A randomized controlled trial of an HIV sexual risk-reduction intervention for young African-American women

R. J. DiClemente and G. M. Wingood
School of Public Health, Department of Health Behavior, University of Alabama, Birmingham 35294-2010, USA.

OBJECTIVE--To evaluate the efficacy of a community-based social skills human immunodeficiency virus (HIV) prevention intervention to enhance consistent condom use. DESIGN--A randomized, single-blind controlled trial. SETTING--Bayview-Hunter's Point neighborhood of San Francisco, Calif, a predominantly African-American community that is economically disadvantaged. PARTICIPANTS--A sample of 128 sexually active, heterosexual, African-American women 18 through 29 years of age was recruited using street outreach techniques. Participants completed a structured baseline interview; 100 women (78.1%) completed 3-month follow-up interviews. INTERVENTION--Women randomized to the social skills intervention completed five sessions that emphasized ethnic and gender pride, HIV risk-reduction information, sexual self-control, sexual assertiveness and communication skills, proper condom use skills, and developing partner norms supportive of consistent condom use. Women randomized to the HIV education condition participated in a single session that provided HIV risk-reduction information. Women randomized to the delayed HIV education control condition received no HIV risk-reduction information until all follow-up interviews were completed. MAIN OUTCOME MEASURES--Consistent condom use, HIV risk-reduction knowledge, sexual self-control, sexual assertiveness, sexual communication, and partner norms supportive of consistent condom use. RESULTS--Compared with the delayed HIV education control condition, women in the social skills intervention demonstrated increased consistent condom use (adjusted odds ratio [OR], 2.1; 95% confidence interval [CI], 1.03 to 4.15; P = .04), greater sexual self-control (adjusted OR, 1.9; 95% CI, 1.00 to 3.60; P = .05), greater sexual communication (adjusted OR, 4.1; 95% CI, 1.67 to 10.01; P = .002), greater sexual assertiveness (adjusted OR, 1.8; 95% CI, 1.01 to 3.27; P = .05), and increased partners' adoption of norms supporting consistent condom use (adjusted OR, 2.1; 95% CI, 1.08 to 3.87; P = .03). No statistically significant differences in outcome variables were observed between the HIV education condition relative to the delayed HIV education control condition. CONCLUSION--Community-based HIV risk-reduction programs that are gender relevant and culturally sensitive and provide social skills training can effectively enhance consistent condom use.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Cost-Effectiveness of HIV Screening in Patients Older than 55 Years of Age
Sanders et al.
ANN INTERN MED 2008;148:889-903.
ABSTRACT | FULL TEXT  

Preventing Recurrent Sexually Transmitted Diseases in Minority Adolescents: A Randomized Controlled Trial
Thurman et al.
Obstet Gynecol 2008;111:1417-1425.
ABSTRACT | FULL TEXT  

Age and HIV Risk and Protective Behaviors Among African American Women
Corneille et al.
Journal of Black Psychology 2008;34:217-233.
ABSTRACT  

The demographical and clinical features of patients reattending a genitourinary medicine clinic and the role of counselling on subsequent incidence of sexually transmitted infections
Manavi and Bolton
Int J STD AIDS 2008;19:168-171.
ABSTRACT | FULL TEXT  

Advancing Health Disparities Research Within the Health Care System: A Conceptual Framework
Kilbourne et al.
Am. J. Public Health 2006;96:2113-2121.
ABSTRACT | FULL TEXT  

Association of sexual revictimization with sexuality and psychological function.
Miner et al.
J Interpers Violence 2006;21:503-524.
ABSTRACT  

Assessing HIV Prevention Provider Knowledge of Behavior Science Theory: Building on Existing Intuitive Experience
Gandelman et al.
Health Promot Pract 2005;6:299-307.
ABSTRACT  

Self-Esteem and Theoretical Mediators of Safer Sex Among African American Female Adolescents: Implications for Sexual Risk Reduction Interventions
Salazar et al.
Health Educ Behav 2005;32:413-427.
ABSTRACT  

HIV Prevention among Women in Low-Income Housing Developments: Issues and Intervention Outcomes in a Place-Based Randomized Controlled Trial
Sikkema
The ANNALS of the American Academy of Political and Social Science 2005;599:52-70.
ABSTRACT  

Cost-Effectiveness of Screening for HIV in the Era of Highly Active Antiretroviral Therapy
Sanders et al.
NEJM 2005;352:570-585.
ABSTRACT | FULL TEXT  

Sexual risk behaviour and infection: epidemiological considerations
Aral
Sex. Transm. Infect. 2004;80:ii8-ii12.
FULL TEXT  

