Many HIV prevention funding agencies require the use of evidence-based behavioral interventions (EBIs) previously shown to be effective through rigorous outcome evaluation. Often, the implementing agency's setting or target population is different than those in the original implementation and evaluation. The Centers for Disease Control and Prevention Division of HIV/AIDS Prevention, in collaboration with internal and external partners, developed draft guidance to adapt an EBI to fit the cultural context, risk determinants, risk behaviors, and unique circumstances of the agency without competing with or contradicting the core elements and internal logic. The guidance described in this article provides a systematic approach to help agencies identify the most appropriate intervention for their target population and agency capacity, monitor the process, and evaluate the outcomes of the adapted intervention. This guidance, currently being piloted with five community-based organizations, will be revised and disseminated at the conclusion of project activities.
Analysis of text from open-ended interviews has become an important research tool in numerous fields, including business, education, and health research. Coding is an essential part of such analysis, but questions of quality control in the coding process have generally received little attention. This article examines the text coding process applied to three HIV-related studies conducted with the Centers for Disease Control and Prevention considering populations in the United States and Zimbabwe. Based on experience coding data from these studies, we conclude that (1) a team of coders will initially produce very different codings, but (2) it is possible, through a process of codebook revision and recoding, to establish strong levels of intercoder reliability (e.g., most codes with kappa 0.8). Furthermore, steps can be taken to improve initially poor intercoder reliability and to reduce the number of iterations required to generate stronger intercoder reliability.
We developed an easily administered and scored 7-item screening index with a cutoff that is predictive of HIV seroconversion in 2 large prospective cohorts of US men who have sex with men. The index can be used to prioritize patients for intensive HIV prevention efforts (eg, preexposure prophylaxis).
Black men who have sex with men (MSM) in the United States experience disproportionately high rates of HIV and other sexually transmitted infections (STIs); however, the number of evidence-based interventions for Black MSM is limited. This study evaluated the efficacy of Many Men, Many Voices (3MV), a small-group HIV/STI prevention intervention developed by Black MSM-serving community-based organizations and a university-based HIV/STI prevention and training program. The study sample included 338 Black MSM of HIV-negative or unknown HIV serostatus residing in New York city. Participants were randomly assigned to the 3MV intervention condition (n = 164) or wait-list comparison condition (n = 174). Relative to comparison participants, 3MV participants reported significantly greater reductions in any unprotected anal intercourse with casual male partners; a trend for consistent condom use during receptive anal intercourse with casual male partners; and significantly greater reductions in the number of male sex partners and greater increases in HIV testing. This study is the first randomized trial to demonstrate the efficacy of an HIV/STI prevention intervention for Black MSM.
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