Hot, Healthy, and Keeping it Up!

Investigators: Kyung-Hee Choi, Steve Lew Eric Vittinghoff, Joseph Catania, Donald Barrett & Thomas Coates

This program is a three-hour, single session, culturally appropriate intervention for use with homosexual Pacific Islander and/or Asian men. The intervention is designed to increase positive ethnic and sexual identity in order to help participants acknowledge HIV risk behaviors by discussing negative experiences of being both Asian or Pacific Islander and homosexual (e.g., lack of social support, racism, homophobia). Guided by the Health Belief Model, the theory of reasoned action, and social cognitive theory, facilitators use interactive and group process techniques to address the following four intervention components: 1) development of positive self-identity and social support; 2) safer sex education; 3) eroticizing safer sex; and 4) negotiating safer sex. Of the 258 participants in the original evaluation, most were about 29 years old, Chinese, college-educated, immigrants. Most had been tested for HIV and had reported multiple partners in the three months prior to the intervention. Results of the evaluation indicate that intervention participants were significantly more knowledgeable about HIV-risk reduction, were significantly more motivated about addressing risk, had significantly fewer partners, and were significantly less likely to report unprotected anal intercourse than counterparts in the control group at three-month follow-up. (Choi et al., 1996). Click here to view more detailed information on this program.

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.

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.

Sniffer

Investigators: Don C. Des Jarlais, Cathy Casriel, Ray Rodriguez, Andrew Rosenblum, Samuel Friedman, Bruce Stepherson & Elizabeth Khuri

Sniffer is designed to prevent intranasal heroin users from making the transition to injection drug use, and to prevent those who have used injection drugs in the past from returning to that mode of use. Participants attend four 90-120 minute sessions in which didactic materials, group discussions, and situational role play scenarios are employed to communicate information about AIDS, drug use, sexual risk behavior, and drug abuse treatment options. The intervention also seeks to reduce non-injection use of illicit drugs, but advocates harm reduction practices and treatment rather than condemning the behavior of group members who use illicit non-injection drugs. The program's effectiveness was evaluated in a study of 104 intranasal drug users in New York City, each of whom had injected heroin less than 60 times in the previous two years and was HIV and/or hepatitis B negative. Participants were recruited and assigned to test and control groups. All subjects received information about AIDS prior to enrollment. Follow-up interviews at roughly nine months after enrollment collected information about drug use and sexual behavior as well as attitudes towards AIDS. Participation in the intervention was associated with a significantly lower probability of self-reported injection drug use and increased condom use during the follow-up period. (Des Jarlais, Casriel, Friedman and Rosenblum, 1995; Casriel et al., 1990). Click here to view more detailed information on this program.

Focus on the Future

Investigators: Richard Crosby, PhD, Ralph J. DiClemente, PhD, Richard Charnigo, PhD, Gregory Snow, Adewale Troutman, MD

FOCUS ON THE FUTURE, a one-to-one, single session intervention, administered by a lay health advisor, is culturally appropriate for use among young (aged 18-29 years) heterosexual African American men newly diagnosed with a sexually transmitted infection (STI). Based on the behavioral skills model, this one hour long program consists of a personalized discussion, presentation of basic STI/HIV/AIDS and safer sex information, and condom use skills practice. For each individual participant, the FOCUS ON THE FUTURE health facilitator initiates a discussion about the disproportionate HIV/AIDS burden experienced by African American men (illustrated using large posters); condom negotiation skills; and any questions, problems, and concerns the men may have regarding safer sex with their partners. The health facilitator also conducts a demonstration of available condom and lubricant varieties and correct condom and lubrication use. Throughout the session, the advisor encourages the individual to feel good about using condoms, to experience condoms as being compatible with sexual pleasure, to equate condom use with an investment in his future, and to actively protect himself from obtaining a future STI. Men are encouraged to use condoms that they feel fit them well and provide them with a sense of security. Participants receive pocketsize vials of water-based lubricants as well as 12 or more condoms of their choice from a broad selection of brands and sizes. Click here to view more detailed information on this program.

Portland Women's Health Program

Investigators: Brian W. Weir, MPH, Rosemary Breger, MPH, Kerth O'Brien, PhD, Carol J. Casciato, Ronda S. Bard, PhD, John A. Dougherty, PhD, Michael J. Stark, PhD

Portland Women's Health Program, a one-to-one behavioral intervention, aims to reduce HIV risk behaviors and increase life stability among women who were recently incarcerated. A community health specialist extensively trained in motivational interviewing (MI) techniques meets individually with women during 10 sessions delivered over three months. During program sessions, the health specialist uses MI techniques to empower and encourage women to explore potential positive changes they can make in their lives. The sessions are both directive, since the health specialist guides the conversation toward particular topics, and participant-centered, since the participant's experiences, views, and reluctance or readiness to change are central topics of discussion. All ten of the Portland Women's Health Program sessions address HIV-prevention in addition to life stability issues. Click here to view more detailed information on this program.

