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Price A, de Bell S, Shaw N, Bethel A, Anderson R, Coon JT. What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1264. [PMID: 36909883 PMCID: PMC9316011 DOI: 10.1002/cl2.1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background Peer support interventions involve people drawing on shared personal experience to help one another improve their physical or mental health, or reduce social isolation. If effective, they may also lessen the demand on health and social care services, reducing costs. However, the design and delivery of peer support varies greatly, from the targeted problem or need, the setting and mode of delivery, to the number and content of sessions. Robust evidence is essential for policymakers commissioning peer support and practitioners delivering services in health care and community settings. This map draws together evidence on different types of peer support to support the design and delivery of interventions. Objectives The aim of this map was to provide an overview of the volume, diversity and nature of recent, high quality evidence on the effectiveness and cost-effectiveness of the use of peer support in health and social care. Search Methods We searched MEDLINE, seven further bibliographic databases, and Epistemonikos for systematic reviews (in October 2020), randomised controlled trials (in March 2021) and economic evaluations (in May 2021) on the effectiveness of peer support interventions in health and social care. We also conducted searches of Google Scholar, two trial registers, PROSPERO, and completed citation chasing on included studies. Selection Criteria Systematic reviews, randomised controlled trials and economic evaluations were included in the map. Included studies focused on adult populations with a defined health or social care need, were conducted in high-income countries, and published since 2015. Any measure of effectiveness was included, as was any form of peer support providing the peer had shared experience with the participant and a formalised role. Data Collection and Analysis Data were extracted on the type of peer support intervention and outcomes assessed in included studies. Standardised tools were used to assess study quality for all studies: assessing the methodological quality of systematic reviews 2 for systematic reviews; Cochrane risk of bias tool for randomised controlled trials; and consensus health economic criteria list for economic evaluations. Main Results We included 91 studies: 32 systematic reviews; 52 randomised controlled trials; and 7 economic evaluations. Whilst most included systematic reviews and economic evaluations were assessed to be of low or medium quality, the majority of randomised controlled trials were of higher quality. There were concentrations of evidence relating to different types of peer support, including education, psychological support, self-care/self-management and social support. Populations with long-term health conditions were most commonly studied. The majority of studies measured health-related indicators as outcomes; few studies assessed cost-effectiveness. Studies were unevenly distributed geographically, with most being conducted in the USA. Several gaps were evident regarding the delivery of peer support, particularly the integration of peers and professionals in delivering support and interventions of longer duration. Authors' Conclusions Although there is evidence available to inform the commissioning and delivery of peer support in health and social care, there are also clear gaps that need to be addressed to further support provision, particularly regarding cost-effectiveness. The effectiveness of peer support in different countries, with varying health and social care systems, is a priority for future research, as is the integration of peers with professionals in delivering peer support.
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Affiliation(s)
- Anna Price
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Siân de Bell
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Naomi Shaw
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Alison Bethel
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Rob Anderson
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Jo Thompson Coon
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
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Ramos SR, Nelson LE, Jones SG, Ni Z, Turpin RE, Portillo CJ. A State of the Science on HIV Prevention Over 40 Years Among Black and Hispanic/Latinx Communities. J Assoc Nurses AIDS Care 2021; 32:253-263. [PMID: 33929978 PMCID: PMC8223201 DOI: 10.1097/jnc.0000000000000266] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT We present a state of the science on HIV behavioral prevention interventions in Black and Hispanic/Latinx communities. The purpose of this article is threefold: (a) highlight the early documented underlying social and political barriers that constrained interventions to prevent new HIV infections; (b) address the structural inequities in HIV prevention and treatment; and (c) describe the need for increasing HIV multilevel prevention interventions that support greater HIV testing and pre-exposure prophylaxis uptake. To address HIV prevention, multilevel interventions that address individual, structural, and social level components have demonstrated more sustainable outcomes. Implications for research and clinical practice include (a) updating antiquated curricula in nursing, medicine, and public health that perpetuate racial, structural-level inequities and (b) increasing the pipeline for Black and Hispanic/Latinx persons to pursue research or clinical-focused doctorate degrees.
