|
Individual-Level - HIV Positive
Person |
|
Patterson, T. L., Shaw, W. S., & Semple, S. J. (2003) Reducing
the sexual risk behaviors of HIV-positive individuals: Outcome
of a randomized control trial. Annals of Behavioral Medicine,
25, 137-145 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
|
HIV + Person |
This study evaluated an intervention designed to reduce sexual
risk behaviors of HIV positive persons. The basis for this
intervention was the social-cognitive theory (SCT). There were
387 HIV positive persons who reported having unprotected sex
with HIV negative partners or partners of unknown status
selected and randomly assigned to one of four intervention
conditions. (1) a single counseling sessions targeting problem
areas identified by the participant; 2) a single session that
covered all three intervention domains; 3) the same
comprehensive intervention followed by 2 monthly boosters; and
4) a three session diet and exercise attention-control
conditions. The ethnic minority composure of those
participating in the intervention consisted of the following:
65% non-Hispanic white, 15% African American, 12% Hispanic and
8% other. The majority of the participants were male (91%);
female participants consisted of 9%. |
The results suggest that brief behavioral interventions designed
to promote safer sex among HIV positive persons can result in
large reductions in HIV transmission. The use of a brief SCT-based
intervention for HIV positive persons, targeting condom use,
negotiation of safer sex practices, and disclosure can result in
reductions in sexual behavior associated with HIV transmission. |
|
Richardson, J. L., Milam, J., McCutchan, A., Stoyanoff, S.,
Bolan, R., Weiss, J., Kemper, C., Larson, R. A., Hollander, H.,
Weismuller, P., Chou, C. P., & Marks, G. (2004). Effects of
brief provider safer-sex counseling of HIV-1 seropositive
patients: A multi-clinic assessment. AIDS, 18, 1179-1186 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
|
HIV + Person
Implementing
of Integrating Prevention Services into Medical Care for People
Living with HIV |
The objective of this intervention was to test the efficacy of a
brief safer-sex counseling intervention for HIV positive clients
conducted by their medical providers. Six HIV clinics
participated in the intervention. Two clinics (214 clients)
used gain-frame messages, two clinics (175 clients) used
loss-frame messages, and two clinics (196) were
attention-control clinics. The counseling was a short 3-5
minute session and delivered to all HIV positive clients who
agreed to participate. The short messages were delivered each
time the client visited the medical provider’s office. |
The intervention trail found that brief safer sex counseling
provided by medical providers can be effective in reducing risky
sexual behavior. The lost-frame intervention reduced unsafe sex
in clients with multiple or casual partners. There was not a
reduction in those clients who had one partner at baseline
interviews; those clients had a much lower prevalence of UAV at
intake making it difficult for the intervention to reduce the
occurrence. |
|
Fisher, J. D., Cornman, D.H., Osborn, C. Y., Amico K. R.,
Fisher, W. A., & Friedland, G., A.. (2004) Clinician-initiated
HIV risk reduction intervention for HIV-positive persons;
Formative research, acceptability, and fidelity of the Options
project. Journal of Acquired Immunodeficiency Syndromes,
37, S78-S87. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
|
HIV + Heterosexual |
The theoretical foundations for this intervention are
motivational interviewing (MI) and information-motivation
behavioral skills (IMB). Research with 231 clients and
practitioners resulted in the formulation of this intervention.
Options is a “shell” or framework a clinician uses to elicit
the dynamics of HIV risk behavior and to assist in creating a
tailored HIV risk reduction intervention for their HIV positive
clients. Options is a 5 – 10 minute collaborative
client-centered discussion. There was a 9 step protocol
outlined for the clinician to follow. Each clinician received
practitioner training in order to conduct the intervention. |
The Options intervention was well accepted as a component of
routine HIV care. It was found to be acceptable and capable of
being delivered with fidelity in clinical care. The results
revealed patients exposed to the protocol reduced HIV sexual
risk behavior significantly over time. |
| Padian NS,
O’Brien TR et al. (1993) Prevention of Heterosexual Transmission
of Human Immunodeficiency Virus Through Couple Counseling.
