Long-term effectiveness of a peer-based intervention to promote condom and contraceptive use among HIV-positive and at-risk women.
OBJECTIVE
The authors used data from a larger study to evaluate the long-term effects of a peer advocate intervention on condom and contraceptive use among HIV-infected women and women at high risk for HIV infection.


METHODS
HIV-infected women in one study and women at high risk for HIV infection in a second study were selected from the Women and Infants Demonstration Project and assigned to a standard or an enhanced HIV prevention treatment group. The enhanced intervention included support groups and one-on-one contacts with peer advocates tailored to clients' needs. The authors interviewed women at baseline and at 6-, 12- and 18-months, and measured changes in consistency of condom and contraceptive use and in self-efficacy and perceived advantages and disadvantages of condom and contraceptive use.


RESULTS
Of HIV-infected women, the enhanced group had improved consistency in condom use, increased perceived advantages of condom use, and increased level of self-efficacy compared with the standard group. Of women at risk, the enhanced intervention group at six months maintained consistent condom use with a main partner and perceived more benefit of condom use compared with the standard group. These differences diminished at 12 months.


CONCLUSIONS
The enhanced intervention was generally effective in the HIV+ study. In the at-risk study, however, intervention effects were minimal and short-lived. Factors related to the theory, intervention design, and sample characteristics help explain these differences.
Fogarty
L A
LA
Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA. lfogarty@jhsph.edu
Heilig
C M
CM
Armstrong
K
K
Cabral
R
R
Galavotti
C
C
Gielen
A C
AC
Green
B M
BM
D000293:Adolescent; D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D018672:Community Health Planning; D017280:Condoms / Q000706:statistics & numerical data; D003270:Contraceptive Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D010379:Peer Group; D015143:Philadelphia / Q000453:epidemiology; D011322:Primary Prevention; D018570:Risk Assessment; D012309:Risk-Taking; D021841:Safe Sex / Q000523:psychology / Q000706:statistics & numerical data*; D020377:Self Efficacy; D012657:Self-Help Groups; D013995:Time; D016387:Women's Health
D003270:Contraceptive Agents