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Ralph J. DiClemente, PhD; Gina M. Wingood, ScD, MPH
Birmingham, Ala

JAMA. 1996;275(8):594-595.

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In Reply.

—We appreciate the thoughtful comments by Drs Winett and Kalichman and by Drs Branson, Moore, and Byers regarding methodological issues relevant to our article.

One concern is the participation rate. Given that one recruitment strategy was distributing flyers throughout the target community, it is impossible to estimate how many eligible women saw flyers and chose not to participate. Another issue is that differential attrition rates may be attributable to frequency of contact associated with treatment conditions. This is likely. Moreover, as we pointed out, including a placebo-attention group may control for differential attention as a plausible explanation for treatment effects and reduce attrition. A third issue is the use of a single behavioral outcome, consistent condom use, to assess program efficacy. This measure was selected because of its public health significance in preventing HIV transmission.¹ Mathematical modeling suggests that, irrespective of the number of sexual partners and . . . [Full Text PDF of this Article]

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