Journal of Acquired Immunodeficiency Syndrome. 6(9): 1043-8 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| HIV+ Heterosexual |
144 HIV infected individuals and
their heterosexual partners. Every six months, each member of
the couple was interviewed separately by a staff member to
obtain demographic and behavioral information and offer couple
counseling. Couples were counseled together for first session
on how to purchase, store and use condoms; how to refrain from
practicing anal sex; how to choose abstinence; and how not to
enter into sexual relations with new partners |
The intervention was
effective at improving safer sex behaviors, with change
occurring between initial enrollment and the first follow up.
85% of the couples who did not use condoms at initial enrollment
did so by the most recent follow-up. During the intake
interview, 49% reported condom use. During the 1st
follow-up, 88% reported condom use. Other behavior changes were
also made. |
| Fisher D, Ryan R, et
al. (1999). Using a community partnership and motivational
interviewing to serve HIV+ gay and bisexual men. National HIV
Prevention Conference, 1999 [Abstract no. 680]. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| HIV+ |
Preliminary report. 107
HIV+ MSM who had anal sex in
preceding 4 months with a male partner. Using motivational
interviewing, assess values, beliefs, attitudes, and details on
4 most recent anal sex partners. In
discussion, highlight discrepancies between values, beliefs, and
risky sexual behaviors. |
Six-month
follow-up data show a 31% reduction in the proportions of
participants reporting unprotected anal
sex with a partner of negative or unknown serostatus. |
|
Wyatt, G. E., Lonngshore, D., Chin, D., Carmona, J. H., & Rivkin,
I. (2004). The efficacy of an integrated risk reduction
intervention for HIV-positive women with child sexual abuse
histories. AIDS and Behavior, 8, 453-462 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
|
HIV + Women |
It was believed that child sexual abuse
history (CSA) is associated with HIV risk behaviors. This
randomized trial tested the impact of a culturally
psychoeducational intervention designed to reduce sexual risk
and increase HIV medication adherence for HIV positive women
with a history of CSA. The study included African American,
European America, English-speaking and monolingual
Spanish-speaking Latina. Once recruited, 147 women were
randomly assigned to an 11 session “Enhanced Sexual Health
Intervention (ESHI)” or and attention control group. Women
assigned to the control group received a one-time group meeting
where they received HIV prevention and CSA information. Women
assigned to the ESHI condition attended 11 weekly sessions each
lasting approximately 2.5 hours. |
Women in the ESHI condition reported greater sexual risk
reduction than the women in the control condition. The
difference between the intervention (75.6%) and control group
(73/3%) were roughly the same concerning medication adherence.
However, women in the ESHI condition who attended at least 8
sessions reported great medication adherence (91.3%) at the
posttest than the women who attended seven or fewer sessions
(49.7%). The unadjusted percentage of women reporting sexual
risk reduction at posttest was higher in the ESHI group (63.6%)
than in the attention control group (56.8%). This was not
considered statistically significant. When adjusted for
covariates, the results were ESHI 74.5% and attention control
group 54.4%. |
|
Prevention Case Management
- HIV Positive Person
Back to Top |
| The CDC
has endorsed Prevention Case Management (PCM) as an effective
intervention to reach HIV positive and/or very high-risk
HIV negative persons. PCM is a client-centered HIV
prevention activity with the fundamental goal of promoting the
adoption and maintenance of HIV risk reduction behaviors by
clients with multiple, complex problems and risk reduction
needs. PCM provides client-centered, multiple-session HIV
risk reduction counseling while using the service brokerage of
traditional case management to address competing needs that may
make HIV prevention a lower priority. This HIV prevention
activity addresses the relationship between HIV risk and other
issues such as substance use, mental health, adherence issues,
social and cultural factors, and physical health problems.
While PCM has yet to be rigorously evaluated, intensive case
management interventions for clients with multiple, complex
problems have been shown to be effective in other health fields.
