Keepin' It R.E.A.L.! A Mother-Adolescent HIV Prevention Program

Investigators: Colleen DiIorio, Frances McCarty, Dongqing Terry Wang, Pamela Denzmore, Ken Resnicow, Anindya K. De, William N. Dudley, PhD

The KEEPIN. IT R.E.A.L.! (Responsible, Empowered, Aware, Living) evaluation tested the effectiveness of two HIV prevention interventions designed for mothers and their adolescents, as compared to a control group. Sites were randomly assigned to one of three conditions: the Social-Cognitive program (SCT--four sites, the focus of this replication kit); another program not included in this kit; or the control condition (four sites). The SCT program was designed to delay initiation of sexual intercourse for those adolescents who were not yet sexually active, and to increase condom use among sexually active participants. SCT involved seven 2-hour meetings conducted over 14 weeks. Participating adolescents (N = 582) were between the ages of 11 and 14 years, mostly male (60%), and African American (97.7%). The number of participating mothers was 470; 110 mothers had more than one adolescent in the study. Assessments were conducted at baseline, and at 4, 12 and 24 months after baseline. At the 24-month assessment, a higher percent of sexually active participants in the SCT groups reported condom use at last sex compared to their control group peers (96% and 85%, respectively), condom use intentions (100% and 94%, respectively), and cessation of sexual activity until they were older (43% and 24%, respectively). For the mothers, their levels of self-efficacy and comfort for talking with their adolescents about sex increased over time. Both mothers and adolescents demonstrated an increase in HIV knowledge. Click here to view more detailed information on this program.

Let's Chat

Investigators: Seth C. Kalichman

Let’s Chat is a four-session intervention designed for use with same-sex groups of adults with chronic mental illness. Based on the Information-Motivation-Behavioral (IMB) Skills Model, Let’s Chat addresses risk-reduction needs specific to persons with mental illness. In each of the 90-minute sessions, a team of two facilitators conveys important AIDS-prevention information, alternating lectures and video clips with role-play and group-participation activities. Participants discuss sexual pressure and coercion, practice negotiating condom use, and learn the proper method for using both male and female condoms. All four sessions place emphasis on clear, simple messages and useful skills practice. Click here to view more detailed information on this program.

Los Angeles Women's Health Risk Study, 1990

Investigators: David Kanouse

Investigators interviewed a stratified probability sample of 1,024 female street prostitutes in Los Angeles County between May 1990 and February 1991 to study behavior that is linked to transmission of HIV and other STDs. Although the study also collected blood samples from a subsample of 638 women to examine markers for HIV infection, as well as past syphilis and hepatitis B infection, the original investigator did not include blood sample data in this public use dataset. The specific aims of this study were to: develop numerical estimates of the size of the prostitute population in Los Angeles County and its distribution by predominant mode of solicitation of customers; characterize prostitute career patterns; perform HIV antibody testing to determine the prevalence of HIV infection in this population and its subgroups; measure the prevalence and incidence of specific sexual and drug-related risk behaviors and prevention behaviors and determine how these are related to prostitute characteristics and risk and prevention behaviors; and compare the characteristics of the population of prostitutes with those subgroups most likely to be recruited in convenience samples (e.g., from jails or STD clinics). The present study is unique in describing the characteristics, risk behavior and serological status of a probability sample of street prostitutes from a major metropolitan area of the U.S., which is also in AIDS epicenter.

Mujer Segura, Healthy Woman

Investigators: Thomas Patterson, Brent Mausbach, Remedios Lozada, Hugo Staines-Orozco, Shirley Semple, Miguel Fraga-Vallejo, Prisci Orozovich, Daniela Abramovitz, Adela de la Torre, Hortensia Amaro, Gustavo Martinez, Carlos Magis-Rodriguez, & Steffanie Strathdee

The Mujer Segura Program aims to increase female sex workers' use of condoms during all sex exchanges. The program demonstrated increases in the total number of protected sex acts and decreases in overall sexually transmitted infection (including HIV) incidence. The program is composed of one session, lasting approximately 35 minutes. During this session, the counselor meets one-on-one with the individual participant and through the use of Motivational Interviewing techniques, assesses sexual risk behaviors; increases awareness of challenges related to condom use; and helps the participant develop solutions to increase safer sex practices. The counselor distributes free condoms and lubricant to all participants. Supervisors meet weekly with the program counselors to discuss program implementation and address any issues that may The Mujer Segura Program was originally implemented in two Mexican border cities of the United States with female sex workers. Although this program was specifically designed to increase condom use during sex exchanges, it may be suitable for use with other at-risk groups who engage in risky sexual behaviors. Click here to view more detailed information on this program.

