National Sexual Health Survey (NSHS), 1996

Investigators: Center for AIDS Prevention Studies (CAPS); University of California, San Francisco

The National Sexual Health survey (NSHS) obtained a probability sample of all U.S. adults 18 years and older residing in the 48 contiguous states. Among identified eligibles, 77% were interviewed and the overall cooperation rate was 65%. All respondents were interviewed by telephone from June 28,1995 to April 30, 1996 in Spanish or English using procedures to ensure anonymity and privacy and to verify study authenticity. Measures were developed to assess a wide range of HIV-related and human sexuality topics, including, but not limited to: condom attitudes, condom slips and breaks, HIV-related care-giving, HIV-testing and home testing use, STD histories, perceived risk for HIV and other STDs and optimistic bias assessments, extramarital sex, sexual development, sexual abuse and rape, sexual dysfunctions, various psychological scales (sensation-seeking, machismo), family assessments and history, health and demographics, an a detailed assessment was conducted of sexual activities with each of the respondent's sexual partners, and, in addition, demographic, geographic, and HIV/STD risk characteristics of their sexual partners were determined.

Voluntary Counseling and Testing for Female Sex Workers (VCT Program)

Investigators: Xiaoming Li, PhD, Bo Wang, PhD, Xiaoyi Fang, PhD, Ran Zhao, MD, Bonita Stanton,MD, Yan Hong, MA, Baiqing Dong, MD, Wei Liu, MD, Yuejiao Zhou, MD, Shaoling Liang, MD, & Hongmei Yang, PhD

The VCT Program aims to increase STI/HIV testing, awareness of infection, STI/HIV knowledge, and consistent use of condoms among female sex workers in China in order to ultimately reduce rates of STI infections. The VCT Program demonstrated increases in knowledge of STI/HIV knowledge and consistent condom use, and decreases in STI incidence. The VCT Program is composed of a pre-test counseling session, STI/HIV testing, and a post-test counseling session. During the first 25-minute VCT counseling session, the counselor works with the participant to: complete a risk assessment; identify challenges related to risk reduction; create a risk reduction plan; and practice condom use skills. After the first counseling session, the participant completes STI/HIV testing. During the 20-minute post-test counseling session, the counselor shares test results and reviews treatment options and risk reduction plans. The VCT Program was originally implemented in a suburban area of Nanning in southern China with female sex workers recruited from entertainment establishments. This program's voluntary counseling and testing content and approach may be useful in increasing testing and safer sex behaviors in many different types of communities and populations. Click here to view more detailed information on this program.

The Future is Ours (FIO)

Investigators: Anke A. Ehrhardt, Heidi Arner, Pam Farquhar, Laura Frye, Jeff Natt, Inez Sieben, Imelda Walavalkar, Susie Hoffman, Jessica Adams-Skinner, & Teresa Exner

The Future Is Ours (FIO) is an eight-session HIV prevention intervention delivered to high-risk heterosexual women in a group setting. FIO is guided by three major theories, Modified AIDS Risk Reduction Model (MARRM), Social Learning Theory, and Gender Theory. The goal of FIO is to empower women to reduce unsafe sexual encounters by increasing the use of male and female condoms and alternate protection strategies including sex without penetration, getting tested for HIV jointly with a partner along with mutual monogamy and a safety agreement, deciding to be celibate, and refusing unsafe sex or deciding to not get involved with a partner who will not use condoms. FIO is a gender-specific HIV/STD risk reduction intervention designed for heterosexually active, at-risk women of diverse ethnicities (African-American/Black, Caribbean, Latina, White), ages 18 to 30, who are not injection drug users, are HIV-negative or of unknown status, are not pregnant or trying to become pregnant, and who live in communities where rates of HIV and other STDs are high.

Project SAFE (P-SAFE)

Investigators: Tamara Kuhn, Charles Klein, Alejandra Moreno, and Carmela Lomonaco

Project SAFE is a computer-delivered HIV/STI prevention program specifically designed for Latinas available in both English and Spanish. P-SAFE includes videos of individual women speaking candidly about HIV/STI-related topics in their lives and communities, skills instruction by the health educator, groups of women practicing condom skills, and role-play and novela vignettes demonstrating intervention themes.

