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Can Brief, Tailored Telephone Counseling Sustain HIV Preventive Behaviors and Reduce Incident STIs: Results from a Randomized Controlled Supplemental Treatment Trial

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Ralph J. DiClemente, PhD , Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory Univeristy, Atlanta, GA
Gina Wingood, ScD, MPH , Department of Behavioral Sciences & Health Education, Emory University Rollins School of Public Health, Atlanta, GA
Jessica M. Sales, PhD , Emory University, Atlanta, GA
Jennifer Brown, Ph.D. , Department of Psychology, Texas Tech University, Lubbock, TX
Eve Rose, MSPH , Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Atlanta, GA
Teaniese Davis, I have worked as health educator for the past 10 years designing strategies to reduce HIV among diverse young African American populations. , Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
Delia Lang, I have worked as a Data Analyst for over 13 years evaluating the efficacy of behavioral interventions to reduce HIV risk. , Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
Angela Caliendo, I have been an Infectious Disease physician and Laboratory Director designing and conducting assays to detect a wide array of diseases, including Chlamydia and gonorrhea. , Alpert School of Medicine, Brown Unviersity, Providence, RI
James Hardin, I am the Director of the Statistical Consulting Center in the Department of Biostatistics and Epidemiology at the Arnold School of Public Health, University of South Carolina. I have worked as the Biostatistician for many randomized controlled trials , Bioststistics and Epidemiology, University of South Carolina, Columbia, SC
Objective:To evaluate the efficacy of a brief, phone counseling Prevention Maintenance Intervention (PMI) to sustain STI/HIV-preventive behaviors and reduce incident STIs over a 36-month follow-up.

Design:A two-arm randomized controlled supplemental treatment trial

Setting:Three clinics in Atlanta, Georgia.

Participants:African-American adolescent females, 14-20 years, (N=701).

Intervention:Participants in the experimental condition received an adapted CDC-defined evidence-based STI/HIV intervention (HORIZONS) and a PMI consisting of brief, tailored phone counseling every 8 weeks over 36-months.  Comparison condition participants received HORIZONS and a time- and dose-consistent PMI focused on general health.

Main Outcome Measure(s):Primary outcomes were proportion of participants with a laboratory-confirmed chlamydial or gonococcal infection. Behavioral outcomes include: (1) proportion of condom-protected sex acts (2) number of sexual episodes in which participants engaged in sexual intercourse while high on drugs/alcohol, and (3) number of vaginal sex partners. 

Results: Over 36-months follow-up, fewer participants in the experimental condition had incident chlamydial (94 versus 104; RR = 0.47; 95%CI 0.25 to 0.89; p=.02) and gonococcal infections (48 versus 54; RR = 0.39; 95%CI 0.14 to 1.04; p=.060).  A dose effect was observed; participants completing more phone contacts had a lower risk of chlamydial infection (RR= 0.94, 95%CI 0.89, 0.99; p=0.049).  Participants in the experimental condition reported a higher proportion of condom-protected sex acts (mean difference6 months=.08; 95%CI 0.06, 0.10; p=0.036), and fewer episodes of sex while high on alcohol/drugs (mean difference=-0.61; 95%CI -0.98,-0.24; p=0.0001).

Conclusions and Relevance: Sustaining the long-term impact of HIV interventions is achievable with brief, tailored phone counseling.

Learning Areas:

Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs

Learning Objectives:
Assess the efficacy of brief, tailored telephone counseling on sustaining HIV preventive behaviors and reducing incident STIs over a 36-month follow-up period

Keyword(s): Adolescents, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: HIV prevention researchers for over 25 years. My focus has been on the design, implementation and evaluation of culturally- and gender-congruent prevention interventions for African American adolescents and young women
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3364.0: Methods in HIV-Related Research