Multimedia WiLLOW Training Modules

Investigators: Lucy Baden & Josefina J. Card

These multimedia, interactive training modules will help you train for and implement the intervention Multimedia WiLLOW: HIV Transmission Reduction Among African American Women Living with HIV. Multimedia WILLOW in an interactive computer-based intervention designed for African American women living with HIV that is gender relevant and culturally sensitive, based on the effective group intervention WiLLOW. The intervention incorporates elements of sexual risk reduction to reduce STI/HIV sexual transmission and to enhance psychosocial mediators and structural factors associated with preventive behaviors. The Multimedia WiLLOW training contains 6 modules, and covers important information and skills for administrators and facilitators. The modules contain videos, quizzes, and interactive learning exercises. Over the course of the training, the modules cover topics such as: program background and information; the original implementation(s) of the program; benefits and challenges of computer-delivered interventions; and other uses of the program.

Multimedia WiLLOW: HIV Transmission Reduction Among African American Women Living with HIV

Investigators: Josefina J. Card, Amie Ashcraft, John Wundes, Nikia Braxton, Gina Wingood, & Ralph DiClemente

Multimedia WILLOW in an interactive computer-based intervention designed for African American women living with HIV that is gender relevant and culturally sensitive, based on the effective group intervention WiLLOW. The intervention incorporates elements of sexual risk reduction to reduce STI/HIV sexual transmission and to enhance psychosocial mediators and structural factors associated with preventive behaviors. Designed for implementation in clinical or community-based settings, the two-session interactive, intervention emphasizes ethnic and gender pride, elements of sexual risk reduction, sexual negotiation skills, proper condom use, and development of partner norms supportive of consistent condom use. Each session offers multimedia learning, games and quizzes to help viewers increase and reinforce their risk-reduction awareness, knowledge, and skills. Women interact with the computer-based intervention individually and at their own speed. Only minimal staff participation is needed to implement Multimedia WiLLOW. A recent study demonstrated the efficacy of Multimedia WiLLOW. The evaluation study (N=168) used a randomized controlled design to examine Multimedia WILLOW.s efficacy by assessing participants. Multimedia WILLOW participants, compared to the control condition, had a significantly higher percentage of condom protected sex acts in the past 30 days (90% vs. 80%, p=.001). This greater condom use occurred with both HIV-negative (90% vs. 80%, p=.037) and HIV-positive (100% v. 70%, P=.011) partners. Women receiving Multimedia WILLOW were also more likely to report 100% condom use (OR = .10; p=.003) and had a lower adjusted mean number of unprotected vaginal and anal sex acts in the past 30 days (.31 vs. 2.33, P=.002). In comparison to women in the control condition, Multimedia WILLOW participants reported significantly higher levels of communication with their partners on HIV risk reduction practices (11.5 vs. 10.8, p=.052); greater sexual communication self-efficacy (36.1 vs. 34.0, p=.003); and less self-reported stress (32.3 vs. 34.3, p=.003). Participants rated the computer-delivered intervention more favorably than the standard of care condition in the four principal satisfaction categories -- enjoyment (4.69 v. 4.26, p

National AIDS Behavioral Survey (NABS II), 1992

Investigators: Center for AIDS Prevention Studies (CAPS); University of California, San Francisco

