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Compendium of Evidence-Based HIV Behavioral Interventions

Nia: A Program of Purpose

GOOD-EVIDENCE

Intervention Description

Target Population
Inner-city heterosexually active, African American men

Goals of Intervention

  • Improve behavioral and communication skills
  • Eliminate or reduce sex risk behaviors

Brief Description

Nia is a video-based motivational skills-building small-group intervention consisting of 6-10 participants in each group. The intervention includes videos, movie clips, and discussion to educate men about HIV/AIDS, elevate their mood, and entertain them while reinforcing information and motivating behavior change. Facilitators discuss with participants ways to prevent HIV/AIDS, including condom use, condom attitudes and the pros and cons of condom use, and teach problem-solving, safer sex, and decision-making skills. Facilitators also teach male condom use skills through demonstration, modeling and practice with feedback using penile anatomical models, as well as show and discuss female condoms. The intervention also teaches personal risk reduction and sexual communication skills such as negotiating safer sex, sexual assertiveness, and risk refusal through movie clips and discussion.

Theoretic Basis

  • Information-Motivation-Behavioral (IMB) Skills Model

Intervention Duration
Two 3-hour sessions delivered over a week

Intervention Settings
Community-based center that housed multiple social services

Deliverer
Two community-based prevention service providers (1 man and 1 woman)

Delivery Methods

  • Demonstration
  • Exercises
  • Group Discussion
  • Practice
  • Risk Reduction Supplies (condoms)
  • Role play
  • Video

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Intervention Package Information

An intervention package was developed with funding from CDC’s Replicating Effective Programs (REP) Project. An intervention manual is available at: http://socialpsych.uconn.edu/downloads.html.

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Evaluation Study and Results

The original evaluation study was conducted in Atlanta, Georgia in 1994.

Key Intervention Effects

  • Reduced unprotected vaginal sex
  • Increased condom use

Study Sample
The baseline study sample of 133 heterosexually-active men is characterized by the following:

  • 100% African American
  • 100% Male
  • 84% heterosexual, 16% bisexual
  • Mean age of 33 years, range: 18-50 years
  • Mean education of 12 years

Recruitment Settings
STD clinic located in a county public health clinic

Eligibility Criteria
STD clinic patients were eligible if they were African American, heterosexual men and were sexually active in past 3 months.

Assignment Method
Men (N = 117) were randomly assigned to 1 of 2 groups: Nia (n = 60) or Video-based Education comparison (n = 57).

Comparison Group
The time-matched video-based education comparison was delivered to groups of 6-10 men and consisted of two 3-hour sessions delivered within the same week by community-based prevention service providers (1 man, 1 woman) who served as group facilitators. This intervention was implemented in a community center and used 4 videos to deliver HIV prevention information which included group discussions, questions and answers, and access to HIV/AIDS information and HIV testing

Relevant Outcomes Measured and Follow-up Time

  • Risk reduction strategies (including refused unsafe sex) were measured at 3- and 6-month follow-ups (recall period not reported).
  • Sex behaviors during past 3 months (including number of partners, frequencies of unprotected and protected vaginal and anal intercourse, proportion of protected intercourse) were measured at 3- and 6-month follow-ups.

Participant Retention

  • Nia Intervention:
    83% retained at 3 months
    72% retained at 6 months
  • Video-based Educational Comparison:
    84% retained at 3 months
    67% retained at 6 months

Significant Findings

  • The intervention participants reported significantly lower rates of unprotected vaginal intercourse than the comparison participants at the 3-month follow-up (p <.05).
  • At the 3-month follow-up, intervention participants reported a significantly greater proportion of condom-protected vaginal sex than comparison participants (p < .05), and a significantly greater proportion of intervention participants than comparison participants reported “almost always” using condoms (p = .02).

Considerations

  • This intervention fails to meet the best-evidence criteria due to small analytical sample sizes.
  • While the intervention meets GOOD-EVIDENCE criteria based on the 3-month findings, findings at the 6-month follow-up do not meet the criteria because of small sample sizes.
  • At the 3-month follow-up, relative to comparison participants, intervention participants reported significantly less alcohol use before sex (p < .05) and significantly less drug use in conjunction with sex (p < .05), and a significantly greater proportion of intervention participants reported talking with a partner about AIDS (p = .01).

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References and Contact Information

  • Kalichman, S.C., Cherry, C., & Browne-Sperling, F. (1999). Effectiveness of a video-based motivational skills-building HIV risk-reduction intervention for inner-city African American men. Journal of Consulting and Clinical Psychology, 67, 959-966.

Researcher: Seth C. Kalichman
Department of Psychology, University of Connecticut
406 Babbidge Road, Unit 1020
Storrs, CT 06269-1020
email: seth.k@uconn.edu

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