  15. Promoting HIV Testing and Condom Use Among Filipina Commercial Sex Workers: Findings from a Quasi-Experimental Intervention Study

    PubMed Central

    Morisky, Donald E.; Ksobiech, Kate; Malow, Robert M.

    2011-01-01

    This study examines the effects of a multi-level social action-based theory (SABT) intervention to increase HIV testing and consistent condom use among female commercial sex workers (FCSWs). Respondents in four socio-demographically similar Philippine cities received an SABT intervention based on: (1) peer influence; (2) manager training; (3) combined peer/manager influence; or (4) usual care (control condition). HIV testing increased 86% from baseline (N = 980) to follow-up (N = 903), and was significantly associated with higher HIV/AIDS knowledge, lower probability of contracting HIV and increased condom use. After adjusting for socio-demographic, HIV knowledge and perceived control variables, FCSWs in the manager training and combined peer/manager conditions were significantly more likely to engage in consistent condom use. Mediational analyses revealed higher HIV/ AIDS risk perceptions and a supportive work environment related to increased condom use. These findings support a growing body of research suggesting the need for multilevel sexual risk reduction interventions among FCSWs. PMID:18543095

  16. Outcomes of a Behavioral Intervention to Increase Condom Use and Reduce HIV Risk Among Urban African American Young Adults.

    PubMed

    Henry Akintobi, Tabia; Trotter, Jennie; Zellner, Tiffany; Lenoir, Shelia; Evans, Donoria; Rollins, Latrice; Miller, Assia

    2016-09-01

    African Americans comprise nearly half of people in the United States living with the human immunodeficiency virus (HIV) but compose one tenth of the population. Infection rate among young African American adults is 11 times that of Whites. The Color It Real Program was a seven-session, weekly administered, age-specific, and culturally tailored intervention designed to provide HIV education and address behavioral motivations (risk awareness, decisional balance exercises, partner negotiation, and attitudes) associated with HIV risk among African Americans ages 18 to 24 years in Atlanta, Georgia. Effectiveness was assessed through a quasi-experimental study design that consisted of intervention (n = 88) and control (n = 52) groups completing a 45-item survey. When controlling for gender and education, repeated measures analysis of variance revealed that the intervention group had significant increases in HIV transmission knowledge (F = 4.84, p = .0305), condom use, and intentions to use condoms (F = 4.38, p = .0385). Risky sexual behavior means did not significantly differ between groups (F = 1.44, p = .2331). Results indicate the value of culturally tailored educational strategies toward improved HIV knowledge and adoption of risk reduction strategies. Future studies investigating the differential impact of programs by gender and sexual orientation are also critical. Continued innovation and tailoring of risk reduction strategies for minority young adults will contribute to reducing HIV incidence and prevalence over the life course. PMID:27216874

  17. A Pilot Study of a Group-Based HIV and STI Prevention Intervention for Lesbian, Bisexual, Queer, and Other Women Who Have Sex with Women in Canada.

    PubMed

    Logie, Carmen H; Lacombe-Duncan, Ashley; Weaver, James; Navia, Daniela; Este, David

    2015-06-01

    Limited research has evaluated interventions to reduce HIV and sexually transmitted infection (STI) vulnerability among lesbian, bisexual, and queer (LBQ) women, and other women who have sex with women. The Queer Women Conversations (QWC) study examined the effectiveness of a group-based psycho-educational HIV/STI intervention with LBQ women in Toronto and Calgary, Canada. We conducted a nonrandomized cohort pilot study. Participants completed a pre-test, post-test, and 6-week follow-up. The primary outcome was sexual risk practices, while secondary objectives included intrapersonal (self-esteem, STI knowledge, resilient coping, depression), interpersonal (safer sex self-efficacy), community (community connectedness, social support), and structural (sexual stigma, access to healthcare) factors. The study was registered at http://clinicaltrials.gov. Forty-four women (mean age 28.7 years) participated in a weekend retreat consisting of six consecutive sessions tailored for LBQ women. Sessions covered a range of topics addressing behavioral and social-structural determinants of HIV/STI risk, including STI information, safer sex negotiation skills, and addressing sexual stigma. Adjusted for socio-demographic characteristics, sexual risk practices (β2=-2.96, 95% CI -4.43, -1.50), barrier use self-efficacy (β2=1.52, 95% CI 0.51, 2.53), STI knowledge (β2=4.41, 95% CI 3.52, 5.30), and sexual stigma (β2=-2.62, 95% CI -3.48, -1.75) scores showed statistically significant changes 6 weeks post-intervention. Initial increases in safer sex self-efficacy, social support, and community connectedness were not sustained at 6-week follow up, highlighting the need for booster sessions or alternative approaches to address social factors. Study results may inform HIV/STI prevention interventions, sexual health care provision, and support services tailored for LBQ women. PMID:25867642

  18. Participant and Staff Experiences in a Peer-Delivered HIV Intervention with Injection Drug Users

    PubMed Central

    Kostick, Kristin M.; Weeks, Margaret; Mosher, Heather

    2015-01-01

    We explore ethical issues faced by investigators as they conduct research as part of a peer-delivered HIV/AIDS risk reduction program for injection drug users (IDUs). Staff and participant experiences in peer-delivered interventions among IDUs have come under scrutiny by ethics researchers because of their potential to inadverte