The National AIDS Behavioral Surveys (NABS) were designed to identify AIDS-relevant risk behaviors and their correlates in a population based sample of adults aged 18-75 residing in the contiguous United States. The overall study design allows for the description of sexual practices, drug use, HIV antibody test seeking, and levels of AIDS-related knowledge, beliefs and social skills over the adult life-span both for the U.S. as a whole and for the major high AIDS prevalence areas. Emphasis was placed on oversampling black and Hispanic populations with the major AIDS epicenters. The specific aims of the survey included: Estimating the prevalence of AIDS-relevant sexual practices in the United States as a whole and in different segments of the population (blacks, Hispanics, and whites; men and women; married and unmarried; age groups). Estimating the prevalence of HIV antibody test-seeking and levels AIDS-related knowledge, beliefs, attitudes, and social skills among various segments of the population (blacks, Hispanics, and whites; men and women; married and unmarried, age groups. Testing the three stages of the proposed AIDS Risk Reduction Model: (a) Labeling: To determine the effects of HIV transmission knowledge, AIDS anxiety, HIV susceptibility beliefs, and AIDS ethnocentrism on "labeling" high risk behavior (i.e. the belief that "unsafe" sex practices put one at risk for HIV infection). (b) Commitment: To examine the effects of response efficacy (i.e. beliefs that safe sex behaviors are enjoyable and decrease the risk of HIV infection) and self-efficacy (i.e. beliefs in one's ability to perform safe sex behaviors) on behavior intentions to buy condoms, to increase condom use, and to reduce multiple-partnered sex. (c) Enactment: To assess the effects of sexual communication, risk behavior labeling (stage 1 outcome) and commitment to change (stage 2 outcome) on buying condoms, condom use and multiple partnered sex. The National AIDS Behavioral Survey II (NABS II) is a telephone survey conducted as a follow-up to the National AIDS Behavioral Surveys I conducted in 1990-91. NABS II has the following specific aims: 1) Estimate changes from 1990/91 to 1992 in AIDS relevant sexual practices (number of sexual partners, unprotected vaginal/anal intercourse, condom use), HIV antibody test-seeking, injection drug use, and AIDS-relevant beliefs and social skills across gender and racial/ethnic groups in a national sample. 2) Estimate the extent to which various subgroups in the population mix sexually and thus are capable of spreading HIV or other sexually transmitted diseases out of established risk groups; such subgroups are defined by age, race/ethnicity, gender, sexual orientation, marital status, level of education, and geographic proximity. 3) Test the predictive power of the AIDS Risk Reduction Model (ARRM) in a longitudinal design. The dataset consists of 5,391 cases and 315 variables.

National AIDS Behavioral Surveys (NABS), NABS I, Complete Sample, 1990-92

Investigators: Center for AIDS Prevention Studies (CAPS); University of California, San Francisco

The National AIDS Behavioral Surveys (NABS) were designed to identify AIDS-relevant risk behaviors and their correlates in a population based sample of adults aged 18-75 residing in the contiguous United States. The overall study design allows for the description of sexual practices, drug use, HIV antibody test seeking, and levels of AIDS-related knowledge, beliefs and social skills over the adult life-span both for the U.S. as a whole and for the major high AIDS prevalence areas. Emphasis was placed on oversampling black and Hispanic populations with the major AIDS epicenters. The specific aims of the survey included: Estimating the prevalence of AIDS-relevant sexual practices in the United States as a whole and in different segments of the population (blacks, Hispanics, and whites; men and women; married and unmarried; age groups). Estimating the prevalence of HIV antibody test-seeking and levels AIDS-related knowledge, beliefs, attitudes, and social skills among various segments of the population (blacks, Hispanics, and whites; men and women; married and unmarried, age groups. Testing the three stages of the proposed AIDS Risk Reduction Model: (a) Labeling: To determine the effects of HIV transmission knowledge, AIDS anxiety, HIV susceptibility beliefs, and AIDS ethnocentrism on "labeling" high risk behavior (i.e. the belief that "unsafe" sex practices put one at risk for HIV infection). (b) Commitment: To examine the effects of response efficacy (i.e. beliefs that safe sex behaviors are enjoyable and decrease the risk of HIV infection) and self-efficacy (i.e. beliefs in one's ability to perform safe sex behaviors) on behavior intentions to buy condoms, to increase condom use, and to reduce multiple-partnered sex. (c) Enactment: To assess the effects of sexual communication, risk behavior labeling (stage 1 outcome) and commitment to change (stage 2 outcome) on buying condoms, condom use and multiple partnered sex. PETRA Dataset #06 is comprised of data from three samples: A nationally-representative, random-digit-dialed (RDD) telephone survey of adults; A partially overlapping RDD Central City Sample (separately weighted), and A sample of Hispanic surnamed households screened for race (Hispanic and African American only) and age (18-49 only)

