AIDS Risk Reduction for College Students

Investigators: Diane I. Kimble Willcutts, Jeffrey Fisher, William Fisher, & Stephen J. Misovich

Originally designed as a workshop for college students, this program consists of three two-hour sessions incorporating information, motivation, and behavioral strategies for AIDS risk reduction. The information component includes "AIDS 101," a slide show that explains the transmission and prevention of HIV, testing for the virus, and the importance of condoms for protection against HIV/AIDS among those who are sexually active. The motivation component is addressed through small-group discussions led by a peer health educator and a video narrated by persons who contracted HIV through unsafe heterosexual intercourse. Finally, behavioral skills development is encouraged through role plays of safe sex communication. In a field study of the program with 744 college students, participants showed significant gains in knowledge, motivation, and behavior; in particular, sexually active participants were more likely than similar control students to purchase and use condoms during a two- to four-month period following the intervention. Click here to view more detailed information on this program.

ASSESS for Adolescent Risk Reduction

Investigators: Bradley O. Boekeloo

The ASSESS program provides tools to enhance risk-reduction communication between health care providers and teens while in a physician's office or clinic setting. A randomized controlled behavioral intervention trial of the program was conducted in the metropolitan Washington, DC area between 1995 and 1997. The trial involved 19 physicians at five primary care pediatric practices, and 215 teens who were randomly assigned to intervention (n=205) or control group (n=114) conditions. Control group teens received their usual health care examination. Intervention group teens listened to an audiotape and answered 11 risk-related questions. The physician used answer sheets, pamphlets, an icebreaker activity and role-playing strategies to encourage risk behavior discussion and practice risk refusal strategies. Participants were interviewed post-checkup to determine how many sexual health topics they had discussed with their provider. Telephone follow-up interviews were conducted at three months and nine months. Study findings showed that more intervention teens reported discussing sexual topics with their physicians than did control group teens. At three-month follow-up, more sexually active intervention group teens reported condom use than control group teens. While more vaginal intercourse was also reported in the intervention group than the control group, this was not true of overall sexual intercourse. At nine months, there were no group differences in sexual behavior; however, more signs of STDs were reported by the control than the intervention group. Click here to view more detailed information on this program.

Adolescents Living Safely: AIDS Awareness, Attitudes and Actions

Investigators: Mary Jane Rotheram-Borus, Ph.D., Sutherland Miller, Ph.D., Cheryl Koopman, Ph.D., Clara Haignere, Ph.D. & Calvin Selfridge

To meet the comprehensive needs of runaway youths between 11 and 18 years of age, this program combines 20 small group discussion sessions with case management and private counseling. The group sessions provide general instruction about HIV/AIDS through video and art workshops in which youth create their own educational materials and review commercially available videos. Participants also receive behavioral and cognitive skills training for coping with high-risk situations. The case management and counseling components are designed to identify individual needs and provide youth with appropriate services (e.g., legal, medical, vocational). A field study of the program was conducted at two urban shelters serving predominantly African-American runaways. The sessions were held over a three week period, but youth joined the program at various points, and their levels of participation varied. For runaways who attended at least fifteen sessions, the high-risk pattern of sexual behavior dropped in frequency from 20% to zero over a six-month period. At the two-year follow-up assessment, program effects remained strongest for male and African-American participants. Click here to view more detailed information on this program.

Adolescents Living Safely: AIDS Awareness, Attitudes and Actions for Gay, Lesbian and Bisexual Teens

Investigators: Sutherland Miller, Joyce Hunter, M.S.W., & Mary Jane Rotheram-Borus, Ph.D.

Designed to provide education, social and medical services, and peer support to gay,lesbian and bisexual youths between 14 and 19 years of age, this program combines case management, comprehensive health care, and risk assessment counseling with small group discussion sessions. During the group sessions, transmission and prevention of HIV/AIDS are investigated through workshops in which youth create their own educational materials. Participants also receive behavioral and cognitive skills training for coping with high-risk situations. The case management and counseling components are designed to identify individual needs and provide youth with appropriate services (e.g., legal, medical, vocational). A field study of the intervention was initiated with 138 males at a community-based agency serving gay youth in New York City. The impact of the program was found to vary over time and across racial/ethnic groups. African-American and white teens showed a significant decrease in unprotected anal intercourse at the three-month follow-up assessment; at six months the decrease was recorded only among whites. On measures of unprotected oral intercourse, white and Hispanic youths engaged in fewer risk acts through the twelve-month assessment; for African-Americans, the decrease was maintained only until six months following the intervention. Click here to view more detailed information on this program.

Alcohol Skills Training Program

Investigators: Alan Marlatt, John S. Baer, Kim Fromme, Mary Larimer, Ellen Williams, & Daniel R. Kivlahan

Guided with the belief that college students can learn to moderate their drinking behavior, this intervention is designed for young people who have experienced negative consequences of alcohol use. The curriculum incorporates basic information and exercises in the areas of addiction, individual drinking cues, skills for resisting alcohol offers, and strategies for relaxation and stress management. Participants are asked to monitor and record their consumption of alcohol for the duration of the program. The program can be implemented with high school students as well. The intervention spans eight sessions. The ASTP program is suitable for university settings as well as social services or community-based organizations. This program was originally presented in eight 90-minute sessions. However, the schedule is flexible and can be adjusted to suit your particular site. Click here to view more detailed information on this program.

