AIDS and Behavior

, Volume 11, Supplement 1, pp 127–137 | Cite as

The Treatment Advocacy Program-Sinai: A Peer-Based HIV Prevention Intervention for Working with African American HIV-Infected Persons

Original Paper


As HIV/AIDS continues to disproportionately affect African American communities, there is a growing need for empirically based, culturally appropriate, tailored interventions for this clientele. As part of a Health Resources and Services Administration (HRSA)/Special Projects of National Significance (SPNS) initiative to increase prevention amongst those living with HIV, we implemented the Treatment Advocacy Program Intervention at Mount Sinai Hospital in Chicago, IL, USA. The main goal of the intervention was to help patients increase their medication adherence and sexual safety skills. This paper describes the rationale for implementing this peer-based HIV-prevention intervention, discusses how the intervention was tailored to work within our low socio-economic status, urban patient population, and reviews the training and quality assurance activities needed to integrate the intervention into our primary care clinic. We review the intervention content in detail, including the structure of the multiple, one-on-one education sessions, and the core topics covered (medication adherence and sexual safety). Finally, we discuss the challenges in implementing this program, many of which arise from the chaotic social situations that our patients experience.


Treatment Advocacy Program HIV Prevention with Positives HIV Prevention with African Americans Peer-Based HIV Prevention 


