A Mixed Methods Evaluation of the Effect of the Protect and Respect Intervention on the Condom Use and Disclosure Practices of Women Living with HIV/AIDS

Abstract

This mixed methods study evaluated the efficacy of an intervention to increase HIV status disclosure and condom use among 184 women living with HIV/AIDS (WLH/A). Participants were recruited from an HIV clinic and randomly assigned to: (1) a comparison group, who received brief messages from their health care providers (HCPs), or; (2) an intervention group, who received messages from HCPs, a group-level intervention, and peer-led support groups. Participants completed risk surveys at baseline, 6-, 12-, and 18-months. Quantitative analyses using hierarchical generalized linear models within a repeated measures framework indicated that intervention participants had significantly higher odds of reporting condom use with sexual partners in months 6 and 18. Grounded Theory-based qualitative analyses suggested that the opportunity to discuss the social context of their lives in addition to HIV/AIDS, including continued stigma and fear related to disclosure, are also essential components of a prevention strategy for WLH/A.

Behavioral interventions to promote condom use among women living with HIV: a systematic review update

“…Even after contact with authors by e-mail, another 3 studies that met the inclusion criteria could not be included in the meta-analysis, since no further information was obtained about either the absolute number of women living with HIV engaged in safe sex or the mean and standard deviation of protected sexual acts 42,43,44 , besides another study due to lack of further information on analyses done on intervention effects by gender 45 . We identified only 1 non-randomized study 46 which provided complete data on female participants, which was not included in the meta-analysis to avoid potential confounding.…”

“…We decided to include the 5 interventions in the systematic review and describe the results reported narratively by the authors. All 5 studies were developed in the United States, and 3 involved interventions targeting women living with HIV 42,43,44 . Kalichman et al 45 conducted interventions for women and men living with HIV separately, and Fisher et al 46 included both female and male participants in the intervention or comparison groups.…”

“…Considering the 13 studies included in the systematic review, most involved group-level interventions 29,36,37,38,41,42,43,44,45 and were delivered in settings for HIV care 29,35,38,39,42,43,44,45,46 . One was home-based 40 and another 3 were developed in community settings 36,37,41 .…”

“…One was home-based 40 and another 3 were developed in community settings 36,37,41 . The intervention facilitators were only health workers in 6 interventions 36,38,39,40,43,46 , health workers plus peer leaders in 4 interventions 29,41,44,45 , and only peer leaders in 1 intervention 37 . One intervention was computerdelivered 35 and another failed to report this information 42 .…”

“…Principles of cognitive-behavioral theory guided almost all of the interventions, focusing on motivational interview, stress management and coping strategies, and psycho-educational techniques. One intervention 37 involved narrative strategies and social support, and 4 added components of gender and power theories 29,37,41,44 . Only 6 studies explicitly mentioned that gender issues were included in the interventions 29,37,38,41,43,44 .…”