CDC HIV
Prevention Case Management – Guidance September 1997
CDC HIV
Prevention Case Management – Literature Review and Current Practice September 1997
CDC
Abbreviations and Acronyms |
|
Group-Level - HIV Positive Person
Back to Top |
|
Carey, M. P., Carey, K. B., Maisto, S. A., Gordon, C. M.,
Schroder, K. E. E., & Vanable, P. A. (2004). Reducing HIV risk
behavior among adults receiving outpatient psychiatric
treatment: results from a randomized controlled trial.
Journal of Counseling Clinical Psychology. April 2004 v74 i2
p252 (17) |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
|
HIV
+
Heterosexual |
This study investigated the efficacy of a 10 session, HIV risk
reduction intervention. There were 211 women and 187 men,
receiving outpatient psychiatric care for mental illness, who
participated in this intervention. Clients were randomly
assigned to one of three situations: HIV risk reduction
intervention, structurally equivalent substance use reduction
intervention, or standard care. Clients were assessed pre and
post intervention and at 3 and 6 month follow-up appointments. |
Compared to clients assigned to the other two situations,
clients assigned to the HIV risk reduction intervention reported
less unprotected sex, fewer casual partners and fewer new
sexually transmitted infections. They also reported more- safer
sex communications, improved knowledge, behavioral skills, more
positive condom attitudes, and stronger condom use intentions. |
|
Wingood, G., M., DiClemente, R. J., Mikhail, I., Lang, D. L.,
McCree, D. H., Davies, S. L., Mardin, J. W., Hook, E. W. 3rd,
Saag, M. (2004). A randomized controlled trial to reduce HIV
transmission risk behaviors and sexually diseases among women
living with HIV: The WILLOW program. Journal of Acquired
Immunodeficiency Syndromes, S58-S67 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
|
HIV + Women |
The WILLOW (women involved in life learning from other women)
object was to evaluate the efficacy of this intervention to
reduce HIV transmission risk behavior, STDs and enhance HIV
prevention psychosocial and structural factors among women
living with HIV. Once recruited, 366 women were randomly
assigned to the comparison group or to the intervention. Women
assigned to the comparison group participated in four 4 hour
sessions that addressed: medication adherence, nutrition, and
provided interaction skill. Women assigned the intervention
group also attended four 4 hour sessions, but there sessions
focused on knowledge, attitudes, self-efficacy, and skills
regarding safer sex. |
Over the 12 month follow-up, women in the intervention reported:
fewer episodes of unprotected vaginal intercourse, less likely
to report never using condoms; lower incidence of bacterial
infections; greater knowledge and condom self-effeminacy; more
network members; fewer beliefs that condoms interfere with sex;
fewer partner related barriers to using condom use; and
demonstrated grater skills in using condoms. |
| Fogarty LA, Heilig CM,
Armstrong K, et al. (2001). Long-Term Effectiveness of a
Peer-Based Intervention to Promote Condom and Contraceptive Use
among HIV-Positive and At-Risk Women. Public Health Reports
116: S103-S119. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| HIV+ women |
HIV infected women in one study
(N=322, Baltimore) and women at high risk for HIV infection in a
second study (N=1289, Philadelphia) assigned to a standard or
enhanced HIV prevention treatment group. Standard intervention
was access to Title X comprehensive health services throughout
study. The enhanced intervention added support groups and
one-on-one contacts with peer advocates tailored to clients’
needs. Based on Stage of Change Theory. |
Measurements at
baseline, 6 months, 12 months, and 18 months. For HIV infected
women, enhanced group had improved consistency in condom use,
increased perceived advantages of condom use, and increased
self-efficacy. For women at-risk, enhanced group showed no
sustained advantage over standard group. |
| Coates TJ, McKusick L
et al. (1989). Stress-reduction training changed numbers of
sexual partners but not immune function in men with HIV.
American Journal of Public Health 79: 885-7 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| HIV + MSM |
64 HIV+ gay men randomly assigned
to 1) eight 2-hour weekly group stress reduction training
session plus one all day retreat, or 2) a 2 month wait-list
control. |
At 2-month follow-up,
experimental group had fewer sexual partners in the past month
than control group (1.1 vs. 2.3). |
| Kalichman SC, Rompa D,
Cage M, et al. (2001). Effectiveness of an Intervention to
Reduce HIV Transmission Risks in HIV-Positive People.
