Evaluating the impact of peer, nurse case-managed, and standard HIV risk-reduction programs on psychosocial and health-promoting behavioral outcomes among homeless women.
Investigators examined the 6-month impact of three cognitive-behavioral HIV risk-reduction programs on behavioral factors (substance use and sexual risk behaviors) and cognitive and psychological resources of 325 women who resided in emergency or sober-living shelters and their 308 intimate sexual partners. Participants were randomized by shelter to a peer-mentored, a nurse case-managed, or a standard care HIV risk-reduction program. Significant improvements were observed in all groups in all behavioral factors and cognitive and psychological resources except for self-esteem. Participants in the peer-mentored and nurse case-managed groups did not differ significantly from the standard group in self-esteem, life satisfaction, psychological well-being, use of noninjection drugs, sex with multiple partners, and unprotected sex at 6 months (n = 633). It was concluded that a standard approach by health care professionals appears to effectively modify HIV risk behaviors for a majority of homeless participants and may have important economic and policy implications. Further, the impact of short-term programs that address psychological vulnerabilities of impoverished populations needs to be studied further.
Nyamathi
A
A
School of Nursing, University of California, Los Angeles, Los Angeles, CA 90095-1702, USA.
Flaskerud
J H
JH
Leake
B
B
Dixon
E L
EL
Lu
A
A
D000293:Adolescent; D000328:Adult; D019090:Case Management; D005260:Female; D015658:HIV Infections / Q000451:nursing* / Q000517:prevention & control*; D015438:Health Behavior; D006293:Health Promotion; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D010379:Peer Group; D012649:Self Concept; D012747:Sexual Partners; D012944:Social Support; D014504:Urban Health; D016387:Women's Health