A 10-hour small-group informational and skill-building intervention was tested among patients (N = 472) attending publicly funded sexually transmitted disease clinics in Maryland, Georgia, and New Jersey. After completing a 90-minute interview concerning HIV risk behaviors, condom use self-efficacy and condom outcome expectancies, participants were randomized to either an intervention or a control condition. Participants in both conditions displayed significant reductions in unprotected encounters and number of partners and increases in condom use. No differences between treatment conditions were observed, indicating that the motivational effects of the interview may have been stronger than the effects of the intervention in this population.
PIP: Sexually transmitted disease (STD) treatment services in low-income communities offer an effective arena for accessing those at greatest risk for HIV infection. This study evaluated an intensive HIV risk reduction program implemented in publicly funded STD clinics in Maryland, Georgia, and New Jersey (US). After completion of a 90-minute interview on HIV risk behaviors, condom use self-efficacy, and condom outcome expectancies, the 472 study participants were randomly assigned to either a 10-hour behavioral intervention designed to increase condom use self-efficacy through modeling and skill building or routine brief counseling. The average age of respondents was 30.1 years; they reported an average of 3.2 lifetime STDs. Participants in both the intervention and control groups reported significant reductions in the number of sexual partners and unprotected sexual encounters and significant increases in condom use at the 90-day follow-up interview, with no significant differences between groups. Four possible moderators of behavior change--gender, crack or heroin use, alcohol problems, and child sex abuse--were not significant. The possibility that the baseline interview, not the intervention, motivated the observed changes in sexual behavior merits consideration.