An intervention for changing high-risk HIV behaviors of African American drug-dependent women

Abstract

The purpose of this study was to test the effectiveness of an AIDS education intervention for methadone-dependent, African American women. The women were randomly assigned to experimental (n=107) or control (n=97) group. The experimental group participated in a peer counseling and leadership training program conducted by two experienced nurse counselors over an 8-week period, followed by 8 weeks of reinforcement. The program was designed to reduce AIDS high-risk sexual behavior, increase self-esteem, decrease depressive affect, and increase the women's community-based AIDS prevention communication activities. A total of 130 women completed all phases of the study, including longitudinal Posttests at 2, 4, and 7 months after enrollment. Compared to the control group, there were statistically significant differences in three of the outcomes for the experimental group: The experimental group reported an increased number of safer sexual behaviors (p=.029), showed decreases in depression (p=.001), and reported engaging in more AIDS-related, community-based communication activities regarding prevention (p=.005).

A role for depression in sexual risk reduction for women? A meta-analysis of HIV prevention trials with depression outcomes

“…It is important to note that decreasing levels of depression was not a stated goal of these interventions, with only two exceptions (Harris et al, 1998; Jewkes et al, 2008). Because depression was a secondary outcome in nearly all of the included studies, it is remarkable to see a significant decrease in depression in both groups.…”

Cultural Leverage

“…In contrast, 3 studies recruited and trained lay peers of the target community as the primary intervention in bringing about individual behavior change. Among this group, Harris et al (1998) and Wyatt et al (2004) promoted safer sex behaviors through education, while Taylor et al (2002) worked to motivate Cambodian women to pursue cervical cancer screening. In comparison, Jenkins et al (1999), Lam et al (2003), and Nguyen et al (2000) crafted a program called Suc Khoe La Vang!…”

“…Of these 32 studies, 16 gathered outcome data from patient self-report (Anderson et al 2004;Braun et al 2005;Briscoe and Pichert 1999;Davies et al 2005;Fitzgibbon, Gapstur, and Knight 2004;Harris et al 1998;Jenkins et al 1999;Kim and Sarna 2004;Lam et al 2003;Lipkus, Lyna, and Rimer 1999;Mishra et al 1998;Nguyen et al 2000;Schneider et al 2001;Sterling et al 2001;Taylor et al 2002;Wyatt et al 2004). Of these 16 studies, 7 showed significant improvements in self-reported outcomes.…”

“…Of these 16 studies, 7 showed significant improvements in self-reported outcomes. Among the 7 studies showing significant improvements, 2 studies about sexual behavior (Harris et al 1998;Sterling et al 2001), 2 about mammography (Kim and Sarna 2004;Mishra et al 1998), 1 on diet (Fitzgibbon, Gapstur, and Knight 2004), and 1 on cervical cancer screening (Taylor et al 2002) showed improvements in processes of care. A smoking cessation program (Lipkus, Lyna, and Rimer 1999) increased "contemplation" but not cessation.…”

Planning strategies for the avoidance of pitfalls in intervention research

“…The way the study is presented may also influence continued participation. For example, based on their knowledge of high‐risk behaviours of female inmates, Harris et al (1998) emphasized the rewards of positive change over the prevention of negative consequences. The focus on positive change for those who had received so many negative messages from society enhanced participation.…”