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Affiliation(s)
- S. Raquel Ramos
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | | | - Sandra Gracia Jones
- Chronic Disease Prevention and Care, Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, Florida, USA
| | - Zhao Ni
- Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Rodman E. Turpin
- Department of Epidemiology and Biostatistics, University of Maryland College Park, School of Public Health, College Park, Maryland, USA
| | - Carmen J. Portillo
- Yale University School of Nursing, Yale University, New Haven, Connecticut, USA
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Abad N, Baack BN, O'Leary A, Mizuno Y, Herbst JH, Lyles CM. A Systematic Review of HIV and STI Behavior Change Interventions for Female Sex Workers in the United States. AIDS Behav 2015; 19:1701-19. [PMID: 25711295 DOI: 10.1007/s10461-015-1013-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The lives of female sex workers (FSW) in the US are typically marked by substance abuse, violence, trauma, and poverty. These factors place FSW at risk for acquiring and transmitting HIV and other sexually transmitted infections (STIs). The purpose of this systematic review is to examine HIV/STI interventions conducted in the US that aim to reduce sexual- or drug-related risk behavior among FSW. Eighteen studies describing 19 unique interventions met our selection criteria: five exclusively targeted FSW, two reported stratified data for FSW, and 12 included at least 50 % FSW. Results indicate that 15 interventions provided HIV/STI information, 13 provided substance abuse prevention information, and few included content tailored to specific needs of FSW. Our findings suggest that current HIV/STI prevention efforts in the US do not adequately address the needs of FSW. Interventions are needed to address issues facing FSW in order to reduce HIV/STI transmission in this high-risk group.
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Affiliation(s)
- Neetu Abad
- Division of STD Prevention, NCHHSTP, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E-44, Atlanta, GA, 30333, USA,
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Shepherd JP, Frampton GK, Harris P. Interventions for encouraging sexual behaviours intended to prevent cervical cancer. Cochrane Database Syst Rev 2011; 2011:CD001035. [PMID: 21491379 PMCID: PMC4040418 DOI: 10.1002/14651858.cd001035.pub2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is the key risk factor for cervical cancer. Continuing high rates of HPV and other sexually transmitted infections (STIs) in young people demonstrate the need for effective behavioural interventions. OBJECTIVES To assess the effectiveness of behavioural interventions for young women to encourage safer sexual behaviours to prevent transmission of STIs (including HPV) and cervical cancer. SEARCH STRATEGY Systematic literature searches were performed on the following databases: Cochrane Central Register of Controlled Trials (CENTRAL Issue 4, 2009) Cochrane Gynaecological Cancer Review Group (CGCRG) Specialised Register, MEDLINE, EMBASE, CINAHL, PsychINFO, Social Science Citation Index and Trials Register of Promoting Health Interventions (TRoPHI) up to the end of 2009. All references were screened for inclusion against selection criteria. SELECTION CRITERIA Randomised controlled trials (RCTs) of behavioural interventions for young women up to the age of 25 years that included, amongst other things, information provision about the transmission and prevention of STIs. Trials had to measure behavioural outcomes (e.g. condom use) and/or biological outcomes (e.g. incidence of STIs, cervical cancer). DATA COLLECTION AND ANALYSIS A narrative synthesis was conducted. Meta-analysis was not considered appropriate due to heterogeneity between the interventions and trial populations. MAIN RESULTS A total of 5271 references were screened and of these 23 RCTs met the inclusion criteria. Most were conducted in the USA and in health-care clinics (e.g. family planning).The majority of interventions provided information about STIs and taught safer sex skills (e.g. communication), occasionally supplemented with provision of resources (e.g. free sexual health services). They were heterogeneous in duration, contact time, provider, behavioural aims and outcomes. A variety of STIs were addressed including HIV and chlamydia. None of the trials explicitly mentioned HPV or cervical cancer prevention.Statistically significant effects for behavioural outcomes (e.g. increasing condom use) were common, though not universal and varied according to the type of outcome. There were no statistically significant effects of abstaining from or reducing sexual activity. There were few statistically significant effects on biological (STI) outcomes. Considerable uncertainty exists in the risk of bias due to incomplete or ambiguous reporting. AUTHORS' CONCLUSIONS Behavioural interventions for young women which aim to promote sexual behaviours protective of STI transmission can be effective, primarily at encouraging condom use. Future evaluations should include a greater focus on HPV and its link to cervical cancer, with long-term follow-up to assess impact on behaviour change, rates of HPV infection and progression to cervical cancer. Studies should use an RCT design where possible with integral process evaluation and cost-effectiveness analysis where appropriate. Given the predominance of USA studies in this systematic review evaluations conducted in other countries would be particularly useful.
