Entre Nous Jeunes

Investigators: Simon-Pierre Tegang, M.Sc., Jean Paul Tchupo, M.A., Gdon Yomi, M.Sc., & Blanche Djofang, B.A.

During the 18-month program, Entre Nous Jeunes utilizes a peer-education strategy to increase contraceptive prevalence and reduce the prevalence of STI/HIV and unintended pregnancies. Young adult peer educators in the community educate youth about HIV prevention and safer sex. Peer educators are trained during a one week-long session for the program. For two years, peer educators engage youth in the community by leading discussion groups, creating and using promotional materials, and referring peers to social and health services. The main objective of the program is for young people who have been exposed to a peer-educator to gain greater knowledge and practice more protective behaviors than those not exposed. The findings indicate the important contribution of the ENJ peer-educator program to the promotion of protective reproductive health behaviors to reduce unintended pregnancies and STIs among adolescents. In particular, the program was significantly associated with greater spontaneous knowledge of modern contraceptives and STI symptoms. Findings also suggest positive intervention effects on contraceptive knowledge for males, and virginity and contraceptive use at last intercourse for sexually active females. 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.

SiHLE: Health Workshops for Young Black Women

Investigators: Ralph DiClemente, Gina Wingood, Kathy Harrington, Delia Lang, Susan Davies, Edward Hook III, M. Kim Oh, Richard Crosby, Vicki Stover Hertzberg, Angelita Gordon, James Hardin, Shan Parker, & Alyssa Robillard

SiHLE (Sistas, Informing, Healing, Living, Empowering) was developed to address the STI/HIV/AIDS prevention needs of African-American adolescent girls. Research has shown that this subgroup of the general population is at higher risk than their White or Hispanic peers. SiHLE was originally implemented in the South, where adolescent HIV prevalence was higher than any other geographic region in the U.S. Participants were girls seeking health services at community health agencies. Eliglible participants were African American between the ages of 14 and 18 who had engaged in vaginal intercourse within the previous six months. At baseline, 522 girls, aged 14-18, completed the baseline survey and were randomized into either the HIV-prevention intervention (n=251) or the general health control group (n=271). The HIV-prevention intervention was grounded in social cognitive theory and the theory of gender and power. Participants explored issues related to ethnic and gender pride, risk reduction strategies (including correct and consistent condom use), negotiating safer sex, and healthy relationships as they relate to practicing safer sex. At the six-month follow-up, intervention girls reported using condoms more consistently in the previous 30 days than did their control group counterparts (intervention, 75.3% vs. control, 58.2%). At the 12-month follow-up, intervention girls reported more consistent condom use both in the previous 30 days (intervention, 73.3% vs. control, 56.5%) and during the entire 12-month review period (adjusted odds ratio, 2.30; 95% CI, 1.51-3.5; Phere 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.

Study to Reduce Intravenous Exposures (STRIVE)

Investigators: Steffanie Strathdee, Ph.D., Sebastian Booner, Ph.D., Elizabeth Golub, Ph.D., Mary Latka, M.P.H., Ph.D., Farzana Kapadia, Ph.D., Holly Hagan, M.P.H., Ph.D., Jennifer Campbell, & Richard Garfein, Ph.D., M.P.H

STRIVE is a group-level, clinic-based, behavioral intervention that aims to reduce risky distributive injection practices (e.g., syringe lending and unsafe drug preparation) among young injection drug users who are HCV positive. During six 2-hour sessions, two trained health advisors promote group cohesion and support peer education within the STRIVE group. The health advisors encourage behavior change by teaching peer-education tactics and risk reduction skills. The STRIVE program increases participants. HCV knowledge and risk awareness, problem-solving and risk-reduction skills, and supports sustained behavior change. The effectiveness of the STRIVE program was evaluated using a randomized trial design with a time-equivalent attention-control group. Participants included 418 HCV-positive injection drug users aged 18 to 35 years in three US cities. Participants reported their injection-related behaviors at baseline, and at three- and six-month follow-ups. Compared with the control group, intervention group participants reported a 26% relative reduction of distributive risk behaviors at three months and six months, but were no more likely to cite their HIV-positive status as a reason for refraining from syringe lending. Effects were strongest among intervention group participants who had known their HCV-positive status for at least six months. Peer mentoring and self-efficacy were significantly increased among intervention group participants, and intervention effects were mediated through self-efficacy. Click here to view more detailed information on this program.

Youth AIDS Prevention Project (YAPP)

Investigators: Susan Levy, Brian Flay, & Arden Handler

Originally designed for African-American youth, YAPP aims to prevent STDs, HIV/AIDS, and substance abuse among high-risk junior high school students. Guiding the program is the social influence model of behavioral change, which targets teens' knowledge, attitudes, intentions, and behaviors regarding high-risk activities. The intervention includes ten sessions for 7th grade students, delivered in regularly scheduled health or science classes, and a five-part booster session offered one year later, when the teens have entered 8th grade. Classes cover transmission and prevention of STDs and HIV/AIDS, the importance of using condoms for those who choose to have sex, and the development of decision-making and resistance/negotiation skills. In addition to lectures and class discussions, active learning is emphasized, with opportunities for students to participate in small group exercises and role plays. There are also homework activities and opportunities for parental involvement. A field study of the intervention was conducted in fifteen high-risk school districts in Chicago. Research focused on the group of students who first became sexually active during the study period. Following the booster session, these students were more likely than a control group of peers to report using condoms with foam; they also expressed greater intention to use condoms with foam in the future. Click here to view more detailed information on this program.

