title: A gender-specific HIV/STD risk reduction intervention for women in a health care setting: short- and long-term results of a randomized clinical trial.
abstract: This study assessed the short- and long-term effect of a gender-specific group intervention for women on unsafe sexual encounters and strategies for protection against HIV/STD infection. Family planning clients (N = 360) from a high HIV seroprevalence area in New York City were randomized to an eight-session, a four-session or a control condition and followed at one, six and 12 months post-intervention. Using an intention-to-treat analysis, women who were assigned to the eight-session group had about twice the odds of reporting decreased or no unprotected vaginal and anal intercourse compared to controls at one month (OR = 1.93, 95% confidence interval [CI] = 1.07, 3.48, p = 0.03) and at 12-month follow-up (OR = 1.65, 95% CI = 0.94, 2.90, p = 0.08). Relative to controls, women assigned to the eight-session condition reported during the previous month approximately three-and-a-half (p = 0.09) and five (p < 0.01) fewer unprotected sex occasions at one- and 12-month follow-up, respectively. Women in the eight-session group also reduced the number of sex occasions at both follow-ups, and had a greater odds of first time use of an alternative protective strategy (refusal, outercourse, mutual testing) at one-month follow-up. Results for the four-session group were in the expected direction but overall were inconclusive. Thus, gender-specific interventions of sufficient intensity can promote short- and long-term sexual risk reduction among women in a family planning setting.
authors.affiliation: HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute, NY 10032, USA. ehrharda@child.cpmc.columbia.edu
authors.forename: A A
authors.initials: AA
authors.lastname: Ehrhardt
authors.forename: T M
authors.initials: TM
authors.lastname: Exner
authors.forename: S
authors.initials: S
authors.lastname: Hoffman
authors.forename: I
authors.initials: I
authors.lastname: Silberman
authors.forename: C-S
authors.initials: CS
authors.lastname: Leu
authors.forename: S
authors.initials: S
authors.lastname: Miller
authors.forename: B
authors.initials: B
authors.lastname: Levin
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D005193:Family Planning Services; D005260:Female; D005500:Follow-Up Studies; D005783:Gender Identity; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology; D006266:Health Education / Q000379:methods*; D006801:Humans; D009519:New York City; D012309:Risk-Taking; D021841:Safe Sex; D018401:Sample Size; D012736:Sex Education / Q000379:methods; D016387:Women's Health