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Affiliation(s)
- Jonathan P Shepherd
- University of SouthamptonSouthampton Health Technology Assessments Centre (SHTAC)1st Floor Epsilon HouseEnterprise Road, Southampton Science ParkChilworth, SouthamptonHampshireUKSO16 7NS
| | - Geoff K Frampton
- University of SouthamptonSouthampton Health Technology Assessments CentreFirst Floor, Epsilon House, Enterprise Road, Southampton Science Park, ChilworthSouthamptonHampshireUKSO16 7NS
| | - Petra Harris
- University of SouthamptonSouthampton Health Technology Assessments Centre (SHTAC)1st Floor Epsilon HouseEnterprise Road, Southampton Science ParkChilworth, SouthamptonHampshireUKSO16 7NS
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Ward EG, Disch WB, Schensul JJ, Levy JA. Understanding low-income, minority older adult self-perceptions of HIV risk. J Assoc Nurses AIDS Care 2011; 22:26-37. [PMID: 20580270 PMCID: PMC2948611 DOI: 10.1016/j.jana.2010.05.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Accepted: 05/17/2010] [Indexed: 10/19/2022]
Abstract
The number of people ages 50 or older living with HIV in the United States is increasing. Yet, few older adults see themselves at risk of infection. This study examines the heuristic reasoning that low income, minority adults, ages 50 or older use in calculating the likelihood of infection. The data are drawn from face-to-face interviews with a sample of 134 African American and Latino residents, ages 50 to 86, living in low-income housing in Chicago, Illinois, and Hartford, Connecticut. Results show that nearly half of the study's participants thought themselves to be at some level of risk for HIV. In self-assessing their risk, they relied on seven heuristic categories: self-imperilment, social imperilment, fate, incidental contact, situational safety, medical iatrogenesis, and self-protection. These findings extend our understanding of how individuals make sense of their likelihood of experiencing a major health threat and provide insight into more effective HIV prevention programming for older adults.
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Affiliation(s)
- Elijah G Ward
- Department of Sociology, Anthropology and Criminal Justice, Saint Xavier University, Chicago, Illinois, USA
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Brecht ML, Stein J, Evans E, Murphy DA, Longshore D. Predictors of intention to change HIV sexual and injection risk behaviors among heterosexual methamphetamine-using offenders in drug treatment: a test of the AIDS Risk Reduction Model. J Behav Health Serv Res 2008; 36:247-66. [PMID: 18214688 DOI: 10.1007/s11414-007-9106-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2007] [Accepted: 12/17/2007] [Indexed: 11/29/2022]
Abstract
This study tested components of the acquired immunodeficiency syndrome (AIDS) Risk Reduction Model (ARRM) for a sample of methamphetamine-using offenders in drug treatment. Analyses included the first two stages of the ARRM, problem recognition and intention to reduce risk (potential precursors to later possible behavior change), assessing predictors of intentions to increase condom use, reduce other sexual risk, and disinfect needles. Path analysis results showed potential applicability of the ARRM as a basis for intervention development for this population. There was a consistent effect of self-efficacy for risk reduction strategies, as well as direct or indirect effects of problem recognition factors (AIDS knowledge, peer norms), on the three intention indicators. Prior sex risk behavior (condom use) was directly negatively related to intention to use condoms; prior needle use was indirectly negatively related to intention to disinfect. Intention to use condoms was lower for women. Results can help identify areas for intervention development.
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Affiliation(s)
- Mary-Lynn Brecht
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California-Los Angeles, 1640 S. Sepulveda Blvd., Suite 200, Los Angeles, CA 90025, USA.
