Information-Motivation-Behavioral Skills HIV Prevention Program (IMB)

Investigators: Jeffrey Fisher, William A. Fisher, Stephen J. Misovich, & Angela D. Bryan

The goal of the Information-Motivation-Behavioral Skills HIV Prevention Program (IMB Program) is to reduce high school students' risk of HIV infection. Program objectives include positively influencing students' HIV prevention knowledge, attitudes and norms, increasing students' levels of HIV prevention behavioral skills, and increasing students' levels of HIV preventive behavior. The intervention involves a four-session classroom component to be conducted by trained high school teachers. The IMB Program is based on the Information, Motivation and Behavioral Skills (IMB) model of health behavior change, which assumes that information, motivation and behavioral skills are the fundamental determinants of HIV preventive behavior. An evaluation of the curriculum offered in three intervention formats (classroom-based only, peer-based only, and combination classroom and peer-based delivery) was conducted by the Center for Health/HIV Intervention and Prevention in 1999. Participants were 1,577 students in four inner-city high schools in Connecticut (61% African-American, 28% Hispanic-American, 11% Caucasian, mixed or "other.") The classroom-based HIV prevention education component effectively promoted risk reduction behavior change in these urban high school settings at one year post-intervention. Click here to view more detailed information on this program.

Intervention with Microfinance for AIDS and Gender Equity (IMAGE)

Investigators: Tanya Abramsky, Joanna Busza, John Gear, James Hargreaves, Julia Kim, Mzamani Benjamin Makhubele, Kalipe Mashaba, Linda Morison, Matshilo Motsei, Luceth Ndhlovu, Chris Peters, Godfrey Phetla, John Porter, Paul Pronyk, & Charlotte Watts

IMAGE is comprised of a gender and HIV training curriculum called Sisters-for-Life. A microfinance program augments the curriculum. For the microfinance component, groups of five women receive loans to establish small businesses. Further credit is offered when all women in these solidarity groups repay their loans. Loan centers of approximately 40 women meet fortnightly. Sisters-for-Life consists of two phases. Phase I is a structured series of 10 one-hour participatory training sessions that are integrated into the Loan Center meetings. Phase II moves the participants toward collective action. Natural Leaders are elected by their peers to participate in a one-week training workshop on leadership and community mobilization. Taking these skills back to their respective loan centers, these Leaders are responsible for developing an Action Plan, with the aim of implementing what they regard as appropriate responses to priority issues. Click here to view more detailed information on this program.

Keepin' It R.E.A.L.! A Mother-Adolescent HIV Prevention Program

Investigators: Colleen DiIorio, Frances McCarty, Dongqing Terry Wang, Pamela Denzmore, Ken Resnicow, Anindya K. De, William N. Dudley, PhD

The KEEPIN. IT R.E.A.L.! (Responsible, Empowered, Aware, Living) evaluation tested the effectiveness of two HIV prevention interventions designed for mothers and their adolescents, as compared to a control group. Sites were randomly assigned to one of three conditions: the Social-Cognitive program (SCT--four sites, the focus of this replication kit); another program not included in this kit; or the control condition (four sites). The SCT program was designed to delay initiation of sexual intercourse for those adolescents who were not yet sexually active, and to increase condom use among sexually active participants. SCT involved seven 2-hour meetings conducted over 14 weeks. Participating adolescents (N = 582) were between the ages of 11 and 14 years, mostly male (60%), and African American (97.7%). The number of participating mothers was 470; 110 mothers had more than one adolescent in the study. Assessments were conducted at baseline, and at 4, 12 and 24 months after baseline. At the 24-month assessment, a higher percent of sexually active participants in the SCT groups reported condom use at last sex compared to their control group peers (96% and 85%, respectively), condom use intentions (100% and 94%, respectively), and cessation of sexual activity until they were older (43% and 24%, respectively). For the mothers, their levels of self-efficacy and comfort for talking with their adolescents about sex increased over time. Both mothers and adolescents demonstrated an increase in HIV knowledge. Click here to view more detailed information on this program.

