Real Men Are Safe (REMAS)

Investigators: Donald A. Calsyn, PhD, Mary Hatch-Maillette, PhD, Susan Tross, PhD, Suzanne R. Doyle, PhD, Yong S. Song, PhD, Judy M. Harrer, PhD, Genise Lalos, MA, Sara B. Berns, PhD

REMAS is a group-level, clinic-based behavioral intervention designed to reduce HIV/STI risk among male substance abuse treatment center attendees. More specifically, the program aims to reduce the number of times that men engage in unprotected vaginal and anal sexual intercourse, or have sex while under the influence of drugs or alcohol. Two trained male health counselors teach participants information, help participants develop risk-reduction skills, and motivate behavior change through group discussion, role-play, and condom use skill training. REMAS is comprised of five 90-minute sessions where participants learn about HIV risky-behaviors, HIV prevention planning, and methods for communicating about safer sex and discussing sex without drugs. Click here to view more detailed information on this program.

Holistic Health Recovery Program for Injection Drug Users Living with HIV (HHRP+)

Investigators: S. Kelly Avants, PhD, Arthur Margolin, PhD, Lara A. Warburton, PhD, Keith A. Hawkins, PsyD, Julia Shi, MD

HOLISTIC HEALTH RECOVERY PROGRAM FOR INJECTION DRUG USERS LIVING WITH HIV is a 12-session, manual-guided, group therapy intervention delivered over six weeks. This risk reduction and health promotion intervention is appropriate for use with drug users in a substance abuse treatment program, and it was designed to specifically address the special needs of HIV-positive injection drug users (IDUs). HHRP+ is based on the Information-Motivation-Behavioral Skills (IMB) model of HIV prevention through behavioral change and uses cognitive remediation components to facilitate learning and retention of IMB treatment components. The primary goals of this intervention are harm reduction, health promotion, and improved quality of life. More specific objectives include abstinence from illicit drug use or from sexual risk behaviors, reduced risk for HIV transmission, reduced drug use, and improved medical, psychological, and social functioning. The HHRP+ program includes session topics such as: reaching your goals; health care participation; reducing the harm of injection drug use; harm reduction with latex; negotiating harm reduction with partners; preventing relapse to risky behavior; healthy lifestyle choices; introduction to the 12-steps; overcoming stigma; motivation for change; moving beyond grief; and healthy social relationships and activities. 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

SMART Couples

Investigators: Robert Remien, PhD, Michael Stirratt, PhD, Joanna Dognin, PsyD, Emily May, MA, Curtis Dolezal, PhD, Alex Carballo-Dieguez, PhD, Nabila El Bassel, DSW, Tiffany Jung, NP, Patricia Warne, PhD, & Glenn Wagner, PhD

SMART COUPLES is a four-session intervention delivered by a nurse practitioner to serodiscordant (mixed HIV status) couples. The program aims to increase antiretroviral therapy (ART) adherence in the partner living with HIV/AIDS by increasing knowledge about the importance of medical care adherence, increasing adherence motivation and self-monitoring, increasing problem solving skills to overcome adherence issues, increasing self-efficacy, and optimizing partner support. In addition, the program was designed to foster active support between partners and help couples address issues of sex, intimacy, and transmission risk behaviors. During four 45- to 60-minute sessions, the couples engage in structured discussion and instruction, as well as specific problem-solving and couple-communication exercises. The nurse practitioner helps participants learn the different components of medical care adherence, and how a partner can help prompt adherence. Participants are also given an opportunity to discuss barriers to adherence, and how to communicate with their partners about different health care concerns including sexual risk taking. Finally, couples determine what their .triggers. are for poor medication adherence, and how to avoid these triggers in the future. Click here to view more detailed information on this program.

Safety Point

Investigators: Fen Rhodes

This program is a community-based intervention that seeks to reduce sex- and drug-related HIV risk factors in populations of injection drug and crack cocaine users. The intervention consists of nine sessions conducted by indigenous outreach workers over a period of four to six months. Participants attend two sessions of NIDA (National Institute on Drug Abuse) standard HIV counseling and testing, two group workshop sessions, and one individual counseling session. In addition, all participants receive a minimum of two planned supportive visits from outreach staff, and are encouraged to attend a minimum of two risk-reduction social events. Monetary and non-monetary incentives are used to encourage attendance. This program's effectiveness was evaluated in comparison to the effectiveness of the NIDA standard HIV counseling and testing intervention for reducing risky behavior among IDUs. Participants were interviewed at enrollment and five to nine months after the intervention. Urine tests at enrollment and follow-up allowed researchers to collect information on opiate and cocaine use. In comparison with participants in the NIDA standard intervention, participants in the enhanced intervention were significantly more likely to increase their self-reported condom use, reduce or cease their self-reported drug use, seek drug-abuse treatment, and/or have a negative urine test for cocaine or opiates at follow-up. (Rhodes, Wood and Hershberger, 1999). Click here to view more detailed information on this program.