Developing theory‐based risk‐reduction interventions for HIV‐positive young people with haemophilia

Schultz, Janet R.; Butler, Regina B.; Mckernan, L.; Boelsen, R.

doi:10.1111/j.1365-2516.2001.00458.x

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…The TTM has received empirical support in the areas of alcohol and other drug abuse in high-risk adolescents (Migneault, Pallonen, & Velicer, 1997; Harlow et al, 1999) and substance use in YLH (Naar-King et al, 2006b). The TTM has also received empirical support in the area risky sex among YLH with hemophilia (Schultz, Butler, McKernan, Boelson, 2001). …”

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confidence: 99%

Predictors of Condom Use in a Multisite Study of High-Risk Youth Living with HIV

Outlaw¹,

Naar‐King²,

Janisse³

et al. 2010

AIDS Education and Prevention

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Risky sexual behavior among youth living with HIV (YLH) must be addressed to prevent the spread of the disease. The purpose of the current study was to investigate factors associated with condom use in a multi-site sample of YLH (ages 16-24). Baseline assessments were conducted with 186 YLH using a computer assisted personal interviewing (CAPI) method. Path analysis suggested that condom use was directly predicted by motivational readiness and self-efficacy for safer sex. Interventions that promote self-efficacy and motivational readiness through a variety of mechanisms may be useful in understanding and conceptualizing sexual risk behavior in YLH. However, further predictors must be studied to account for more variance. KeywordsHIV; Adolescents; Young Adults; Condom Use; Sexual Risk Young people between the ages of 13 to 24 are at persistent risk for HIV infection in the United States (CDC, 2006). Young adulthood is a period characterized by experimentation, including engagement in risky behaviors (e.g., substance use and sexual behavior) (Moore & Parsons, 2000). Most young adults are sexually active, with the highest rates of sexual activity reported among youth of color (Park, Mulye, Adams, Brindis, & Irwin, 2006). The prevalence of sexually transmitted infections (STIs), especially chlamydia and gonorrhea, peak in young adulthood and are highest among youth of color (CDC, 2003).Risky sexual behavior among youth living with HIV (YLH) must be addressed to prevent the spread of the disease. Learning that one is HIV infected presents the youth with the challenge of changing their risky sexual behavior. However, this may be difficult for some youth. Research with YLH has found high rates of sexual risk behaviors (Hein, Dell, Futterman, Rotheram-Borus, & Shaffer, 1992;Murphy et al., 2001;Naar-King et al, 2006a;Rotheram-Borus et al., 1997). Specifically, Vermund and colleagues (2001) found high rates of STIs in HIV-infected adolescents in care settings in the Reaching for Excellence in Adolescent Care and Health (REACH) study (aged 12-18). However, there have only been a few multi-site studies describing sexual risk behaviors of YLH that represent the demographics of the epidemic and the adolescent clinics providing treatment to this group (minority females and men who have sex with men; adolescents and young adults) (Comulada et al., 2003;Rotheram-Borus et al., 2004).While factors associated with sexual risk behavior among HIV-infected adults has received much attention (Heckman, Kelly, & Somiai, 1998;Kalichman, 1999;Reilly & Woo, 2001;Rosser, Gobby, & Carr, 1999), the research literature is sparse for YLH. Emotional distress has been associated with risky sexual behavior in YLH (Murphy, et al., 2001 (2005) found that lower selfesteem predicted sexual risk behavior in HIV-infected males (ages 15-24) and several other psychosocial factors (i.e., coping style, peer norms, emotional distress, self-esteem, and social support) indirectly predicted sexual risk behavior. This study included only males, and thus, ...