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Schlosser AV, Abdallah AB, Callahan CL, Bradford S, Cottler LB. Does readiness to change predict reduced crack use in human immunodeficiency virus prevention? J Subst Abuse Treat 2007; 35:28-35. [PMID: 17935929 DOI: 10.1016/j.jsat.2007.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Revised: 07/09/2007] [Accepted: 08/08/2007] [Indexed: 11/28/2022]
Abstract
This study examines crack cocaine (crack) use, readiness to change, and gender in a sample of 923 men and women randomized to standard human immunodeficiency virus (HIV) education (standard intervention [SI]) or peer-delivered intervention (enhanced intervention [EI]). Four levels of crack use characterized frequency of use in the past 30 days; readiness was assessed on three levels (precontemplation, contemplation, and preparation/action). Differences between intervention groups on crack use and readiness by gender were examined from baseline to 3-month follow-up. Overall, participants reduced their crack use from baseline, with those in the EI showing greater improvement than those in the SI. A small proportion of participants improved readiness; those who improved were more likely to improve their crack use. No significant gender differences were found. These findings suggest that the readiness construct does not fully capture the dynamics of change among out-of-treatment crack users. Further research is needed to fully comprehend the dynamics of change among this group.
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Affiliation(s)
- Allison V Schlosser
- Department of Psychiatry, Epidemiology and Prevention Research Group, Washington University School of Medicine, St. Louis, MO 63108, USA.
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Kapadia F, Latka MH, Hudson SM, Golub ET, Campbell JV, Bailey S, Frye V, Garfein RS. Correlates of consistent condom use with main partners by partnership patterns among young adult male injection drug users from five US cities. Drug Alcohol Depend 2007; 91 Suppl 1:S56-63. [PMID: 17329041 DOI: 10.1016/j.drugalcdep.2007.01.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2006] [Revised: 01/10/2007] [Accepted: 01/11/2007] [Indexed: 11/23/2022]
Abstract
This paper examined correlates of consistent condom use with a main partner among heterosexual male injection drug users (IDUs). Using data from a multi-site sample of young IDUs, we identified 1770 sexually active men of whom 24% (429/1770) reported an exclusive main female sex partner and 49% (862/1770) reported both main and casual female sex partners. Consistent condom use with a main partner was low among men with an exclusive main partner and those with multiple partners (12% and 17%, respectively). In multivariate analysis, consistent condom use with a main partner across partnership patterns was directly associated with anticipating a positive response to requests for condom use and by partner support of condom use; consistent condom use was inversely associated with a main partner's pregnancy desires. Among men with an exclusive main partner, consistent condom use was also inversely associated with needle sharing with a main partner. Among men with multiple partners, consistent condom use with a main partner was inversely associated with injecting with a used needle and intimate partner violence. The low prevalence of consistent condom use with main female partners among heterosexually active male IDUs indicates an increased risk for HIV transmission between men and their primary sex partners. Interventions for heterosexual males that are geared toward increasing condom use in primary relationships are warranted.
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Affiliation(s)
- F Kapadia
- Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY 10029, USA.
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Rhodes F, Stein JA, Fishbein M, Goldstein RB, Rotheram-Borus MJ. Using theory to understand how interventions work: Project RESPECT, condom use, and the Integrative Model. AIDS Behav 2007; 11:393-407. [PMID: 17323123 DOI: 10.1007/s10461-007-9208-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2006] [Accepted: 01/08/2007] [Indexed: 11/24/2022]
Abstract
The Integrative Model of Behavioral Prediction (IM) provides guidelines for the development of successful HIV/STD interventions, yet few HIV prevention programs have identified which components of the IM have been associated with successful behavioral outcomes. Using structural equation modeling, this study examines in detail how components of the IM assessed prior to, and immediately after, the delivery of an intervention are associated with reported condom use 3 months later among participants in Project RESPECT, a multisite randomized controlled trial testing HIV/STD risk reduction strategies among clients attending public health clinics for sexually transmitted diseases. Overall, the IM predicted condom use at 3 months; there were, however, variations in the relative contribution of differing IM components as a function of gender and type of sexual partner as well as the type of intervention the participant had received.
