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Compendium of Evidence-Based HIV Behavioral Interventions

Female Condom Skills Training (FEMIT)

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Intervention Description

Target Population
HIV-negative heterosexual women attending family planning clinics

Goals of Intervention

  • Increase use of female condoms
  • Increase protected sex

Brief Description

The Female Condom Skills Training (FEMIT) is a 4-session intervention designed to increase knowledge about safer sexual practices, condom use skills, and ability to negotiate condom use. The first 2 sessions (2hours each) are delivered to individual participants by a health educator and focus on safer sex education, male and female condom use, and communication skills building. These 2 sessions include demonstration and practice of male and female condom use, address personal barriers to female condom use, and introduce and practice effective communication skills for talking to male partners about female condoms. The third session is conducted in small groups of 6-10 women and facilitated by 2 health educators. This 2.5-hour group discussion focuses on barriers to and eroticization of female condom use and negotiation skills building. The last session is a 30-minute telephone follow-up with each individual participant to review personal goals made during previous sessions, and to identify and address any additional barriers to female condom use. Participants also receive male and female condom supplies based on the reported amount of sexual activity.

Theoretic Basis

  • Social Learning Theory

Intervention Duration
Four sessions delivered over 6 weeks, including 2 individual and 1 group session ranging from 2 to 2.5 hours and a 30-minute telephone follow-up session

Intervention Settings
Family planning clinics

Deliverer
Health educators

Delivery Methods

  • Demonstration
  • Discussion
  • Exercises
  • Goal setting
  • Interactive activities
  • Lecture
  • Practice
  • Risk reduction supplies
  • Role play
  • Video

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Intervention Package Information

An intervention package is not available at this time. Please contact Dr. Kyung-Hee Choi, Center for AIDS Prevention Studies, University of California, San Francisco, 50 Beale Street, Suite 1300, San Francisco, CA 94105, email: kyung-hee.choi@ucsf.edu for details on intervention materials.

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Evaluation Study and Results

The original evaluation was conducted in 4 San Francisco Bay Area cities (Concord, Mountain View, Santa Cruz, and San Francisco), California, between 2003 and 2005.

Key Intervention Effects

  • Increased female condom use
  • Increased any condom use

Study Sample
The baseline study sample of 409 women is characterized by the following:

  • 64% White, 17% Hispanic, 11% African American, 8% Asian
  • 100% Female
  • Mean age of 22 years, range: 18-39 years
  • 42% completed high school and 16% completed at least some college

Recruitment Settings
Family planning clinics

Eligibility Criteria
Women were eligible if they self-identified as African American, Asian, Latina or White, were English-speakers, between 18 and 39 years of age, had 2 or more male sexual partners in the prior year, had no known allergies to polyurethane, latex or lubricants, were HIV-negative, had no plans to get pregnant within the next 6 months, and attended the first scheduled intervention session.

Assignment Method
Women (N = 409) were assigned using block randomization, stratified by race/ethnicity, to 1 of 2 groups: FEMIT intervention (n = 213) or Women’s General Health Promotion comparison (n = 196).

Comparison Group
The Women’s General Health Promotion comparison was designed to increase knowledge about behaviors associated with major health problems (e.g., cancer and heart disease) and to improve motivation to change health risk behaviors. The format and length (4 sessions over 6 weeks delivered by health educators individually and in groups) were identical to those of the FEMIT intervention and included a demonstration of female condom use. Participants also received male and female condom supplies based on the reported amount of sexual activity.

Relevant Outcomes Measured and Follow-up Time

  • Sex behaviors (including using a female or male condom at least once for anal or vaginal intercourse, and anal or vaginal intercourse protected by female condoms, by male condoms, or by any condom during the past 3 months) were measured at 3 and 6 months post-intervention

    Participant Retention

    • FEMIT Intervention:

      83% retained at 3 months
      83% retained at 6 months

    • Women’s General Health Promotion Comparison:

      87% retained at 3 months
      88% retained at 6 months

    Significant Findings

    • Intervention participants were significantly more likely to report female condom use at least once at the 3-month follow-up (p < .001) and at the 6-month follow-up (p < .001) than comparison participants.
    • At the 6-month follow-up, intervention participants reported a significantly higher proportion of vaginal or anal intercourse acts protected by any male or female condom than the comparison group (p = .028).
    • Across the 2 follow-up time points, intervention participants reported a significantly higher proportion of vaginal or anal intercourse acts protected by a female condom (p = .04) and by any male or female condom (p = .032) than comparison participants.

    Considerations

    • None

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    References and Contact Information

    • Choi, K.-H., Hoff, C., Gregorich, S.E., Grinstead, O., Gomez, C., Hussey, W. (2008). The efficacy of female condom skills training in HIV risk reduction among women: A randomized controlled trial. American Journal of Public Health, 98, 1841-1848.

    Researcher: Dr. Kyung-Hee Choi
    Center for AIDS Prevention Studies
    University of California, San Francisco
    50 Beale Street, Suite 1300
    San Francisco, CA 94105
    email: kyung-hee.choi@ucsf.edu

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