A Mixed Methods Evaluation of the Effect of the Protect and Respect Intervention on the Condom Use and Disclosure Practices of Women Living with HIV/AIDS
- 862 Downloads
This mixed methods study evaluated the efficacy of an intervention to increase HIV status disclosure and condom use among 184 women living with HIV/AIDS (WLH/A). Participants were recruited from an HIV clinic and randomly assigned to: (1) a comparison group, who received brief messages from their health care providers (HCPs), or; (2) an intervention group, who received messages from HCPs, a group-level intervention, and peer-led support groups. Participants completed risk surveys at baseline, 6-, 12-, and 18-months. Quantitative analyses using hierarchical generalized linear models within a repeated measures framework indicated that intervention participants had significantly higher odds of reporting condom use with sexual partners in months 6 and 18. Grounded Theory-based qualitative analyses suggested that the opportunity to discuss the social context of their lives in addition to HIV/AIDS, including continued stigma and fear related to disclosure, are also essential components of a prevention strategy for WLH/A.
KeywordsHIV prevention Sexual risk reduction Women living with HIV/AIDS Prevention with positives
The authors give special thanks to their supportive collaborators at HRSA, EPPEC, the Partnership Comprehensive Care Practice, and the School of Public Health at Drexel University. We are especially grateful to all of the women who participated in Protect and Respect. This research was supported by grant number 03048 from the Health Resources and Services Administration (HRSA) special projects of national significance (SPNS) program. This publication’s content is solely the responsibility of the authors and do not represent the official view of HRSA or the SPNS program.
- Aidala, A. A., Lee, G., Garbers, S., & Chiasson, M. A. (2006). Sexual behaviors and sexual risk in a prospective cohort of HIV-positive men and women in New York City, 1994–2002: Implications for prevention. AIDS Education and Prevention, 18(1), 12–32. doi: 10.1521/aeap.2006.18.1.12.CrossRefPubMedGoogle Scholar
- Centers for Disease Control and Prevention (CDC). (2008). HIV/AIDS among women. Retrieved September 1, 2008, from http://www.cdc.gov/hiv/topics/women/resources/factsheets/women.htm.
- Charmaz, K. (2006). Constructing Grounded Theory, a practical guide through qualitative analysis. London: Sage.Google Scholar
- Collins, C., Morin, S. F., Shriver, M., & Coates, T. J. (2000). Designing primary prevention for people living with HIV (policy monograph series). University of California, San Francisco: AIDS Policy and Research Center & Center for AIDS Prevention Studies.Google Scholar
- Diaz, R. (2007). Impact on communities of color. National HIV Prevention Conference. Atlanta, GA.Google Scholar
- Ehrhardt, A. A., Exner, T., Miller, S., & Stein, Z. (1992). Sexual risk behavior and behavior change in heterosexual women and men. New York: HIV Center for Clinical and Behavioral Studies at the New York Psychiatric Institute.Google Scholar
- Fisher, J. D., Fisher, W. A., Cornman, D. H., Amico, R. K., Bryan, A., & Friedland, G. H. (2006). Clinician-delivered intervention during routine clinical care reduces unprotected sexual behavior among HIV-infected patients. Journal of Acquired Immune Deficiency Syndromes, 41(1), 44–52. doi: 10.1097/01.qai.0000192000.15777.5c.CrossRefPubMedGoogle Scholar
- Fogarty, L. A., Heilig, C. M., Armstrong, K., Cabral, R. J., Galavotti, C., Gielen, A. C., 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(Supplement 1), S103–S119. doi: 10.1093/phr/116.S1.103.CrossRefGoogle Scholar
- Kalichman, S. C. (2004). Positive prevention, reducing HIV transmission among people living with HIV/AIDS. New York: Kluwer.Google Scholar
- 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. doi: 10.1016/S0749-3797(01)00324-5.CrossRefPubMedGoogle Scholar
- Kvale, S. (1996). Interviews: An introduction to qualitative research interviewing. Thousand Oaks, CA: Sage.Google Scholar
- Maman, S., & Medley, A. (2004). Gender dimensions of HIV status disclosure to sexual partners: Rates, barriers and outcomes. Geneva: World Health Organization.Google Scholar
- Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: Applications and data analysis methods. Thousand Oaks, CA: Sage.Google Scholar
- Richardson, J. L., Milam, J., McCutchan, A., Stoyanoff, S., Boland, R. J., Weiss, J., et al. (2004). Effect of brief safer-sex counseling by medical providers to HIV-1 seropositive patients: A multi-clinic assessment. AIDS (London, England), 18, 1179–1186. doi: 10.1097/00002030-200405210-00011.Google Scholar
- Sikkema, K. J., Hansen, N. B., Kochman, A., Tarkeshwar, N., Nuefeld, S., Meade, C. S., et al. (2007). Outcomes from a group intervention for coping with HIV/AIDS and childhood sexual abuse: Reductions in traumatic stress. AIDS and Behavior, 11, 49–60. doi: 10.1007/s10461-006-9149-8.CrossRefPubMedGoogle Scholar
- Simbayi, L. C., Kalichman, S. C., Strebel, A., Cloete, A., Henda, N., & Mqeketo, A. (2007). Disclosure of HIV status to sex partners and sexual risk behaviors among HIV-positive men and women, Cape Town, South Africa. Sexually Transmitted Infections, 83(1), 29–34. doi: 10.1136/sti.2006.019893.CrossRefPubMedGoogle Scholar
- Teti, M., Bowleg, L., & Lloyd, L. (2008). “Don’t ever stop these groups”: The role of group interventions for women living with HIV/AIDS (manuscript submitted for publication).Google Scholar
- The Healthy Living Project Team. (2007). Effects of a behavioral intervention to reduce risk of transmission among people living with HIV: The healthy living project randomized controlled study. Journal of Acquired Immune Deficiency Syndromes, 44(2), 213–221. doi: 10.1097/QAI.0b013e31802c0cae.CrossRefGoogle Scholar
- Wingood, G. M., DiClemente, R. J., Mikhail, I., Lang, D. L., McCree, D. H., Davis, 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 Syndromes, 37(Suppl 2), S58–S67. doi: 10.1097/01.qai.0000140603.57478.a9.PubMedGoogle Scholar