Washington, DC (12 June 1998)-With all of the excitement about the latest generation of AIDS drugs, it can be easy to forget that every day more people become infected with HIV. Public health officials have launched many campaigns to encourage safer sex practices, but there has been little substantive data to show whether such behavioral interventions actually work. Now, as part of a special section on AIDS in the 19 June 1998 issue of Science, investigators with the National Institute of Mental Health (NIMH) report the results of a major HIV prevention trial involving one of the most at-risk groups: low-income women and men living in urban areas. The results of this study, the largest of its kind, suggest that behavioral interventions can indeed reduce HIV-related sexual risk in this population, at least over a one-year period.
In the United States, rates of infection and AIDS are highest among racial and ethnic minorities living in low-income, urban settings. So the NIMH Multisite HIV Prevention Trial recruited 3,700 such participants from 37 health clinics at seven sites: the Bronx and Harlem; Manhattan, Brooklyn, and northern New Jersey; Baltimore; Atlanta; Milwaukee; Los Angeles; and Orange and San Bernardino counties in California. Half of the participants were randomly assigned to attend a small-group, seven-session HIV risk reduction program; the other half attended a one-hour AIDS education session.
One year after the intervention, the people who attended the long program reported significantly fewer unprotected sexual acts, had higher levels of condom use, and were more likely to use condoms consistently. These self-reported results were backed-up by a review of the participants' clinical records, which showed that those who attended the long intervention program exhibited a lower rate of sexually transmitted disease symptoms compared to the control group.
"We think the study's full-year follow-up, with the clinical charts as an objective measure to back up the self-reports, is indicative that the participants' behavior is really changing over time," says co-author Ellen Stover, director of NIMH's Division of Mental Disorders, Behavorial Research and AIDS. Even a one-year improvement in risky behaviors can have a profound public health impact, according to the authors. Adds Stover, "Our study is a good start in terms of identifying an intervention that reduces risk, but we are encouraging new investigators to extend the follow-up period in future studies." The NIMH study is just one of a series of papers published as part of a special section on AIDS in the 19 June 1998 issue of Science. The section also includes articles on the search for an HIV vaccine; the interplay between HIV proteins and normal cellular activities; and the virus's wily strategies for evading the immune system. In addition, there are commentaries on a variety of topics, including: the challenge of testing HIV patients for resistance to AIDS drugs; a proposal to create a national tissue bank with which to track HIV eradication; an overview of what remains to be done in the race to defeat HIV; and Thailand's successes and difficulties in that nation's response to HIV.
Please note: A related news conference will take place on Thursday, 18 June at 1 p.m. on the main campus of NIH, Wilson Hall, Building 1, Bethesda, MD. For more information, contact the NIMH Office of Scientific Information at 301-443-4536.
For copies of the NIMH study or any of the other AIDS special section papers, contact Heather Singmaster at 202-326-6414 or scipak@aaas.org.
"The National Institute of Mental Health Multisite HIV Prevention Trial:
Reducing HIV Sexual Risk Behavior," by The National Institute of Mental Health
Multisite HIV Prevention Trial Group at the National Institute of Mental
Health, NIH in Rockville, MD.
CONTACT: Rayford Kytle, National Institute of
Mental Health Office of Scientific Information at 301-443-4536.
Journal
Science