Brother to Brother

Investigators: John L. Peterson, Thomas J. Coates, Joseph Catania, Walter W. Hauck, Michael Acree, Dennis Daigle, Bobby Hillard, Lee Middleton, & Norman Hearst

Brother to Brother is a three-session behavioral intervention aimed at reducing HIV infection among African-American gay and bisexual men. Sessions are designed to foster positive identity development, educate participants about HIV/AIDS risk, teach assertiveness, and encourage the sharing of commitments and strategies for risk reduction among group members. Participants gain mastery through role-play, group discussion, and behavioral skills exercises. Click here to view more detailed information on this program.

Community-based Directly Observed Therapy (C-DOT) Program

Investigators: Maribel Muñoz, RN, Karen Finnegan, MPH, Jhon Zeladita, RN, Adolfo Caldas, MSW, Eduardo Sanchez, MD, Miriam Callacna, RN, Christian Rojas, MD, Jorge Arevalo, MD, Jose Luis Sebastian, MD, Cesar Bonilla, MD, Jaime Bayona, MPH, MD, & Sonya Shin, MPH, MD

The C-DOT Program aims to increase adherence of individuals living with HIV beginning highly active antiretroviral therapy (HAART). The program includes 4-day training for DOT workers. After training, DOT workers provide support to participants for a total of 11 months. For eight months DOT workers monitor all HAART doses (and doses of other medications for indications other than HIV) in participants' homes while providing social, emotional, and informational support to participants and their families and reporting missed doses, adverse events, and psychosocial crises to nurses. During the last three months DOT workers visit participants less frequently to prepare the participant for self-administration. Supervisors act as an intermediary between participants and the medical organization, coordinating other aspects of participants. medical care. Nurses supervise C-DOT Program staff and monitor follow-up care of participants. The C-DOT Program was shown to increase adherence, suppress viral load, and be associated with better tuberculosis outcomes. Additionally, the program has been shown to improve stigma, social support, self-efficacy, and health service acquisition. The C-DOT Program was originally implemented throughout the community as DOT workers conducted home visits to participants and monitored medication doses in homes or other community locations. This program may also be applicable to clinic settings and feasible to implement in clinics or hospitals serving individuals living with HIV. Click here to view more detailed information on this program.

Computer-Assisted Motivational Interviewing (CAMI): Preventing Repeat Births Among Adolescent Mothers

Investigators: Beth Barnet, Jiexin Liu, Margo DeVoe, Anne K. Duggan, Melanie A. Gold, & Edward Pecukonis

According to the Centers for Disease Control and Prevention, in 2010, more than 360,000 infants were born to women aged 15 to 19 years in the United States. Nearly one-quarter of adolescent mothers give birth to another child within two years, despite national efforts to increase timing between births. Adolescent mothers who give birth to more than one child may be at high risk for experiencing poorer medical, educational, economic, and developmental outcomes. The purpose of the Computer-Assisted Motivational Interviewing (CAMI) is to increase motivation among adolescent mothers to consistently use condoms and contraception with the long-term goal of reducing rapid repeat births. CAMI consists of at least two 60-minute sessions conducted in two-parts by trained counselors who meet one-on-one with pregnant and/or parenting adolescent mothers, ages 12 through 18 years old. During the first part of each session, participants use the computer-based CAMI Program to answer questions about current sexual relationships and contraceptive use intentions and behaviors. Based on the responses generated, CAMI counselors conduct a stage-matched motivational interviewing session to enhance participants' motivation to consistently use condoms and contraception in order to reduce the risk for a repeat pregnancy. An evaluation of CAMI has demonstrated that receiving two or more CAMI sessions, either alone or within a multi-component home-based intervention, reduced the risk of repeat births among adolescent mothers aged 18 years and younger. Click here to view more detailed information on this program.

CyberSenga

Investigators: Michelle Ybarra, Tonya Prescott, Josephine Korchmaros, Julius Kiwanuka, Sheana Bull, David Bangsberg, Norma Ware, & Ruth Birungi

CyberSenga is part of an effort to increase technology-based HIV prevention research in resource-limited settings such as Uganda. The purpose of CyberSenga is to prevent more people from getting HIV and to help those who have HIV live healthy lives by taking advantage of Internet technology to give young people both honest and truthful information, and the tools they need to make good decisions. CyberSenga consists of five one-hour modules conducted through the online CyberSenga software, along with a four-month post-intervention booster session. At the beginning of the program, participants answer two questions to sort them into four groups: abstinent boys, abstinent girls, sexually active boys, and sexually active girls. Based on their responses, participants are directed to intervention content tailored for saliency based upon their biological sex and sexual experience, although all versions include the same concepts. Content discusses relevant topics to provide youth with the information and skills they need to make healthy decisions in the future. An evaluation of CyberSenga has demonstrated that receiving the five CyberSenga sessions improves youths’ HIV preventive information as well as motivation to use condoms, and the booster session delivered four months after the initial intervention enhances the learning effect. Click here to view more detailed information on this program.

Doing Something Different: Group Counseling at STD Clinics to Promote Condom Use

Investigators: Deborah A. Cohen

Doing Something Different, a single-session, one-hour intervention, was designed for use in an inner-city public health clinic, but is appropriate for use in any community setting that provides education or services to at-risk populations. The intervention is led by a health educator, who presents a video on the social acceptability of condom use, demonstrates proper condom-use techniques, and directs a role-playing session in which participants practice negotiating condom use with sexual partners. Click here to view more detailed information on this program.