Drug User Intervention Trial (DUIT)

Investigators: Richard S. Garfein, PhD, MPH, Steffanie Strathdee, Ph.D, Lawrence Ouellet, PhD, Sharon Hudson, PhD, Mary Latka, PhD, Holly Hagan, PhD, Hanne Thiede, DVM, MPH, Elizabeth Golub, PhD, Marie Bailey-Kloch, Karen Yen-Hobelman, PhD, Susan Bailey, PhD, Joyce Fitzgerald, Peter Kerndt, MD, MPH, Karla Wagner, PhD, David Vlahov, PhD, Farzana Kapadia, PhD, Nadine Snyder, BA, Jennifer V. Campbell, MPH, David Purcell, PhD, JD, Ian Williams, PhD, Paige Ingram, RN, Andrea Swartzendruber, MPH

DUIT is a small-group, clinic-based, behavioral intervention that aims to reduce risky injection and sexual behaviors among injection drug users who are HIV and HCV negative. During six 2-hour sessions, two trained health advisors promote group cohesion and peer education within the DUIT group. The health advisors also encourage behavior change by teaching peer-education tactics, risk-reduction strategies, and safer sex and injection negotiation skills. Ultimately, the DUIT program increases participants. perceived risk of HIV/HCV, their motivation to practice safer injection and sexual behaviors, their knowledge of risky behaviors, and key risk-reduction strategies. Click here to view more detailed information on this program.

Protect and Respect

Investigators: Michelle Teti, Linda Lloyd, Susan Rubinstein, Lisa Bowleg, Mary Ann Nkansa, Russell Cole, Zekarias Berhane, Erika Aaron, Ann Ricksecker, Marla Gold, Susan Spencer, Rhonda Ferguson, Dianne Rorie

PROTECT AND RESPECT, a clinic-based, behavioral intervention, aims to reduce the sexual transmission of HIV by decreasing high-risk behaviors among women living with HIV/AIDS. The intervention delivers HIV prevention messages in the following three ways: (1) a primary care provider counsels participants during health care visits; (2) an Intervention Specialist leads five group skills building sessions that teach skills to reduce sexual risk behaviors; and (3) Peer Educators conduct weekly discussion groups, which support participants. attempts to implement behaviors learned in the group skills building sessions. The program provider delivers a one-time, brief prevention message lasting 3 . 5 minutes, while the group skills building sessions consist of five 2-hour weekly educational sessions delivered over a 5-week period. The peer-led support groups meet weekly for 1-hour, beginning after the group skills building sessions have concluded, and may extend for as long as the program is in effect. During support group sessions, women are provided with an opportunity to discuss specific topics such as HIV risk reduction strategies, how to disclose, handling stress, or communicating with partners. Click here to view more detailed information on this program.

Point for Point

Investigators: San Francisco AIDS Foundation HIV Prevention Project & The Prevention Point Research Group

Point for Point is a needle exchange intervention designed for implementation in street settings. Needle exchange operates on the premise that increased availability of sterile syringes can reduce the prevalence of needle-sharing among injection drug users (IDUs). Needle sharing, the use of the same syringe by more than one person, is associated with high rates of transmission of infectious diseases, including HIV/AIDS. Point for Point relies on trained volunteers to operate exchange sites at which sterile hypodermic syringes are exchanged for used syringes on a one-for-one basis. Volunteers also distribute condoms and provide exchangers with bleach, alcohol swabs, sterile cotton, and other materials associated with safer drug-injection techniques. Point for Point was evaluated under the name Prevention Point in connection with the Urban Health Study (UHS), a long-term study of the IDU community in San Francisco, CA. Data collected through UHS surveys revealed that Point for Point quickly became the principal source of sterile syringes for San Francisco IDUs, and that IDUs who reported regular use of the needle exchange were significantly less likely to report needle-sharing than IDUs who did not use the needle exchange. Participants also reported a significant drop in the median number of daily injections, and the proportion of respondents who reported their first injection behavior in the previous year dropped significantly. An overall decline in reported needle sharing was also observed (Watters, 1996; Watters, Estillo, Clark and Lorvick, 1994). Click here to view more detailed information on this program.

Holistic Health Recovery Program for Injection Drug Users (HHRP)

Investigators: S. Kelly Avants, PhD, Arthur Margolin, PhD, Mary Helen Usubiaga, MD, Cheryl Doebrick, PhD

HOLISTIC HEALTH RECOVERY PROGRAM FOR INJECTION DRUG USERS 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-negative and status unknown 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 drug use, reduced risk of HIV infection, 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; emotional and spiritual healing; and healthy social relationships and activities. Click here to view more detailed information on this program.