  1. Anderson, J. R. (1996). Peer counseling for HIV-infected women. The Hopkins HIV Report, 8(2), 3.5. Retrieved August 31, 2006 from
  2. Boskay, K., Thomas, S., Gibbs, K., Harper, D., & Reina, M. (2005). Community area health inventory part two: Community area comparisons (Health Status Index Series, Vol. 15, No. 3). Chicago, IL, USA: Chicago Department of Public Health Office of Epidemiology.Google Scholar
  3. Boyd, M., Moneyham, L., Murdaugh, C., Phillips, K., Tavakoli, A., Jackwon, K., et al. (2005). A peer-based substance abuse intervention for HIV + rural women: A pilot study. Archives of Psychiatric Nursing, 19(1), 10–17.PubMedCrossRefGoogle Scholar
  4. Bright, J. I., Baker, K. D., & Neiymeyer, R. A. (1999). Professional and paraprofessional group treatments for depression: A comparison of cognitive-behavioral and mutual support interventions. Journal of Consulting and Clinical Psychology, 67(4), 491–501.PubMedCrossRefGoogle Scholar
  5. Cabral, R., Galavotti, C., Gargiullo, P., Armstrong, K., Cohen, A., Gielen, A., et al. (1996). Paraprofessional delivery of a theory based HIV prevention counseling intervention for women. Public Health Reports, 111(1), 75–82.PubMedGoogle Scholar
  6. Centers for Disease Control and Prevention. (1999). U.S. HIV and AIDS cases reported through June 1999. HIV/AIDS Surveillance Report, 11(1), 3–42.Google Scholar
  7. Centers for Disease Control and Prevention. (2003). Late Versus Early Testing of HIV—16 Sites, United States, 2000–2003. Morbidity and Mortality Weekly Report, 52(25), 581–586.Google Scholar
  8. Centers for Disease Control and Prevention. (2005). Mortality L285 slide series through 2002. Retrieved August 31, 2006 from Scholar
  9. Chicago Department of Public Health. (2005). STD/HIV/AIDS Chicago surveillance report. Chicago: Chicago Department of Public Health.Google Scholar
  10. Dean, H. D., Steele, C. B., Satcher, A. J., & Nakashima, A. K. (2005). HIV/AIDS among minority races and ethnicities in the United States, 1999–2003. Journal of the National Medical Association, 97(7), 55–125.Google Scholar
  11. DiClemente, R. J., & Wingood, G. M. (1995). A randomized controlled trial of an HIV sexual risk reduction intervention for young African-American women. Journal of the American Medical Association, 274(16), 1271–1276.PubMedCrossRefGoogle Scholar
  12. Fisher, J. D., & Fisher, W. A. (1992). Changing AIDS risk behavior. Psychological Bulletin, 111(3), 455–472.PubMedCrossRefGoogle Scholar
  13. Health Resources and Services Administration. (2005). Providing HIV/AIDS care in a changing environment. Retrieved on March 8, 2006 from Scholar
  14. Health Resources and Services Administration. (1997). Youth-to-youth-peer workers in HIV/AIDS youth program: A peer guide. Overview of HRSA/HAB’s SPNS adolescent care project. Retrieved on March 14, 2006 from Scholar
  15. Kalichman, S. C., Rompa, D., Cage, M., DiFonzo, K., Simpson, D., Austin, J., et al. (2001). Effectiveness of an intervention to reduce HIV transmission risks in HIV-positive people. American Journal of Preventive Medicine, 21(2), 84–92.PubMedCrossRefGoogle Scholar
  16. Kegeles, S. M., Hays, R. B., & Coates, T. J. (1996). The empowerment project: A community-level HIV prevention intervention for young gay men. American Journal of Public Health, 86(8), 1129–1136.PubMedGoogle Scholar
  17. Kelly, J. A., Murphy, D. A., Sikkema, K. J., McAuliffe, R. L., Roffman, R. A., Solomon, L. J., et al. (1997). Randomized, controlled, community-level HIV-prevention intervention for sexual-risk behavior among homosexual men in US cities. Community HIV prevention research collaborative. Lancet, 350(9090), 1500–1505.PubMedCrossRefGoogle Scholar
  18. Lauby, J. L., Smith, P. J., Stark, M., Person, B., & Adams, J. (2000). A community-level prevention intervention for inner city women: Results of the women and infants demonstration projects. American Journal of Public Health, 90(2), 216–222.PubMedGoogle Scholar
  19. Mayer, K. H. (Ed.) (2004). Recommendations for incorporating human immunodeficiency virus (HIV) prevention into the medical care of persons living with HIV. Clinical Infectious Diseases, 38(1), 104–121.CrossRefGoogle Scholar
  20. McKirnan, D. J., Swanson, F., Tolu-Shams, M., Ramey, B., Flynn, J., & Howard Brown Health Center. (2001). Effectiveness of a general coping approach to HIV adherence. Presentation at Society of Behavioral Medicine Conference, Seattle, WA.Google Scholar
  21. Morin, S. F., Koester, K. A., Steward, W. T., Maiorana, A., McLaughlin, M., Myers, J. J., et al. (2004). Missed opportunities: Prevention with HIV-infection patients in clinical care settings. Journal of Acquired Immune Deficiency Syndrome, 36(4), 960–966.CrossRefGoogle Scholar
  22. Neilson, B. A. (1995). Paraprofessionals: They can be competent, and there is more good news. Journal of Psychological Practice, 1(3), 133–140.Google Scholar
  23. Porco, T. C., Martin, J. N., Page-Shafer, K. A., Cheng, A., Charlebois, E., Grant, R. M., et al. (2004). Decline in HIV infectivity following the introduction of highly active antiretroviral therapy. AIDS, 18(1), 81–89.PubMedCrossRefGoogle Scholar
  24. Treisman, G., & Angelino, A. F. (2004). The psychiatry of AIDS. Baltimore, MD: Johns Hopkins University Press.Google Scholar
  25. Vargo, S., Agronick, G., O’Donnell, L., & Stueve, A. (2004). Using peer recruitment and OraSure to increase HIV testing. American Journal of Public Health, 94(1), 29–31.PubMedCrossRefGoogle Scholar
  26. Wingood, G., DiClemente, R., Mikhail, I., Lang, D., McCree, D., Davies, S., et al. (2004). A randomized controlled trial to reduce HIV transmission risk behaviors and sexually transmitted diseases among women living with HIV. Journal of Acquired Immune Deficiency Syndrome, 37(2), S58–S67.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Mount Sinai Hospital Medical Center, Urban Health InstituteChicagoUSA
  2. 2.University of Illinois at ChicagoChicagoUSA

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