Barcelona 2013
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| Abstract #432 - Information Technologies | ||||
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Session: 17.2: Information Technologies (Parallel) on Monday @ 14.30-16.00 in Mirador Chaired by Ferran Pujol, Rich Wolitski Authors: Presenting Author: Dr Christiana Noestlinger - Institute of Tropical Medicine, Belgium |
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| Additional Authors: | ||||
| Aim: Migrants stemming from high endemic regions are highly affected by HIV in Europe, with an increasing proportion among them acquiring HIV in the host countries. While interventions to support migrants in reducing sexual risk behaviour are needed, service providers may struggle with culturally appropriate sexual health advice for this target group. Eurosupport 6 (a multicenter study in 10 countries throughout Europe) aimed at developing and evaluating a positive prevention intervention focusing on sexual risk reduction for this target group. | ||||
| Method / Issue: CISS (Computerised intervention for safer sex) was developed using the intervention mapping method, integrating evidence-based behavioural theories (Information-Motivation-Behavioral Skills Model, Stages of Change Theory, and innovative theories on System 1-System 2 thinking, i.e. Dual Process Theory). Trained health care providers delivered the intervention between 02/2010 - 11/2012. CISS counsellors used motivational interviewing and cognitive?behavioral techniques supported by target-group appropriate computerised materials (videos, self-learning material, software to develop an individual risk reduction plan). Effectiveness was evaluated through a randomised controlled trial comparing an intervention group with a control group (treatment as usual) at 3 and 6 months follow-up (FU) compared to baseline assessment. Self-reported anonymous online evaluation tools assessed sexual risk and underlying determinants (mental health, attitudes, motivation, and self-efficacy). A logistic mixed effect model was used to asses intervention effectiveness. A descriptive process evaluation was conducted among intervention participants immediately after completion of the CISS. | ||||
| Results / Comments: Baseline data were obtained from 80 migrants (44 women, 36 men; n=49 in intervention and n= 31 in control group). At baseline, no relevant differences were found between intervention and control group with respect to underlying determinants and condom use as outcome variable. Overall treatment effect measured by condom use at last intercourse at 3 months FU was statistically not significant (p=0.275; 95% CI: 0.00-5.51); self-efficacy to use condoms was significantly higher in the intervention group than in the control group (p<0.03) at 3 months FU. Also intention to use condoms was significantly higher in the intervention group than the control group at post-intervention and at 6 months FU respectively (p<0.002; p<0.026). 88% of the participants were satisfied with the overall quality of the CISS, 87% felt that the CISS enabled them to discuss safer sex, and 93% felt accepted by the counsellors. | ||||
| Discussion: Limitation was a low sample size due to recruitment difficulties, limiting statistical power. Barriers to recruitment were situated at contextual (legal situation, criminalization of HIV), organisational (time constrains, referral from health care providers), and individual (fear of being judged) levels. When up-scaling this intervention, these challenges need to be addressed at multiple levels. Overall satisfaction with the CISS among participants was high. While it did not result in sexual risk reduction, psychological constructs being a prerequisite for behaviour change such as self-efficacy and intention to use improved more over time for the CISS, compared with the control condition. A follow-up session to boost intervention content and evaluate and eventually adapt the individual risk reduction plan could potentially contribute to improving the intervention?s effectiveness in terms of behavioural change and change maintenance. | ||||
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