HIV behavioral interventions can cut high-risk sexual behaviors in half and more than double the regular use of condoms, according to researchers at the Johns Hopkins School of Public Health. The School was one of seven sites across the country participating in the National Institute of Mental Health (NIMH) Multi-site HIV Prevention Trial, a new study of behaviors in mostly low-income women and men served in public health care clinics. The study was published in the June 19, 1998, issue of Science.
Site principal investigator David D. Celentano, ScD, professor, Epidemiology, Johns Hopkins School of Public Health, said, "This study is significant to public health because it identifies a successful strategy to reduce high-risk behaviors and prevent new HIV infections."
The largest, randomized, controlled HIV behavioral intervention study ever conducted in the United States, the study enrolled 3,706 men and women in 37 inner-city, community-based clinics.
Those attending HIV prevention sessions designed to teach ways to reduce high-risk sexual behaviors reported significant reductions across a range of sexual risk indicators over a one-year period. The more intervention sessions the participants attended, the less high-risk behaviors they engaged in.
Among men who took the seven-session intervention, for instance, the incidence of gonorrhea fell by half. Gonorrhea is an important indicator of unprotected sexual behavior and a leading sexual risk factor for HIV infections among heterosexuals.
Researchers at seven sites in five metropolitan areas recruited participants from three distinct populations at risk of acquiring HIV and other STDs: men and women in public STD clinics, and women attending public primary health care clinics. Seventy-four percent of participants were African American and 25 percent were Hispanic; most were single and unemployed and had been treated previously for STDs, and all were engaging in behaviors that put them at high risk for HIV. Most participants reported primarily heterosexual behavior, although 7 percent of male participants reported having sex with men during the three months prior to the baseline interview.
Nationwide, rates of HIV infection and AIDS are higher among racial and ethnic minority populations, especially African Americas, who represented 41 percent of new AIDS cases in 1996. Heterosexual transmission of HIV is rising rapidly, especially among ethnic minority women.
In addition to Johns Hopkins School of Public Health, the sites included: Columbia University, New York City; Rutgers University, New Brunswick, New Jersey; Emory University, Atlanta, Georgia; The Medical College of Wisconsin, Milwaukee, Wisconsin; UCLA, Los Angeles, California; UC-Irvine, Irvine, California.
The study was funded by the National Institute of Mental Health, NIH.
Journal
Science