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Affiliation(s)
- Fen Rhodes
- Department of Psychology (Emeritus), California State University Long Beach, Long Beach, USA.
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Todd CS, Earhart KC, Botros BA, Khakimov MM, Giyasova GM, Bautista CT, Carr JK, Sanchez JL. Prevalence and correlates of risky sexual behaviors among injection drug users in Tashkent, Uzbekistan. AIDS Care 2007; 19:122-9. [PMID: 17129867 DOI: 10.1080/09540120600852150] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The objective of this paper is to describe prevalence and correlates of sexual risk behaviors among injection drug users (IDUs) in Tashkent, Uzbekistan. Participants in this cross-sectional study completed a questionnaire detailing sociodemographic, medical and drug and sexual risk behaviors and HIV antibody testing. Of 701 IDUs surveyed, only 20.5% reported consistent condom use, which was more likely for women. Prior sexually-transmitted infection (STI) diagnosis was reported by 36.2% of participants and was associated with early (</=18 years) drug initiation, group drug use, being older, higher educational level, marriage, needle sharing, multiple sex partners in the preceding month and daily injection use. Having multiple partners in the preceding month was common (29.71%) and related to employment, consistent condom use with regular partners and STI self-treatment in multivariate logistic regression. Participants with a history of sharing needles were less likely to have had multiple partners in the previous month. Risky sexual behaviors are common and interrelated with risky injection habits among IDUs in Tashkent, Uzbekistan, representing a continued threat of infection with HIV and other blood-borne agents.
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Affiliation(s)
- C S Todd
- Department of Family & Preventive Medicine, University of California, San Diego, La Jolla, California, USA.
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Wolitski RJ. Relative efficacy of a multisession sexual risk-reduction intervention for young men released from prisons in 4 states. Am J Public Health 2006; 96:1854-61. [PMID: 17008583 PMCID: PMC1586131 DOI: 10.2105/ajph.2004.056044] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We compared the effects of an enhanced multisession intervention with a single-session intervention on the sexual risk behavior of young men released from prison. METHODS Young men, aged 18 to 29 years, were recruited from US prisons in 4 states and systematically assigned to the prerelease single-session intervention or the pre- and postrelease enhanced intervention. Both interventions addressed HIV, hepatitis, and other sexually transmitted infections; the enhanced intervention also addressed community reentry needs (e.g., housing, employment). Assessment data were collected before intervention, and 1, 12, and 24 weeks after release. RESULTS A total of 522 men were included in intent-to-treat analyses. Follow-up rates ranged from 76% to 87%. Unprotected vaginal or anal sex during the 90 days before incarceration was reported by 86% of men in the enhanced intervention and 89% in the single-session intervention (OR=0.78; 95% CI=0.46, 1.32). At 24 weeks, 68% of men assigned to the enhanced intervention reported unprotected vaginal or anal sex compared with 78% of those assigned to the single-session intervention (OR=0.40; 95% CI=0.18, 0.88). CONCLUSION Project START demonstrated the efficacy of a sexual risk-reduction intervention that bridges incarceration and community reentry.
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Affiliation(s)
- Richard J Wolitski
- Prevention Research Branch, Division of HIV and AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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Ward EG, Disch WB, Levy JA, Schensul JJ. Perception of HIV/AIDS risk among urban, low-income senior-housing residents. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2004; 16:571-588. [PMID: 15585432 DOI: 10.1521/aeap.16.6.571.53795] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Despite the rising number of cases of HIV in adults over age 50, older persons rarely are considered to be at risk for HIV/AIDS, and even though they may be involved in risky behavior, such as unprotected penetrative sex, they may not consider themselves vulnerable to becoming infected. Informed awareness of risk is essential to making positive decisions about adopting preventive measures. We examined demographic, sociobehavioral, and contextual factors that predict urban, low-income older adults' perception of HIV/AIDS risk. Logistic regression results from 398 residents aged 50-93 living in six buildings in two American cities found that males, younger participants (aged 50-61), those living in higher risk buildings, and those who worried more about contracting HIV/AIDS were more likely to perceive themselves to be at HIV/AIDS risk. Findings accounted for 32% of the variance and the prediction success rate was 72%. Results point to the importance of considering sociodemographic characteristics and environmental (contextual) factors as they influence heuristic decision making in understanding HIV/AIDS risk perception among low-income urban older adults and when designing HIV/AIDS education and intervention strategies targeting this population.
