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