title: Effectiveness of a video-based motivational skills-building HIV risk-reduction intervention for female military personnel.
abstract: Anecdotal evidence suggests that the HIV/AIDS prevalence rates in several African armed forces are high, with gender inequality rendering female military personnel more vulnerable to the disease. The objective of this study was to replicate a successful videotape-based HIV prevention intervention among Nigerian female military personnel in an effort to establish the cross-cultural stability, feasibility and cost-effectiveness of this approach in resource-limited countries. Enlisted women (N346) were recruited from two cantonments in Southwestern Nigeria and randomly assigned to either (a) a 5-session video-based, small group, cognitive-behavioral, HIV prevention intervention, or (b) a 5-session, video-based, contact-matched, HIV education control condition. Participants provided self-report of their HIV/AIDS-related knowledge and sexual behaviors at baseline, 3 and 6 months after completing the intervention. The results indicate that the motivational skills-building intervention did not improve participants' knowledge of HIV/AIDS any better than did the HIV education control condition at each assessment period, but it significantly increased condom use among women in this group by 53.6% at 3-month follow-up. HIV preventive behaviors among women in the motivational skills-building intervention group improved significantly, being 2 and 3 times more, compared to women in the HIV education control group at 3-month and 6-month follow-up assessments. The intervention also significantly improved behavioral intentions of participants as well as reduced alcohol use before sex by 25%, after 3 months; and number of sexual partners by 12% after 6 months. Women in the intervention group were five times more likely than women in HIV education control group to suggest that their new male partners use condom. These findings indicate that a videotape-based, HIV prevention intervention is a feasible and effective approach to HIV prevention among female military personnel from sub-Saharan Africa.
authors.affiliation: Institute of Community Health, University of Houston, Texas Medical Center, 1441 Moursund Street, Houston, TX 77030, USA. Ejessien@uh.edu
authors.forename: E James
authors.initials: EJ
authors.lastname: Essien
authors.forename: Osaro
authors.initials: O
authors.lastname: Mgbere
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Monjok
authors.forename: Ernest
authors.initials: E
authors.lastname: Ekong
authors.forename: Marcia M
authors.initials: MM
authors.lastname: Holstad
authors.forename: Seth C
authors.initials: SC
authors.lastname: Kalichman
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control*; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008889:Military Personnel / Q000193:education*; D009042:Motivation; D009549:Nigeria; D015397:Program Evaluation; D040242:Risk Reduction Behavior; D012725:Sexual Behavior; D014743:Videotape Recording; D055815:Young Adult