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Affiliation(s)
- Elijah G Ward
- University of Illinois at Chicago, School of Public Health, 60608-1264, USA.
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Cabral RJ, Galavotti C, Stark MJ, Gargiullo PM, Semaan S, Adams J, Green BM. Psychosocial Factors Associated With Stage of Change for Contraceptive Use Among Women at Increased Risk for HIV and STDs. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2004. [DOI: 10.1111/j.1559-1816.2004.tb02579.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rosengard C, Anderson B, Stein MD. Intravenous drug users' HIV-risk behaviors with primary/other partners. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2004; 30:225-36. [PMID: 15230073 PMCID: PMC1351211 DOI: 10.1081/ada-120037375] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The objective of this study was to determine how injection drug users' (IDUs) HIV-risk behavior differs with primary and other sex partners. Interviews were conducted with injection drug users from a needle exchange program (n = 243). Those with one sexual partner were more likely to report never using condoms with primary partners than were those with more than one partner (74% vs. 54%, p < 0.001). Those with more than one partner differed, between primary and other sexual partners, in their disclosure of HIV and IDU status, condom use, and drug use in combination with sex. Primary sexual partners of IDUs are placed at risk from IDUs' risk behavior with other sexual partners. Those planning HIV-risk reduction interventions for IDUs should consider risk behavior with primary partners separately from behavior with other partners. Evaluation of intervention effects should use partner-specific assessments of risk behavior.
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Affiliation(s)
- Cynthia Rosengard
- Department of Medicine, Brown University School of Medicine, Providence, Rhode Island, USA.
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Yacoubian GS, Miller S, Pianim S, Kunz M, Orrick E, Link T, Palacios WR, Peters RJ. Toward an ecstasy and other club drug (EOCD) prevention intervention for rave attendees. JOURNAL OF DRUG EDUCATION 2004; 34:41-59. [PMID: 15468747 DOI: 10.2190/qqct-61h5-cl3f-fvq3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A growing body of recent research has identified that "rave" attendees are at high risk for the use of "club drugs," such as 3,4-methylenedioxymethamphetamine (MDMA or "ecstasy"). Rave attendees, however, comprise only one of several club-going populations. In the current study, we explore the prevalence of ecstasy and other club drug (EOCD) use among a sample of club attendees in Washington, DC. Data were collected from adult, primarily homosexual, club attendees during the summer of 2003. Data collection was scheduled between 11 p.m. and 3 a.m. Participation rates were high. Of the 211 club attendees approached, 88% (n = 186) completed the interview. Drug use prevalence rates were low. With the exception of alcohol and marijuana, 2-day self-reports were less than 1% for each drug. These findings, amalgamated with results from other EOCD-related studies involving several distinct populations, offer considerable insight into the state of ecstasy in American society. Based on a meta-analysis of this literature, we offer a community-level prevention intervention for the population at highest risk for EOCD use-rave attendees.
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Affiliation(s)
- George S Yacoubian
- Pacific Institute for Research Evaluation (PIRE), Calverton, MD 20705-3102, USA.
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Posner SF, Pulley LV, Artz L, Cabral R, Macaluso M. Psychosocial factors associated with self-reported male condom use among women attending public health clinics. Sex Transm Dis 2001; 28:387-93. [PMID: 11460022 DOI: 10.1097/00007435-200107000-00005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous research has identified factors associated with condom use. However, less information exists on the impact that a history of sexually transmitted disease (STD) has on condom use. GOAL To identify factors associated with self-reported male condom use that relate to a history of STD. STUDY DESIGN Women attending STD clinics completed a survey that assessed sexual behavior, STD history, and psychosocial characteristics. Binomial regression was used to estimate the association between these factors and condom use. RESULTS Of the 12 factors included in the regression model, 11 were significant for all women. When the analysis was stratified by STD history, high condom use self-efficacy, high convenience of condom use, and high frequency of condom use requests were significantly associated with increased condom use among women with or without a history of STD. Factors such as greater perceived condom use norms, higher perceived level of risk, and greater need for condom use in long-term relationships were significantly associated with increased condom use among women with a history of STD. Factors such as shorter duration of a relationship, less violence in the relationship, and lifetime drug use were associated with increased condom use among women with no history of STD. CONCLUSIONS The pattern of psychosocial factors determining condom use is modified by a positive history of STD. These findings suggest that a history of STD could be an important factor in targeting condom use interventions.