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confidence: 99%

Predictors of Condom Use in a Multisite Study of High-Risk Youth Living with HIV

Outlaw¹,

Naar‐King²,

Janisse³

et al. 2010

AIDS Education and Prevention

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“…The TTM has been useful for understanding safer sexual behaviours (Galvotti et al, 1995;Grimley et al, 1993Grimley et al, , 1995Noar et al, 2002). Successful TTM-based sexual-risk and associated behavioural interventions have been conducted with male and female injection drug users (Jamner et al, 1997), HIV-positive adolescents (Schultz et al, 2001) and men with hemophilia (McConnaughy et al, 1983).…”

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confidence: 98%

A process evaluation of the implementation of a computer-based, health provider-delivered HIV-prevention intervention for HIV-positive men who have sex with men in the primary care setting

et al. 2008

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There is increasing interest in using healthcare providers to deliver HIV-prevention services to their patients. Unfortunately, lack of counselling skills and time constraints within busy clinics serve as barriers to such efforts. The Providers Advocating for Sexual Health Initiative (PASHIN) study used state-of-the-art computer technology to assess each participant's risk behaviours and to determine the patient's readiness for changing each behaviour. The computer synthesized the participant-entered data, determined the targeted risk behaviour and printed a behavioural theory-based provider advice sheet and a 3-point patient prescription for the targeted risk behaviour. Since the intervention does not require providers to spend time performing a detailed sexual-risk assessment and it does not require providers to have received extensive counselling training, it has the potential to minimize some of the barriers associated with provider-delivered interventions. Thus, the purpose of this process evaluation was to assess how the PASHIN intervention was implemented in the field, including issues such as the fidelity of implementation and health providers' views on and experience with implementing the intervention. Overall, the results demonstrated that the computer-based, provider-delivered intervention was successfully delivered by providers within the context of regularly scheduled treatment sessions with HIV-positive men who have sex with men (MSM) patients. The majority of providers (79.4%) and patients (83.5%) reported that the quality of HIV-prevention services delivered during these sessions was 'good'. The majority of the providers also reported that they had received adequate training, felt more confident in communicating HIV-prevention issues with their patients and provided more HIV-prevention counselling to their patients, due to the project. However, the experience of delivering HIV-prevention counselling during an 18-month period did not appear to change providers' attitudes toward a provider-delivered HIV-prevention intervention nor their belief in the effectiveness of HIV prevention in general. Future studies should focus on how to enhance providers' acceptance and commitment to delivering HIV-prevention counselling to their patients during the clinic visit.

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Promoting safer sex among HIV‐positive youth with haemophilia: theory, intervention, and outcome

Butler

Schultz²,

Forsberg³

et al. 2003

Haemophilia

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The goal of the project was to develop and evaluate theory-based interventions designed to change sexual behaviour and promote safer sex practices of HIV seropositive young men and adolescents with haemophilia to prevent transmission to sexual partners and offspring. Safer sex was defined as abstinence, consistent condom use, or 'outercourse' (intimate, non-intercourse sexual behaviour). This project utilized the Transtheoretical Model developed by Prochaska and DiClemente, which describes behaviour change as an incremental, stage-based process. The 1-year intervention protocol consisted of two individual sessions and two peer-centred activities. One hundred and four adolescents, residing in 22 states, participated. Pre- and post-intervention evaluations were conducted to measure stage progression for participants. The number who were in the action or maintenance stage of change for safer sex was significantly greater at post-test than at pre-test (79 vs. 62%, P < 0.0001). Participants also reported an increased use of outercourse. In addition, significant increases in self-efficacy and knowledge regarding safer sex were demonstrated. Following these stage-based interventions, participants were significantly more likely to be engaging in safer sex behaviours than they were previously. These intervention activities can be adapted for use with other adolescent populations and for other behaviour change goals in adolescents with haemophilia.

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Developing theory‐based risk‐reduction interventions for HIV‐positive young people with haemophilia

Cited by 3 publications

References 32 publications

Predictors of Condom Use in a Multisite Study of High-Risk Youth Living with HIV

Predictors of Condom Use in a Multisite Study of High-Risk Youth Living with HIV

A process evaluation of the implementation of a computer-based, health provider-delivered HIV-prevention intervention for HIV-positive men who have sex with men in the primary care setting

Promoting safer sex among HIV‐positive youth with haemophilia: theory, intervention, and outcome

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