Let's Chat

Investigators: Seth C. Kalichman

Let’s Chat is a four-session intervention designed for use with same-sex groups of adults with chronic mental illness. Based on the Information-Motivation-Behavioral (IMB) Skills Model, Let’s Chat addresses risk-reduction needs specific to persons with mental illness. In each of the 90-minute sessions, a team of two facilitators conveys important AIDS-prevention information, alternating lectures and video clips with role-play and group-participation activities. Participants discuss sexual pressure and coercion, practice negotiating condom use, and learn the proper method for using both male and female condoms. All four sessions place emphasis on clear, simple messages and useful skills practice. Click here to view more detailed information on this program.

Mujer Segura, Healthy Woman

Investigators: Thomas Patterson, Brent Mausbach, Remedios Lozada, Hugo Staines-Orozco, Shirley Semple, Miguel Fraga-Vallejo, Prisci Orozovich, Daniela Abramovitz, Adela de la Torre, Hortensia Amaro, Gustavo Martinez, Carlos Magis-Rodriguez, & Steffanie Strathdee

The Mujer Segura Program aims to increase female sex workers' use of condoms during all sex exchanges. The program demonstrated increases in the total number of protected sex acts and decreases in overall sexually transmitted infection (including HIV) incidence. The program is composed of one session, lasting approximately 35 minutes. During this session, the counselor meets one-on-one with the individual participant and through the use of Motivational Interviewing techniques, assesses sexual risk behaviors; increases awareness of challenges related to condom use; and helps the participant develop solutions to increase safer sex practices. The counselor distributes free condoms and lubricant to all participants. Supervisors meet weekly with the program counselors to discuss program implementation and address any issues that may The Mujer Segura Program was originally implemented in two Mexican border cities of the United States with female sex workers. Although this program was specifically designed to increase condom use during sex exchanges, it may be suitable for use with other at-risk groups who engage in risky sexual behaviors. Click here to view more detailed information on this program.

Multimedia WiLLOW: HIV Transmission Reduction Among African American Women Living with HIV

Investigators: Josefina J. Card, Amie Ashcraft, John Wundes, Nikia Braxton, Gina Wingood, & Ralph DiClemente

Multimedia WILLOW in an interactive computer-based intervention designed for African American women living with HIV that is gender relevant and culturally sensitive, based on the effective group intervention WiLLOW. The intervention incorporates elements of sexual risk reduction to reduce STI/HIV sexual transmission and to enhance psychosocial mediators and structural factors associated with preventive behaviors. Designed for implementation in clinical or community-based settings, the two-session interactive, intervention emphasizes ethnic and gender pride, elements of sexual risk reduction, sexual negotiation skills, proper condom use, and development of partner norms supportive of consistent condom use. Each session offers multimedia learning, games and quizzes to help viewers increase and reinforce their risk-reduction awareness, knowledge, and skills. Women interact with the computer-based intervention individually and at their own speed. Only minimal staff participation is needed to implement Multimedia WiLLOW. A recent study demonstrated the efficacy of Multimedia WiLLOW. The evaluation study (N=168) used a randomized controlled design to examine Multimedia WILLOW.s efficacy by assessing participants. Multimedia WILLOW participants, compared to the control condition, had a significantly higher percentage of condom protected sex acts in the past 30 days (90% vs. 80%, p=.001). This greater condom use occurred with both HIV-negative (90% vs. 80%, p=.037) and HIV-positive (100% v. 70%, P=.011) partners. Women receiving Multimedia WILLOW were also more likely to report 100% condom use (OR = .10; p=.003) and had a lower adjusted mean number of unprotected vaginal and anal sex acts in the past 30 days (.31 vs. 2.33, P=.002). In comparison to women in the control condition, Multimedia WILLOW participants reported significantly higher levels of communication with their partners on HIV risk reduction practices (11.5 vs. 10.8, p=.052); greater sexual communication self-efficacy (36.1 vs. 34.0, p=.003); and less self-reported stress (32.3 vs. 34.3, p=.003). Participants rated the computer-delivered intervention more favorably than the standard of care condition in the four principal satisfaction categories -- enjoyment (4.69 v. 4.26, p

Nia: A Group-Level Intervention with African American Men Who Have Sex with Women

Investigators: Seth Kalichman, University of Texas Southwestern Medical Center, Southeast HIV/AIDS Research and AIDS Survival Project, & the Centers for Disease Control and Prevention (CDC)