Theoretical Domains: A Heuristic for Teaching Behavioral Theory in HIV/STD Prevention Courses
Dolcini et al.
Health Promot Pract 2004;5:404-417.
ABSTRACT  

Another Look at HIV in African American Women: The Impact of Psychosocial and Contextual Factors
Jipguep et al.
Journal of Black Psychology 2004;30:366-385.
ABSTRACT  

Efficacy of a Woman-Focused Intervention to Reduce HIV Risk and Increase Self-Sufficiency Among African American Crack Abusers
Wechsberg et al.
Am. J. Public Health 2004;94:1165-1173.
ABSTRACT | FULL TEXT  

HIV Prevention Research for African Americans: Current and Future Directions
Beatty et al.
Journal of Black Psychology 2004;30:40-58.
ABSTRACT  

African American Women and AIDS: Factors Influencing Risk and Reaction to HIV Disease
McNair and Prather
Journal of Black Psychology 2004;30:106-123.
ABSTRACT  

Client Satisfaction and Perceived Helping Components of an HIV/AIDS Preventive Intervention for Urban Couples
Schiff et al.
Research on Social Work Practice 2003;13:468-492.
ABSTRACT  

HIV-Associated Histories, Perceptions, and Practices Among Low-Income African American Women: Does Rural Residence Matter?
Crosby et al.
Am. J. Public Health 2002;92:655-659.
ABSTRACT | FULL TEXT  

Building Community Trust: Lessons from an STD/HIV Peer Educator Program with African American Barbers and Beauticians
Lewis et al.
Health Promot Pract 2002;3:133-143.
ABSTRACT  

Condom Use and Correlates of African American Adolescent Females' Infrequent Communication with Sex Partners about Preventing Sexually Transmitted Diseases and Pregnancy
Crosby et al.
Health Educ Behav 2002;29:219-231.
ABSTRACT  

Peer-delivered health promotion for young people: A systematic review of different study designs
Harden et al.
Health Education Journal 2001;60:339-353.
ABSTRACT  

Cervical cancer and sexual lifestyle: a systematic review of health education interventions targeted at women
Shepherd et al.
Health Educ Res 2000;15:681-694.
ABSTRACT | FULL TEXT  

Correlates of Unprotected Vaginal Sex Among African American Female Adolescents: Importance of Relationship Dynamics
Crosby et al.
Arch Pediatr Adolesc Med 2000;154:893-899.
ABSTRACT | FULL TEXT  

Modeling Intervention Efficacy for High-Risk Women: The WINGS Project
Greenberg et al.
Eval Health Prof 2000;23:123-148.
ABSTRACT  

Sampling for Evaluation: Issues and Strategies for Community-Based HIV Prevention Programs
O'Connell
Eval Health Prof 2000;23:212-234.
ABSTRACT  

Preventive Intervention to Reduce Sexually Transmitted Infections: A Field Trial in the Royal Thai Army
Celentano et al.
Arch Intern Med 2000;160:535-540.
ABSTRACT | FULL TEXT  

From psycho-social theory to sustainable classroom practice: developing a research-based teacher-delivered sex education programme
Wight and Abraham
Health Educ Res 2000;15:25-38.
ABSTRACT | FULL TEXT  

Exploring young people's difficulties in talking about contraception: how can we encourage more discussion between partners?
Coleman and Ingham
Health Educ Res 1999;14:741-750.
ABSTRACT | FULL TEXT  

Two-Year Follow-Up of AIDS Education Programs for Impoverished Women
Nyamathi et al.
West J Nurs Res 1999;21:405-425.
ABSTRACT  

A Randomized, Controlled Trial of a Behavioral Intervention to Prevent Sexually Transmitted Disease among Minority Women
Shain et al.
NEJM 1999;340:93-100.
ABSTRACT | FULL TEXT  

Efficacy of Risk-Reduction Counseling to Prevent Human Immunodeficiency Virus and Sexually Transmitted Diseases: A Randomized Controlled Trial
Kamb et al.
JAMA 1998;280:1161-1167.
ABSTRACT | FULL TEXT  

Human Immunodeficiency Virus Sexual Risk Reduction in Homeless Men With Mental Illness
Susser et al.
Arch Gen Psychiatry 1998;55:266-272.
ABSTRACT | FULL TEXT  

Boosting Women's Social Skills Gets Men to Use Condoms
AIDS Clin Care 1995;1995:4-4.
FULL TEXT  

REDUCING HIV RISK AMONG AFRICAN-AMERICAN WOMEN
JWatch General 1995;1995:3-3.
FULL TEXT