American Journal Preventive Medicine 21(2): 84-92. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| HIV+ and African-American
"Health Relationships" |
233 men and 99 women living with
HIV/AIDS randomly assigned to receive either 1) a five-session
group intervention focused on strategies for practicing safer
sexual behavior, or 2) a five-session, contact-matched,
health-maintenance support group (standard-of-care comparison).
74% of participants were African-American. Based on Social
Cognitive Theory, emphasizing building behavioral skills,
enhancing self-efficacy for practicing risk-reduction behaviors,
promoting intentions to change, and developing strategies for
change. Framed intervention content within context of managing
stress related to HIV disclosure and practicing safer sexual
behavior. The five 120-minute sessions were delivered at the
rate of two per week using gender-specific presentations. This
intervention was outlined in CDC’s
Procedural Guidance
for selected strategies and interventions for CBOs under Program
Announcement 04064. |
Outcomes measured
immediately post intervention, 3 months, and 6 months. 78%
retention at 6 months. At 6-month follow-up, intervention group
reported fewer HIV negative partners, less unprotected anal and vaginal intercourse, and
greater condom use. |
| Kelly JA, St. Lawrence
JS et al. (1989). Behavioral intervention to reduce AIDS risk
activities. Journal of Consulting and Clinical Psychology
57: 60-7. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| HIV +, negative, or unknown status
high-risk MSM "Many Men, Men Voices" |
104 participants randomly assigned
to 1) 12 weekly sessions, 75-90 min small group counseling which
provided AIDS risk information, behavioral self-management,
assertiveness training, and relationship-building skills or 2) a
wait-list control. This intervention was outlined in CDC’s
Procedural Guidance for selected strategies and
interventions for CBOs under Program Announcement 04064. |
Skills training
resulted in less unprotected anal sex
(mean=2.3 for experimental group; 3.3 for control group) and
higher condom use during anal sex
in the past 4 months (experimental group used condoms during 66%
of all anal episodes; 19% for
control group). Behavior change maintained at 8-month follow-up |
| Kelly JA, St. Lawrence
JS et al. (1990). A skills-training group intervention model to
assist persons in reducing risk behaviors for HIV infection.
Education and Prevention 2: 24-35. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| HIV +, unknown, status, or negative
high-risk MSM |
Purpose of study to evaluate impact
of more abbreviated intervention than Kelly et al. (1989) above.
15 participants received 7 small group sessions, 60-90 min each.
Covered AIDS risk information, behavioral self-management,
assertiveness training, pride and support issues. One 3-month
follow-up booster session. |
At 8-month follow-up,
UAI in past 4 months fell from .93 to .21 mean occurrences.
Proportion of all intercourse occasions where condoms used
increased from 72% to 90%. Risk index (risky practices x no of
partners) decreased from 4.7 to 1.4. |
| Rotheram-Borus MJ, Lee
MB, Murphy DA et al. (2001) Efficacy of a prevention
intervention for youths living with HIV. American Journal of
Public Health 91: 400-5. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
Youth/ HIV+
(Mostly MSM)"Teens Linked to Care" |
310 youths, 72% male
(mostly MSM) and 28% female, aged 13-24, 27% African-Am and 37%
Latino. Study conducted at 9 adolescent clinical care sites in 4
cities. Assigned by small cohort to a 2-module ("Stay Healthy"
and "Act Safe") intervention with 23 sessions or to a control
condition. In intervention condition, 73% attended at least 1
session. Assessment of module 1 conducted 6 months after
completion. Assessment of module 2 conducted 3 months after
completion. Cohorts mixed according to sex. (Detailed manual
available on web at http://chipts.ucla.edu.) Had difficulty
getting youths to attend sessions. This intervention was
outlined in CDC’s
Procedural Guidance for selected
strategies and interventions for CBOs under Program Announcement
04064. |
Following "Stay Healthy" module,
number of positive lifestyle changes and active coping styles
increased among intervention females vs. control. Social support
coping increased for all intervention clients vs. controls.