National AIDS Behavioral Surveys (NABS); NABS I, Poststratified separately to selected U.S. metropolitan cities: Chicago, Detroit, Houston, Los Angeles, Miami, New York, Philadelphia, 1990-92

Investigators: Center for AIDS Prevention Studies (CAPS); University of California, San Francisco

The National AIDS Behavioral Surveys (NABS) were designed to identify AIDS-relevant risk behaviors and their correlates in a population based sample of adults aged 18-75 residing in the contiguous United States. The overall study design allows for the description of sexual practices, drug use, HIV antibody test seeking, and levels of AIDS-related knowledge, beliefs and social skills over the adult life-span both for the U.S. as a whole and for the major high AIDS prevalence areas. Emphasis was placed on oversampling black and Hispanic populations with the major AIDS epicenters. The specific aims of the survey included: Estimating the prevalence of AIDS-relevant sexual practices in the United States as a whole and in different segments of the population (blacks, Hispanics, and whites; men and women; married and unmarried; age groups). Estimating the prevalence of HIV antibody test-seeking and levels AIDS-related knowledge, beliefs, attitudes, and social skills among various segments of the population (blacks, Hispanics, and whites; men and women; married and unmarried, age groups. Testing the three stages of the proposed AIDS Risk Reduction Model: (a) Labeling: To determine the effects of HIV transmission knowledge, AIDS anxiety, HIV susceptibility beliefs, and AIDS ethnocentrism on "labeling" high risk behavior (i.e. the belief that "unsafe" sex practices put one at risk for HIV infection). (b) Commitment: To examine the effects of response efficacy (i.e. beliefs that safe sex behaviors are enjoyable and decrease the risk of HIV infection) and self-efficacy (i.e. beliefs in one's ability to perform safe sex behaviors) on behavior intentions to buy condoms, to increase condom use, and to reduce multiple-partnered sex. (c) Enactment: To assess the effects of sexual communication, risk behavior labeling (stage 1 outcome) and commitment to change (stage 2 outcome) on buying condoms, condom use and multiple partnered sex. PETRA Dataset #01 is comprised of a subset of the RDD Central City Sample (a partially overlapping, separately weighted RDD Central City Sample) divided into seven non-combinable subsamples from the following high risk urban areas: Chicago (n=951), Detroit (n=566), Houston (n=526), Los Angeles (n=839), Miami (n=494), New York (n=555), and Philadelphia (n=549). These samples, when properly weighted, may be used to make separate, individual estimates for large, high-risk metropolitan areas.

National Health and Social Life Survey, 1992

Investigators: Edward O. Laumann, Robert T. Michaels, John H. Gagnon, & Stuart Michaels

The 1992 National Health and Social Life Survey (NHSLS) is the most comprehensive representative survey to date of sexual behavior in the United States general population. Conducted by a research team centered at the University of Chicago, the NHSLS was designed not only to determine the prevalence of various sexual practices, but also to examine the social and psychological contexts in which those practices occur. The NHSLS dataset contains information on 1,604 variables gathered from interviews with a national probability sample of 3,432 American men and women between the ages of 18 and 59. The study explores the extent to which sexual conduct and general attitudes toward sexuality are influenced by gender, age, marital status, and other demographic characteristics. Among the numerous topics covered by the NHSLS are early sexual experiences, masturbation, contraception and fertility, sexual abuse, coercion, sexual health, satisfaction, sexual fantasy, sexual dysfunction and homosexuality. Demographic information was collected on race, religious affiliation, education, and income.