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These findings, in combination with findings supporting the efficacy and cost-effectiveness of HIV VCT, support the dissemination of HIV VCT with appropriate support services in developing countries.

Objectives-Evaluate the efficacy of skills training designed to increase female condom use among women.Methods-A randomized trial of 409 women, recruited from family planning clinics in northern California, randomly assigned to the experimental 4-session female condom skills training intervention or the comparison 4-session women's general health promotion intervention. Participants received condom use instructions at baseline and male and female condoms during the study. They completed audio computer-assisted self-interviews at baseline, 3, and 6 months.Results-At 3 and 6 months, women in the experimental group were more likely than those in the comparison group to have used the female condom at least once in the prior 3 months. The increase in the percentage of sex acts protected by female condoms from baseline to the 6-month follow-up was greater for the experimental group. The percentage of sex acts protected by any condom was higher in the experimental group at 6 months. There were no group differences in male condom use.Conclusions-Outcomes suggest that skills training can increase female condom use and protected sex acts without reducing male condom use among women.

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The prevalence of AIDS is five times higher among prison inmates than in the general population. Because recidivism is common and many inmates are serving short sentences for parole violation, HIV-seropositive inmates move frequently between prison and their home communities. We designed an eight-session prerelease intervention for HIV seropositive inmates to decrease sexual and drug-related risk behavior and to increase use of community resources after release. The intervention sessions were delivered at the prison by community service providers. We found that a prerelease risk reduction intervention for HIV seropositive inmates was feasible. Descriptive results support the effectiveness of the program in reducing sexual and drug-related behaviors and in increasing use of community resources after release. Compared with men who signed up for the intervention but were unable to attend, men who received the intervention reported more use of community resources and less sexual and drug-related risk behavior in the months following release. We recommend dissemination and continued evaluation of this risk-reduction intervention.

In an effort to deepen our understanding of how circumstances of forced separation and the interdiction of physical contact affect women's sexual behavior, we investigated the development and maintenance of heterosexual couples' intimacy when the male partner is incarcerated. As HIV-prevention scientists who work with women visiting men at a California state prison, we recognize that correctional control extends to these women's bodies, both when they are within the facility's walls visiting their mates and when they are at home striving to remain connected to absent men. This paper analyzes the impact of a peculiar public "place", a penitentiary, on couples' romantic and sexual interactions, drawing out the implications of imprisonment for relationship decision making, sexual health, and HIV risk. Using qualitative interviews with 20 women who visit their incarcerated partners and 13 correctional officers who interact with prison visitors, we examined how institutional constraints such as the regulation of women's apparel, the prohibition of physical contact, and the lack of forums for privacy result in couples forging alternative "spaces" in which their relationships occur. We describe how romantic scripts, the build-up of sexual tension during the incarceration period, and conditions of parole promote unprotected sexual intercourse and other HIV/STD risk behavior following release from prison.

Male prison inmates within 2 weeks of release were recruited to evaluate a prerelease HIV prevention intervention. A total of 414 inmates were randomly assigned to receive the intervention or to a comparison group. All participants completed a face-to-face survey at baseline; high rates of preincarceration at-risk behavior were reported. Follow-up telephone surveys were completed with 43% of participants; results support the effectiveness of the prerelease intervention. Men who received the intervention were significantly more likely to use a condom the first time they had sex after release from prison and also were less likely to have used drugs, injected drugs, or shared needles in the first 2 weeks after release from prison. Implications for the development, implementation, and evaluation of prison-based HIV prevention programs are discussed.