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Affiliation(s)
- S F Posner
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
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Lauby JL, Smith PJ, Stark M, Person B, Adams J. A community-level HIV prevention intervention for inner-city women: results of the women and infants demonstration projects. Am J Public Health 2000; 90:216-22. [PMID: 10667182 PMCID: PMC1446151 DOI: 10.2105/ajph.90.2.216] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study examined the effects of a multisite community-level HIV prevention intervention on women's condom-use behaviors. METHODS The theory-based behavioral intervention was implemented with low-income, primarily African American women in 4 urban communities. It was evaluated with data from pre- and postintervention cross-sectional surveys in matched intervention and comparison communities. RESULTS At baseline, 68% of the women had no intention of using condoms with their main partners and 70% were not using condoms consistently with other partners. After 2 years of intervention activities, increases in rates of talking with main partners about condoms were significantly larger in intervention communities than in comparison communities (P = .03). Intervention communities also had significant increases in the proportion of women who had tried to get their main partners to use condoms (P = .01). The trends for condom use with other partners were similar but nonsignificant. CONCLUSIONS Many women at risk for HIV infection are still not using condoms. Community-level interventions may be an effective way to reach large numbers of women and change their condom-use behaviors, particularly their behaviors with regard to communication with main sex partners.
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Affiliation(s)
- J L Lauby
- Philadelphia Health Management Corporation, PA 19102, USA.
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Shepherd J, Weston R, Peersman G, Napuli IZ. Interventions for encouraging sexual lifestyles and behaviours intended to prevent cervical cancer. Cochrane Database Syst Rev 2000:CD001035. [PMID: 10796735 DOI: 10.1002/14651858.cd001035] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cervical cancer is one of the most common cancers affecting women world-wide. Prevention falls into two main categories - primary and secondary. Primary prevention is characterised by health promotion to promote lifestyles and behaviours minimising risk of cervical cancer. Interventions to promote the use of condoms for sexual intercourse (especially early intercourse amongst young women), sexual partner reduction, and negotiated safer sex strategies has been recommended as one approach to limit the spread of Human Papilloma Virus (HPV), one of the major risk factors for cervical cancer. OBJECTIVES To determine the effectiveness of health education interventions to promote sexual risk reduction behaviours amongst women in order to reduce transmission of HPV. SEARCH STRATEGY Electronic searching of EMBASE, ERIC, MEDLINE, PsycLIT, Social Science Citation Index and the CCTR were undertaken using a highly sensitive search strategy. Hand-searching took place of selected journals and reference lists. SELECTION CRITERIA Studies were included if they evaluated educational interventions targeting women only, and measured the impact on : either a behavioural outcome such as condom use for sexual intercourse, partner reduction, or abstinence; or a clinical outcome such as incidence of a sexually transmitted disease (STD). DATA COLLECTION AND ANALYSIS Data were extracted and methodological quality was assessed independently by two reviewers and any discrepancies were resolved between them. Ten per cent of the total number of studies were reviewed additionally by a third reviewer as a quality check and differences in judgement were resolved accordingly. MAIN RESULTS Thirty trials met the inclusion criteria for the review. All of them had the primary aim of preventing HIV and other STDs rather than cervical cancer. Four core methodological qualities were present in 10 of the 30 studies and constitute the subset from which potentially reliable conclusions may be drawn. Each of the 10 studies showed a statistically significant positive effect on sexual risk reduction, typically with increased use of condoms for vaginal intercourse. This positive effect was generally sustained up to three months after intervention. REVIEWER'S CONCLUSIONS Educational interventions targeting socially and economically disadvantaged women in which information provision is complemented by sexual negotiation skill development can encourage at least short-term sexual risk reduction behaviour. This has the potential to reduce the transmission of HPV, thus possibly reduce the incidence of cervical carcinoma.