Nia is a group-level, video-based intervention with African American men 18 years and older, with at least six hours of content. While the original researcher split the content into two, three-hour sessions, the intervention can also be conducted as three or four sessions. The goal of the Nia intervention is to reduce sexual risk behavior among African American men who have sex with women. The sessions create a context through which men can do the following: Learn new information and affirm existing correct knowledge about HIV/AIDS, Examine their own sexual risks, Build motivation and skills to reduce their risks, and Receive feedback from others. Nia sessions are interactive meetings that have both an educational and an entertaining aspect. In addition, Nia uses factors, such as male pride, racial and sexual identity, receiving and giving respect, and maintaining sexual pleasure while reducing risk, to reinforce procedures for risk reduction. A male facilitator helps create an environment where the men are comfortable learning, while a female facilitator is present to assist with practice of making and communicating safer sex decisions and to help challenge and change negative attitudes towards women. Nia groups can be held in a variety of settings, as long as they are conducted in a private room where the men will feel comfortable enough to participate.

Optimizing Partner Notification (OPeN)

Investigators: Tracey E. Wilson PhD, Matthew Hogben, PhD, Nicole Liddon, PhD, William M. McCormack, MD, Steve R. Rubin, & Michael A. Augenbraun, MD

OPEN, a clinic-based patient-centered program, promotes sexually transmitted infection (STI) partner notification in urban, minority populations with high rates of infection. A trained health educator delivers OPEN in 2 one-on-one counseling sessions. The first session (which lasts approximately 30 minutes) is delivered after the initial STI diagnosis, and the second session (which lasts about 10 minutes) is optional, and occurs roughly four weeks later, either in person or by phone. During the first session, the health educator engages in a discussion with the participant about the participant's risky sexual behaviors, and helps the participant to identify potential sexual partners needing notification of the STI. Then the participant and health educator develop a notification plan, and work on skills to improve sexual partner notification through role playing. At the end of the session the participant completes and signs a notification contract. During the second session, the health educator reviews with the participant any progress made on notification, and together they discuss any barriers encountered in notifying partners. Click here to view more detailed information on this program.

Play and Learning Strategies (PALS) I & II: A Responsive Parenting Program for Parents of Infants and Toddlers

Investigators: Susan H. Landry, PhD & Karen E. Smith, PhD

The Play and Learning Strategies (PALS) program is a home visiting intervention for parents of infants and toddlers that target aspects of a responsive parenting style shown to enhance children's cognitive and social development. The goal of the PALS program is to teach parents responsive parenting skills to support their child's social-emotional, cognitive, and language development. The parent learns specific behaviors that help her tune into her child, respond in a sensitive and contingent manner, provide appropriate cognitive and language stimulation, and manage behavior and discipline in a positive, developmentally appropriate manner. The PALS program consists of two separate curricula: the PALS I Infant curriculum and the PALS II Toddler curriculum. Family coaches deliver the intervention by visiting families on a weekly basis over the course of three months. Each session includes a discussion of the parent's practice during the preceding week; introduction of the new topic; viewing of educational videos demonstrating the skill; guided, videotaped practice using the skill with her own child; review of the videotaped practice; and planning for practice during the upcoming week. Click here to view more detailed information on this program.

Poder Latino: A Community AIDS Prevention Program for Inner-City Latino Youth

Investigators: Hispanic Office of Planning & Evaluation and New England Research Institutes

This multifaceted community-based intervention targets Latino youth, ages 14 to 20, at elevated risk for HIV/AIDS. One goal of the program is to increase awareness of the disease by saturating target neighborhoods with public service announcements broadcasting risk reduction messages. In addition, the program aims to reduce infection by encouraging sexually active teens to use condoms. Project messages are reinforced through ongoing activities conducted by specially-trained peer leaders, including workshops in schools, community organizations, and health centers, group discussions in teens' homes, presentations at large community centers, and door-to-door canvassing. At all activities, condoms are available, along with pamphlets explaining their correct use. In a field study of the intervention in Boston, MA, researchers compared the sexual behavior of teens in the target community and a similar, control community. At the 18-month follow-up assessment, the intervention appeared to reduce the incidence of multiple sexual partners among females and delay the onset of sexual activity among males. Click here to view more detailed information on this program.