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.

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.

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.

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.

The Abstinence and Contraception Education Storehouse (ACES)

Investigators: Josefina J. Card, Shobana Raghupathy & Charles Klein

ACES is an online library of multimedia activities and exercises that can be used to enhance behavioral skills training in teen sexual risk reduction interventions. The goal is to enable teachers and practitioners to improve program delivery by using these activities to supplement existing interventions, and consequently promote active youth engagement and involvement. ACES has two components: (1) The Youth Activities Library (YAL) (2) The Teacher Training Library (TTL) The activities in the Youth Activities Library are aimed at youth and include multimedia audio-visual presentations, role-play demonstrations, group discussion activities, video clips, quizzes and polls, as well as traditional classroom exercises, handouts, and homework assignments. The library also includes classroom presentation materials that provide factual information on HIV/AIDS and STD awareness (incidence, prevalence, modes of STI transmission etc.). These activities in the YAL are arranged into 40 separate modules, with each module focusing on the following themes in the area of teen HIV/AIDS/STDS and pregnancy prevention: Refusal skills and resistance to peer pressure Assessing risks/using safety skills Stress management/ conflict resolution Dating and relationship decisions Negotiation skills/contraception use HIV/AIDS/STD awareness Safe sex practices Abstinence/delaying sexual activity Sexual orientation Buying contraception Condom demonstration Parent-child communication To help teachers use these modules, ACES also includes tutorials for teacher training. The ACES Teacher Training Library (TTL) is aimed at teachers and will train teachers and practitioners by offering video demonstrations in conducting role plays, group discussions and general classroom management strategies.

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.

The SISTA Project

Investigators: Ralph DiClemente & Gina Wingood

SISTA, a gender-relevant, culturally sensitive group program for African-American women, is designed to be implemented in a community setting. Based on social cognitive theory and the theory of gender and power, SISTA seeks to prevent HIV transmission by promoting consistent condom use. Peer Health Educators lead five two-hour sessions, focusing first on ethnic and gender pride, then moving on to provide knowledge about HIV/AIDS and skills training to promote sexual safety. Each session employs group discussion, lecture, role play activities and written homework to increase retention of risk reduction strategies. Click here to view more detailed information on this program.

HoMBReS: Hombres Manteniendo Bienestar y Relaciones Saludables (Men Maintaining Wellbeing and Healthy Relationships)

Investigators: Scott D. Rhodes, PhD, MPH, CHES, Kenneth C. Hergenrather, PhD, MSEd, MRC, Fred R. Bloom, PhD, Jami S. Leichliter, PhD, Jaime Montano

HoMBReS is a lay health advisor (LHA), community-based, behavioral intervention that aims to increase condom use and HIV testing among Latino men by working with sports teams. Each team selects a leader to serve as an LHA, known as a Navegante (Navigator or Health Navigator), who receives a 4-session, 16-hour training from the HoMBReS facilitator in order to become a health advisor, opinion leader, and community advocate. He may then provide his teammates with information and referrals to increase their knowledge about HIV and STI transmission, prevention, and testing, and increase their condom use skills. In addition, the Navegantes advocate positive and reframe negative sociocultural expectations about what it means to be a man, and they work toward structural changes in their communities. 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.

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.