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Affiliation(s)
- J Shepherd
- NCCHTA, Wessex Institute for Health Research and Development, University of Southampton, Boldrewood, Bassett Crescent East, Southampton, Hants, UK, SO16 7PX.
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Freeman RC, Williams ML, Saunders LA. Drug use, AIDS knowledge, and HIV risk behaviors of Cuban-, Mexican-, and Puerto-Rican-born drug injectors who are recent entrants into the United States. Subst Use Misuse 1999; 34:1765-93. [PMID: 10540972 DOI: 10.3109/10826089909039426] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
To date, relatively little research attention has been devoted to the HIV-risky behaviors of persons who are newly arrived in the United States and who use drugs. Data gathered from street-recruited injection drug users (IDUs) recruited in 10 United States cities who were born in Mexico, Cuba, and Puerto Rico and who are recent entrants into the United States suggest that, in comparison to US-born IDUs, Mexican-born subjects are at elevated risk for acquiring and transmitting HIV as a result of sharing needles with friends and running partners; sharing drug injection implements such as cookers, cotton, and rinse water; frequent injection in HIV-risky settings; use of unsterilized needles; and relatively frequent trading of sex for drugs or money. Puerto-Rican-born IDUs were found to inject drugs relatively frequently, and to do so relatively often in high-risk settings in which sterile injecting equipment and cleaning materials often are scarce. These data also show generally lower levels of AIDS knowledge among the in-migrant IDUs than among US-born IDUs. Respondents from each nationality group most often cited television as the source of their most useful and reliable AIDS information, but also tended to regard community outreach workers as a significant source of reliable AIDS and needle cleaning information. The high levels of involvement in HIV-risky behaviors, deficits in knowledge concerning the means of HIV transmission, and relative ease of mobility of the at-risk (for HIV) individuals examined here indicate a need for a comprehensive public health prevention initiative to limit the future spread of HIV. At a minimum, such an undertaking would do well to incorporate group-specific, culturally appropriate behavioral interventions as well as an information campaign.
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Affiliation(s)
- R C Freeman
- NOVA Research Company, Bethesda, Maryland 20814, USA
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O'Leary A. Preventing HIV infection in heterosexual women: What do we know? What must we learn? ACTA ACUST UNITED AC 1999. [DOI: 10.1016/s0962-1849(05)80040-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Community-level HIV intervention in 5 cities: final outcome data from the CDC AIDS Community Demonstration Projects. Am J Public Health 1999; 89:336-45. [PMID: 10076482 PMCID: PMC1508588 DOI: 10.2105/ajph.89.3.336] [Citation(s) in RCA: 191] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study evaluated a theory-based community-level intervention to promote progress toward consistent condom and bleach use among selected populations at increased risk for HIV infection in 5 US cities. METHODS Role-model stories were distributed, along with condoms and bleach, by community members who encouraged behavior change among injection drug users, their female sex partners, sex workers, non-gay-identified men who have sex with men, high-risk youth, and residents in areas with high sexually transmitted disease rates. Over a 3-year period, cross-sectional interviews (n = 15,205) were conducted in 10 intervention and comparison community pairs. Outcomes were measured on a stage-of-change scale. Observed condom carrying and intervention exposure were also measured. RESULTS At the community level, movement toward consistent condom use with main (P < .05) and nonmain (P < .05) partners, as well as increased condom carrying (P < .0001), was greater in intervention than in comparison communities. At the individual level, respondents recently exposed to the intervention were more likely to carry condoms and to have higher stage-of-change scores for condom and bleach use. CONCLUSIONS The intervention led to significant communitywide progress toward consistent HIV risk reduction.
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Jamner S, Wolitski RJ, Corby NH, Fishbein M. Using the theory of planned behavior to predict intention to use condoms among female sex workers margaret. Psychol Health 1998. [DOI: 10.1080/08870449808406746] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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