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Intervention Description
Intervention Package Information
Evaluation Study and Results
References and Contact Information
Intervention Description
Target Population
Inner-city sexually active heterosexual STD clinic patients
Goals of Intervention
- Eliminate or reduce sex risk behaviors
Brief Description
The intervention consists of an
educational component and an HIV blood
test for STD patients. The educational
component includes a (a) written
pamphlet that explicitly discusses safe
and unsafe sexual acts and explains
condom use; (b) 15-minute video that
examines HIV risk behavior, promotes
condom use, and discusses potential
risks with sex partners; and (c)
10-minute, one-on-one counseling session
with a physician. The counseling
session, which includes all usual
aspects of HIV pretest counseling,
focuses on assessing personal risk,
discussing the elements of HIV testing,
and answering any questions about
HIV/AIDS or testing. After completing
the educational module, intervention
participants have blood drawn for an HIV
test. Test results are revealed
approximately 2 weeks after study entry
and are accompanied by the same risk
reduction messages as those presented
during the pre-test counseling (for seronegative results) or in-depth
counseling (for seropositive results). |
Theoretic Basis
None specified
Intervention Duration
Two sessions approximately two weeks apart
(one prior to and one after HIV testing)
Intervention Settings
Inner-city STD clinic
Deliverer
A physician (educational module) and clinic
nurse (for the clinic blood draw)
Delivery Methods
- Counseling
- Pamphlets
- Video
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Intervention Package Information
An intervention package is not available at this time. Please contact Dr.
Neil S. Wenger, UCLA Division of General Internal Medicine and Health Services
Research, 911 Broxton Plaza, RM 309, Los Angeles, CA 90095-1736. email:
nwenger@mednet.ucla.edu for details
on intervention materials.
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Evaluation Study and Results
The original evaluation was conducted in
Los Angeles in 1988.
Key Intervention Effects
- Reduced unprotected sex with last
partner
Study Sample
The analytic study sample of 186 STD clinic patients is characterized by the
following:
- 88% African American, 12% Other
- 67% Male, 33% Female
- 100% heterosexual
- Mean age of 27 years, range:
18-66 years
- 84% completed high school
education
Recruitment Settings
Inner-city STD clinic
Eligibility Criteria
STD clinic patients were eligible if they
were over 18 years of age, not homosexual or
bisexual, able to speak English, and able to
provide a follow-up address for the
follow-up questionnaire to be mailed to
them.
Assignment Method
Participants (N = 256) were randomly
assigned to 1 of 2 groups: AIDS education +
HIV testing intervention (n = 125) or AIDS
education only comparison (n = 131).
Comparison Group
The comparison group received the same
AIDS educational module as the intervention
group, but not the on-site HIV testing. They
were offered a list of locations for free
anonymous HIV antibody testing.
Relevant Outcomes Measured and Follow-up Time
Sex behaviors during the past month
(including the number of sex partners, the
number of episodes of vaginal and anal
intercourse and of oral sex with and without
a condom with all sex partners, and the
number of sex acts with the most recent
partner) were assessed at least 8 weeks post
baseline, which translate to approximate 6
weeks after intervention.
Participant Retention
- AIDS Education + HIV testing:
72% retained at approximately 6 weeks after intervention
- AIDS Education only:
74% retained at approximately 6 weeks after intervention
Significant Findings
Intervention participants were
significantly more likely than
comparison participants to report having
avoided vaginal or anal intercourse
without a condom with their last sexual
partner at 6 weeks after intervention (p
= .05).
Considerations
- This intervention fails to meet the best-evidence criteria due to a short
follow-up time.
- At 6 weeks after intervention, a significantly greater percentage of
intervention participants used a condom, had only oral sex, or stated that
they knew their partner’s HIV serostatus was negative compared to comparison
participants (p < .003). The difference between the groups in protected
sexual activity was greater when knowledge of a partner’s risk factors was
taken into account.
- Although both intervention and comparison groups received the AIDS
Education module, the intervention effect should be considered in the
context of AIDS Education and HIV testing combined rather than HIV testing
only.
- This two-session AIDS Education + HIV testing intervention is similar to
the more current HIV testing protocols described in the RESPECT project (see
2-session brief intervention). The RESPECT brief counseling
intervention, which meets the best-evidence criteria, is theory-based,
includes goal setting and exercises, was evaluated using a more rigorous
design, larger sample size, more diverse sample, and had stronger
intervention effects. The intervention package and training are available
for the RESPECT brief intervention through CDC’s
REP and
DEBI
projects.
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References and Contact Information
- Wenger, N. S., Linn, L. S., Epstein,
M., & Shapiro, M. F. (1991). Reduction
of high-risk sexual behavior among
heterosexuals undergoing HIV antibody
testing: A randomized clinical trial.
American Journal of Public Health,
81,
1580-1585.
Researcher: Dr. Neil S. Wenger
UCLA Division of General Internal
Medicine and Health Services Research
911 Broxton Plaza, RM 309
Los Angeles,
CA 90095-1736
email:
nwenger@mednet.ucla.edu
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