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.

Multimedia SiHLE

Investigators: Josefina J. Card, Tabitha Benner, Amie Ashcraft, Tamara Kuhn, Barbara Lee Federle, Gina Wingood, Ralph DiClemente, Deja L. Hunger, and Tanisha Grimes

SiHLE is an interactive, computer-based intervention addressing the HIV/AIDS and STI prevention needs of sexually active, African-American young women ages 14-18. The product is based on SiHLE: Health Workshops for Young Black Women, a popular group level intervention in CDC.s Diffusion of Evidence-based Intervention (DEBI) library and Sociometric's Program Archive on Sexuality, Health, and Adolescence (PASHA). The original SiHLE program consists of four, 3-hour social-skills building sessions and is grounded in social cognitive theory and the theory of gender and power. Under the leadership of one adult and two peer facilitators, participants discuss ethnic and gender pride, risk reduction strategies (including correct and consistent condom use), negotiating safer sex, and healthy relationships and their relation to practicing safer sex. Multimedia SiHLE explores these same issues through two, one-hour sessions that combine interactive learning, videos, games and quizzes to help viewers increase and reinforce their risk-reduction awareness, knowledge and skills. Users interact with the computer-based intervention individually at their own speed, and only minimal staff participation is needed to implement the 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.

Behavioral Risk Factor Surveillance System (BRFSS), 2000

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. The 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 2000, 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 physical activity, fruit and vegetable consumption. 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 09 is comprised of cases from Florida, Montana, and Ohio.

Rikers Health Advocacy Program (RHAP)

Investigators: Stephen Magura, Janet Shapiro, & Sung-Yeon Kang

This program, originally developed for use with incarcerated male adolescent drug users between 16 and 18 years of age, consists of four one hour small group sessions focusing on health education issues, particularly HIV/AIDS. Adapting techniques of Problem Solving Therapy, the facilitator guides eight-person groups in discussing the following topics: general health, HIV and AIDS, drug abuse and its consequences, sexual behavior, health and AIDS-risk behaviors, and strategies for seeking health and social services. Active learning is emphasized, with opportunities for youths to define high-risk attitudes and behaviors, suggest alternative actions, and engage in role play and rehearsal activities. A field study of the curriculum compared the attitudes and behaviors of RHAP participants with those of a control group of teens, selected from a waiting list for the program. Both samples were predominantly African-American and Hispanic. Following the intervention, program participants were more likely to use condoms during intercourse, compared to the comparison group of teens. RHAP is supported by the Office of Adolescent Health (OAH)'s Teen Pregnancy Prevention (TPP) program as an EBI that is medically accurate, age appropriate, and has proven through rigorous evaluation to prevent teen pregnancy and/or associated sexual risk behaviors. 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 Risk Reduction Education and Skills Training Program (ARREST)

Investigators: Michele D. Kipke

Principles of the health belief model and social learning theory form the conceptual framework for this program, together with strategies previously found to be effective in changing such adolescent health-risk behaviors as cigarette smoking and early pregnancy. Originally designed for teens between 12 and 16 years of age, the intervention includes three 90-minute, small group sessions, in which participants receive five forms of assistance: (1) information about the transmission and prevention of HIV/AIDS; (2) instruction in purchasing and using condoms with spermicide; (3) guidance in self-assessment of risk behaviors; (4) training in decision-making, communication, and assertiveness skills; and (5) peer group support for HIV/AIDS prevention and risk reduction. In addition to lectures and modeling by instructors, teens complete role plays, skill-building exercises, and homework activities. A field study of the program was conducted with 87 African-American and Latino youths, who were recruited from three New York City community-based organizations providing alternative education and after-school programs for high-risk teens. Comparing four week follow-up measures of program participants with a control group of peers, participants showed significant gains in knowledge and attitudes about AIDS, as well as in sexual refusal and negotiation skills. However, no differences were found between the groups' risk-related sexual behaviors. 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.