Following "Act Safe" module, intervention youths reported 82%
fewer unprotected sexual acts, 45% fewer sexual partners, 50%
fewer HIV negative partners, and 31% less substance use than
controls. |
| Rhodes, F., Wood, MM,
Hershberger S (2000) A cognitive-behavioral intervention to
reduce HIV risk among active drug users. In staying negative in
a positive world: HIV prevention strategies that work (pp.
113-124). Sacramento: California Department of Health Services,
Office of AIDS. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| HIV + or negative IDUs "Safety
Counts" |
This intervention (Safety
Counts) is aimed at reducing high-risk drug use and sexual
behaviors of injective drug and crack cocaine users not in
treatment. This seven-session behaviorally focused intervention
includes both structured and unstructured psychoeducational
activities. These sessions were both in group and individual
settings over four to six months.
This intervention was outlined in CDC’s
Procedural
Guidance for selected strategies and interventions for CBOs
under Program Announcement 04064. |
Participants were more than 2.5
times more likely to self-report an increase in condom use at
follow-up (5-9 months following enrollment). They were also more
likely to report a reduction in the number of times they inject
and more likely to test negative for opiates through urinalysis.
Plus, they were also more likely to enter drug treatment. |
| Margolin A, Avants SK,
Warburton LA, Hawkins KA, Shi J. (2003). A randomized clinical
trial of a manual-guided risk reduction intervention for
HIV-positive injecting drug users. Health Psychology,
22(2) 223-228. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| HIV + IDUs "Holistic Harm
Reduction Program (HHRP)" |
This intervention uses
a 12-session, manual-guided, group level program to reduce harm,
promote health, and improve quality of life. The program is
based on the Information, Motivation, Behavior (IMB) model of
behavior change. In this program, HIV positive IDUs are viewed
as autonomous individuals responsible for making informed
choices concerning behaviors that pose risk to themselves and
others. Activities in this
intervention are designed to address clients as complex human
beings is search of physical emotional, social, and spiritual
well-being.
HHRP training manuals and other intervention materials
This intervention was outlined in CDC’s
Procedural Guidance for selected strategies and
interventions for CBOs under Program Announcement 04064. |
Participants in this intervention
exhibited many significant improvements. They included: measures
of addiction severity, harm reduction behaviors, harm reduction
knowledge, motivation, behavioral skills, and quality of life.
After three months, the participants displayed a greater
improvement in behavioral skills and showed a continued decrease
in addiction severity and risk behavior. Members in a control
group did not maintain gains. |
|
Partner Notification -
HIV Positive Person
Back to Top |
| Partner Counseling and
Referral Services to Identified Persons with Undiagnosed
HIV---North Carolina. MMWR December 5, 2003/52 (48);
1181-1184 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
|
In 1989, North Carolina Department
of Health and Human Services began offering PCRS to clients who
tested positive in confidential and anonymous testing venues.
HIV infection became reportable in 1990 and anonymous testing
was discontinued in 1997. A trained disease intervention
specialist (DIS) completed six important steps. All notified
partners received risk reduction counseling and appropriate
referrals. |
Data collected from 2001 revealed a
total of 1,603 persons were newly reported to have HIV
infections. DIS were assigned to conduct PCRS with 1,580 (99%)
index clients, 1,378 (87%) were located and PCRS identified
1,532 sex or needle sharing partners. 1,359 partners were
located and notified of their possible exposure to HIV. After
PCRS, from those who not previously testing positive for HIV,
108 newly tested partners were diagnosed HIV positive. |
|
CDC Technical Guidance for Partner Notification and Referral
Services
Procedural Guidance for Implementation of Partner Notification
and Referral Services (Adobe
Acrobat, 33 pages) An
alternative
format of this publication is also available upon request. |
|
No reviews on Mass &
Other Media, Social Marketing, Hotlines, and Clearinghouse for
HIV Positive Persons. |
|
|
|
No reviews on Mass & Other Media,
Social Marketing, Hotlines, and Clearinghouse for an HIV
Positive Person. |
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