title: Efficacy of an HIV intervention in reducing high-risk human papillomavirus, nonviral sexually transmitted infections, and concurrency among African American women: a randomized-controlled trial.
abstract: OBJECTIVE
  This trial evaluated the efficacy of an HIV-intervention condition, relative to a health-promotion condition, in reducing incidence of nonviral sexually transmitted infections (STIs; Chlamydia, gonorrhea, and trichomoniasis), oncogenic human papillomavirus (HPV) subtypes 16 and 18, sexual concurrency, and other HIV-associated behaviors over a 12-month period.
  
  
  METHODS
  Randomized-controlled trial. Data analysts blinded to treatment allocation.
  
  
  METHODS
  Kaiser Permanente, GA.
  
  
  METHODS
  A random sample of 848 African American women.
  
  
  METHODS
  The two 4-hour HIV intervention sessions were based on Social Cognitive Theory and the Theory of Gender and Power. The intervention was designed to enhance participants' self-sufficiency and attitudes and skills associated with condom use. The HIV intervention also encouraged STI testing and treatment of male sex partners and reducing vaginal douching and individual and male partner concurrency.
  
  
  METHODS
  Incident nonviral STIs.
  
  
  RESULTS
  In generalized estimating equations' analyses, over the 12-month follow-up, participants in the HIV intervention, relative to the comparison, were less likely to have nonviral incident STIs (odds ratio [OR] = 0.62; 95% confidence interval [CI]: 0.40 to 0.96; P = 0.033) and incident high-risk HPV infection (OR = 0.37; 95% CI: 0.18 to 0.77; P = 0.008) or concurrent male sex partners (OR = 0.55; 95% CI: 0.37 to 0.83; P = 0.005). In addition, intervention participants were less likely to report multiple male sex partners, more likely to use condoms during oral sex, more likely to inform their main partner of their STI test results, encourage their main partner to seek STI testing, report that their main partner was treated for STIs, and report not douching.
  
  
  CONCLUSIONS
  This is the first trial to demonstrate that an HIV intervention can achieve reductions in nonviral STIs, high-risk HPV, and individual concurrency.
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA. gwingoo@sph.emory.edu
authors.forename: Gina M
authors.initials: GM
authors.lastname: Wingood
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: Diclemente
authors.forename: Lashun
authors.initials: L
authors.lastname: Robinson-Simpson
authors.forename: Delia L
authors.initials: DL
authors.lastname: Lang
authors.forename: Angela
authors.initials: A
authors.lastname: Caliendo
authors.forename: James W
authors.initials: JW
authors.lastname: Hardin
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006678:HIV; D015658:HIV Infections / Q000150:complications / Q000517:prevention & control*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D030361:Papillomavirus Infections / Q000208:ethnology / Q000517:prevention & control*; D015397:Program Evaluation; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000208:ethnology / Q000517:prevention & control*; D016387:Women's Health; D055815:Young Adult