AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #198 - Results of a pilot test of a computer-assisted tailored HIV prevention intervention
Authors: Presenting Author: Dr. William Zule - RTI International
Additional Authors: Dr. Wendee Wechsberg, Mr. Curtis Coomes, Ms. Winona Poulton,
Aim: To describe the preliminary results of a pilot test of a computer-assisted HIV prevention intervention that is tailored to the gender, racial ethnic group and HIV risk behaviors of the person receiving it. Research suggests that HIV prevention interventions, which are tailored to specific demographic and risk behaviors, are more efficacious than generic interventions. However, many HIV counseling and testing sites, particularly in rural areas do not see enough member of risk groups such as men who have sex with men (MSM), injecting drug users (IDUs) and sex workers to justify devoting resources to specialized interventions for each risk group. In response to this situation, we developed and pilot tested a computer-assisted tailored intervention for use with all of these risk groups.
Method / Issue: The intervention consists of two sessions, which last between 20 and 45 minutes each depending on the number of different risk behaviors a person reports. The sessions are delivered by an interventionist as PowerPoint presentations that are tailored to each participant’s gender, race/ethnicity and risk behaviors. The second intervention session is also tailored by test results for HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and herpes. We enrolled 120 participants using a quota sampling approach to insure 20 males and 20 females of three racial ethnic groups—African-American, Hispanic and non-Hispanic white. Participants were randomized to intervention and delayed-treatment control conditions after blocking on gender and race/ethnicity. To date we have completed 3-month follow-up interviews with 94% (85/90) of participants whose follow-up interviews are due. The remaining 30 participants will be due for follow-up interviews by June 2011. Due to the small sample sizes within subgroups, analyses are limited to examining directions of changes and effect sizes rather than statistical significance.
Results / Comments: The median age of the sample was 40 years and the mean age was 39. Forty percent had less than a high school education, 60% were homeless and 70% were unemployed. Prevalence was: 7% HIV, 3% HBV, 19% HCV, 7% syphilis and 58% for herpes. Twenty-seven percent reported injecting drug use, 60% reported exchanging sex for money or drugs and 46% of men reported male to male sex in the previous 30 days. Most participants engaged in multiple risk behaviors. Participants assigned to the intervention condition showed more improvement in very high risk behaviors such as unprotected intercourse with a casual or trade partner and unprotected intercourse with a new partner. However, the intervention did not seem to be effective in reducing sexual risk with main partners. Effect sizes were small for most outcomes.
Discussion: The intervention group improved on more outcomes than the control group, but the effect sizes were generally small. It appears that the intervention may be particularly efficacious in reducing some very high risk behaviors such as unprotected intercourse with a new partner and unprotected anal intercourse with casual and trading partners. Even with relatively small effects a brief tailored intervention that can be implemented with existing resources may be useful for low resource settings.
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