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.

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.

Turning Point

Investigators: Russel S. Falck, Robert G. Carlson, & Harvey A. Siegal

Turning Point includes two separate interventions designed to reduce the frequency and probability of injection-risk behavior among IDUs not participating in drug abuse treatment programs. The basic intervention consists of two sessions. In the first session, participants undergo HIV antibody tests and receive pre-test counseling. In the second session, a counselor-educator provides detailed information about HIV and HIV transmission and guides the participant group through activities intended to teach behavioral strategies for avoiding exposure to HIV. Participants in the enhanced intervention complete the basic intervention and attend three additional sessions, in which they address HIV/AIDS pathology, drug addiction, and safer sex practices. Both interventions employ videotape presentations, role-play, hands-on demonstrations, and print materials. The enhanced intervention also employs slide presentations, self-assessment tests, and lecture/discussion. The program's effectiveness was evaluated in Dayton and Columbus, OH. Participants were randomly assigned to one of the two interventions. Surveys were administered to both groups at enrollment and six months after the intervention. A majority of participants in both the standard and enhanced interventions reported safer needle practices at follow-up. Although no difference in needle risk was observed between intervention groups when all subjects were included in analyses, participants in the enhanced intervention who reported unsafe needle practices at enrollment were significantly more likely to report safer needle practices at follow-up than similar participants in the standard intervention (Siegal, Falck, Carlson and Wang, 1995). Click here to view more detailed information on this program.

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.

Los Angeles Women's Health Risk Study, 1990

Investigators: David Kanouse

Investigators interviewed a stratified probability sample of 1,024 female street prostitutes in Los Angeles County between May 1990 and February 1991 to study behavior that is linked to transmission of HIV and other STDs. Although the study also collected blood samples from a subsample of 638 women to examine markers for HIV infection, as well as past syphilis and hepatitis B infection, the original investigator did not include blood sample data in this public use dataset. The specific aims of this study were to: develop numerical estimates of the size of the prostitute population in Los Angeles County and its distribution by predominant mode of solicitation of customers; characterize prostitute career patterns; perform HIV antibody testing to determine the prevalence of HIV infection in this population and its subgroups; measure the prevalence and incidence of specific sexual and drug-related risk behaviors and prevention behaviors and determine how these are related to prostitute characteristics and risk and prevention behaviors; and compare the characteristics of the population of prostitutes with those subgroups most likely to be recruited in convenience samples (e.g., from jails or STD clinics). The present study is unique in describing the characteristics, risk behavior and serological status of a probability sample of street prostitutes from a major metropolitan area of the U.S., which is also in AIDS epicenter.

Urban Mens Health Survey (UMHS), 1997-98

Investigators: Center for AIDS Prevention Studies (CAPS); University of California, San Francisco

The Urban Men's Health Study (UMHS) is a telephone interview of a probability sample of men who have sex with men (MSMs) living in four cities – San Francisco, New York, Los Angeles, and Chicago. An MSM was defined as any male who reported same sex contact since age 14 or who self-identified as gay or bisexual. The dataset contains 855 variables and 2881 cases. Data were collected between November 1996 and February 1998 on the respondent's sexual behaviors in the preceding 12 months, information on up to four (4) male or female partners, sexual development, anti-gay victimization, sexual coercion, access to medical care, sexual problems, depression, alcohol and drug use, STD assessment, HIV antibody test, attitudes about being HIV positive, and well-being. A total of 2,881 interviews were obtained between November 1996 and February 1998. Data were collected on the respondent's sexual behaviors in the preceding 12 months, information on up to four (4) male or female partners, sexual development, anti-gay victimization, sexual coercion, access to medical care, sexual problems, depression, alcohol and drug use, STD assessment, HIV antibody test, attitudes about being HIV positive, and well-being. Interviews were conducted in English and Spanish (n=17) at a time of the respondents' choosing and lasted an average of 75 minutes. Only male interviewers were employed for the MSM screening and questionnaire portions of the interview.