Efficacy of a multimedia computer-based HIV intervention for enhancing consistent condom use among African-American women: Results of a feasibility trial

BACKGROUND: Advances in technology have created an opportunity for developing HIV interventions that are interactive, enhance accessibility, are less costly, and can be implemented reliably. OBJECTIVE: To evaluate the efficacy of an interactive, multimedia, computer-based HIV intervention to enhance HIV-protective sexual behaviors and mediators among African-American women. METHODS: African-American women, 21 – 29 years old (N = 160), reporting unsafe sex in the prior 3 months and seeking services at Planned Parenthood in Atlanta, GA, were eligible to participate. Participants were randomized to either a single 60-minute group session of general health information including HIV prevention (N = 68) or two, 60-minute interactive computer-based HIV intervention sessions administered by a laptop computer in which each session concluded with a 20-minute small group session (N = 67). The intervention was adapted from an evidence-based intervention for African-American women emphasizing ethnic and gender pride, HIV knowledge, communication, condom use and relationship skills. RESULTS: Participants were, on average, 24 years old, and 85%, were currently in a relationship. Compared with participants in the comparison, participants in the interactive computer-based HIV intervention reported more consistent condom use during vaginal sex (OR = 5.90; 95% CI; 1.09 – 31.95; P = .039), a higher proportion of condom-protected episodes of vaginal sex (85.3 vs. 52.8; P = .03), higher HIV knowledge (9.45 vs. 8.99; P = .001) and higher condom use self-efficacy (30.81 vs. 28.96; P = .012). DISCUSSION: This is the first interactive computer-based HIV intervention to demonstrate an increase in HIV-preventive mediators and consistent condom use.