AIDS Prevention and Health Promotion among Women

Investigators: Stevan Hobfoll, Anita Jackson, Justin Lavin, & James Shepherd

AIDS Prevention and Health Promotion among Women is designed to assist participants between 16 and 29 years of age in developing and following a sound sexual health plan. Based on the concepts of empowerment, group social support and culturally sensitive skill building, this program comprises four 1 1/2- to 2-hour small (2-8 participant) group sessions conducted over the course of three months. Video segments promote group discussion, spark group role plays and engage participants in cognitive rehearsal and guided exercises designed to encourage healthy choices about one's body and sexuality. Specifically, this program encourages women to think about the physical and emotional consequences of unsafe sex. It helps them achieve a sense of mastery and positive expectations when discussing sexual history, HIV/AIDS testing, monogamy, spermicide and condom use, and other health-related concerns with their partners. In addition, the program teaches participants how to effectively negotiate safer sex with one's partner and maintain safer sex goals. This program was field tested with pregnant low-income African-American and white women who were using medical center obstetrics services in Akron, Ohio. Compared to control groups, participants showed significant and sustained increases in HIV/AIDS knowledge, safer sex goals, and safer-sex behaviors, including spermicide and condom purchases and use. Click here to view more detailed information on this program.

AIDS Prevention for Adolescents in School

Investigators: Heather J. Walter & Roger D. Vaughan

This six-session program for high school students is delivered by regular classroom teachers. Combining principles of the health belief model with social psychology, the curriculum aims to improve students' knowledge, beliefs, self-efficacy, and risk behaviors concerning HIV/AIDS. The first two classes provide general information about the transmission and prevention of HIV/AIDS and teach students how to appraise their own risk behaviors. During the next two sessions, myths about peers' sexual behaviors are corrected, values clarification is introduced, and students use role play and negotiation skills to practice delaying sexual intercourse. The final lessons involve discussions of purchasing and using condoms. A field study of the program was conducted with a predominantly African-American and Hispanic sample of students attending four New York City public high schools. Compared with a comparison group of peers, program participants scored significantly higher on measures of knowledge, beliefs about the benefits of risk reduction, and beliefs about one's own ability to effect positive change (e.g., self-efficacy). At the three-month follow-up assessment, the program was found to be particularly effective in reducing sexually active participants' number of total sex partners and number of sex acts with high-risk partners, and in increasing the use of condoms. Click here to view more detailed information on this program.

Safer Sex Efficacy Workshop

Investigators: Karen Basen-Engquist

This single session, three-hour workshop is designed to increase college students' self-efficacy, or belief in their own ability to act successfully to prevent HIV/AIDS and other sexually transmitted diseases. Drawing upon social learning theory, the program includes numerous role-play and skill-building exercises, and is led by peer educators who are trained to serve as persuasive models. To give students the knowledge necessary to practice preventive behaviors, the leaders begin by facilitating a group discussion about HIV/AIDS and STDs, including transmission and prevention. During the next section, participants discuss personal experiences of and feelings about AIDS and other STDs. Finally, the students role play safe-sex discussions and learn about correct condom use, gaining confidence in their abilities in the process. A field study of the workshop was conducted with 209 undergraduate students enrolled in a health education class at the University of Texas. Compared to comparison groups of their peers, program participants showed significant increases in self-efficacy at the two month follow-up assessment. Sexually active students also showed an increase in their frequency of condom use. Click here to view more detailed information on this program.

Behavioral Risk Factor Surveillance System (BRFSS), 1999

Investigators: Centers for Disease Control and Prevention

The Behavioral Risk Factor Surveillance System (BRFSS) is a collaborative project of the Centers for Disease Control and Prevention (CDC), and U.S. states and territories. BRFSS, administered and supported by the Behavioral Surveillance Branch (BSB) of the CDC, is an on-going data collection program designed to measure behavioral risk factors in the adult population 18 years of age or over living in households. The BRFSS was initiated in 1984, with 15 states collecting surveillance data on risk behaviors through monthly telephone interviews. The number of states participating in the survey increased, so that by 1999, 50 States, the District of Columbia, Puerto Rico, Guam, and the Virgin Islands were participating in the BRFSS. The objective of the BRFSS is to collect uniform, state-specific data on preventive health practices and risk behaviors that are linked to chronic diseases, injuries, and preventable infectious diseases in the adult population. Factors assessed by the BRFSS include tobacco use, general health status, health care coverage, HIV/AIDS, and use of cancer screening services, among others. Data are collected from a random sample of adults (one per household) through a telephone survey. This dataset contains observations from only those states that participated in the "Sexual Behavior" modules, which included questions on HIV/AIDS. PETRA 08 is comprised of cases from Delaware, Florida, Maine, Minnesota, Montana, New Jersey, New York, Ohio, South Dakota, Tennessee, and Vermont.