Psychological and behavioral interventions to reduce HIV risk: evidence from a randomized control trial among orphaned and vulnerable adolescents in South Africa.

Evidence-based approaches are needed to address the high levels of sexual risk behavior and associated HIV infection among orphaned and vulnerable adolescents. This study recruited adolescents from a support program for HIV-affected families and randomly assigned them by cluster to receive one of the following: (1) a structured group-based behavioral health intervention; (2) interpersonal psychotherapy group sessions; (3) both interventions; or (4) no new interventions. With 95% retention, 1014 adolescents were interviewed three times over a 22-month period. Intent-to-treat analyses, applying multivariate difference-in-difference probit regressions, were performed separately for boys and girls to assess intervention impacts on sexual risk behaviors. Exposure to a single intervention did not impact behaviors. Exposure to both interventions was associated with risk-reduction behaviors, but the outcomes varied by gender: boys reported fewer risky sexual partnerships (ß = -.48, p = .05) and girls reported more consistent condom (ß = 1.37, p = .02). There was no difference in the likelihood of sexual debut for either gender. Providing both psychological and behavioral interventions resulted in long-term changes in sexual behavior that were not present when either intervention was provided in isolation. Multifaceted approaches for reducing sexual risk behaviors among vulnerable adolescents hold significant promise for mitigating the HIV epidemic among this priority population.

Recognizing unfamiliar faces: the effects of distinctiveness and view.

Three experiments are reported in which the effects of viewpoint on the recognition of distinctive and typical faces were explored. Specifically, we investigated whether generalization across views would be better for distinctive faces than for typical faces. In Experiment 1 the time to match different views of the same typical faces and the same distinctive faces was dependent on the difference between the views shown. In contrast, the accuracy and latency of correct responses on trials in which two different faces were presented were independent of viewpoint if the faces were distinctive but were view-dependent if the faces were typical. In Experiment 2 we tested participants' recognition memory for unfamiliar faces that had been studied at a single three-quarter view. Participants were presented with all face views during test. Finally, in Experiment 3, participants' were tested on their recognition of unfamiliar faces that had been studied at all views. In both Experiments 2 and 3 we found an effect of distinctiveness and viewpoint but no interaction between these factors. The results are discussed in terms of a model of face representation based on an inter-item similarity in which the representations are view specific.

Sex worker, client sex behaviour and condom use in Harare, Zimbabwe.

One-hundred sex workers and 100 clients were interviewed at a bar/disco complex in Harare, Zimbabwe in 1989. Sociodemographic characteristics of sex workers and clients were examined. Almost a third of sex workers and nearly 90% of clients had engaged in commercial sex over 5 or more years. Sex workers reported that they worked an average of 4.6 nights a week, averaged 2.2 clients a night and charged a mean of Z$8.7 per session and Z$19.8 per night. Clients reported that they averaged 7.4 visits a month to a sex worker and paid a mean of Z$6.2 per session and Z$17.2 per night. Over half the sex workers said their last client was drunk and nearly two-thirds said he was a repeat client. Sex workers and clients were asked about the sex behaviours completed in their last paid sex act. Vaginal intercourse was reported by 98% of sex workers and clients alike. Manual stimulation of the sex worker's and client's genitalia was reported by roughly 80% of sex workers and clients. Oral and anal sex were rarely reported. Fifty-four percent of sex workers and 44% of clients reported using a condom in their last paid sex act. Client reports thus suggest that sex worker reports of sex acts and condom use with the last client possess considerable validity. Ethnographic approaches were used to study the social and work environment of sex workers. Ethnographic analysis demonstrated a lack of organisation among sex workers and a need to develop cohesive groups for successful health interventions. The study also highlighted the need to include clients in health interventions, the possible role of alcohol as an impediment to health interventions and the feasibility of using bar/disco security and the bar personnel as health educators.

PIP: 100 sex workers and 100 clients were interviewed at a bar/disco complex in Harare, Zimbabwe in 1989. Sociodemographic characteristics of sex workers and clients were examined. Almost 1/3 of sex workers and nearly 90% of clients had engaged in commercial sex over 5 or more years. Sex workers reported that they worked an average of 4.6 nights a week, averaged 2.2 clients a night and charged a means of z$8.7 per session and z$19.8 per night. Clients reported that they averaged 7.4 visits a month to a sex worker and paid a mean of z$6.2 per session and z$17.2 per night. Over 1/2 the sex workers said their last client was drunk and nearly 2.3 said he was a repeat client. Sex workers and clients were asked about the sex behaviors completed in their last paid sex act. Vaginal intercourse was reported by 98% of sex workers and clients alike. Manual stimulation of the sex worker's and client's genitalia was reported by roughly 80% of sex workers and clients. Oral and anal sex were rarely reported. 54% of sex workers and 44% of clients reported using a condom in their last paid sex act. Client reports thus suggest that sex worker reports of sex acts and condom use with the last client possess considerable validity. Ethnographic approaches were used to study the social and work environment of sex workers. Ethnographic analysis demonstrated a lack or organization among sex workers and a need to develop cohesive groups for successful health interventions. The study also highlighted the need to include clients in health interventions, the possible role of alcohol as an impediment to health interventions and the feasibility of using bar/disco security and the bar personnel as health educators. (Author's).

Sex worker and client sex behaviour and condom use in Harare; Zimbabwe

One hundred sex workers and 100 clients were interviewed at a bar/disco complex in Harare; Zimbabwe in 1989. Sociodemographic characteristics of sex workers and clients wre examined. Sex workers reported that they worked an average of 4.6 nights a week; averaged 2.2 clients a night. Clients reported that they averaged 7.4 visits a month to a sex worker. Over half the sex workers said their last client was drunk and nearly two-thirds said he was a repeat client. Sex workers and clients were asked about sex behaviours completed in their last paid sex act. Vaginal intercourse was reported by 98 of sex workers and clients alike. Manual stimulation of the sex worker's and client's genitalia was reported by roughly 80 of sex workers and clients. Oral and anal sex were rarely reported. Fifty-four percent of sex workers and 44 of clients reported using a condom in their last paid sex act. Client reports thus suggest that sex worker reports of sex acts and condom use with the last client possess considerable validity. Ethnographic analysis demonstrated a lack of organization among sex workers and a resultant need to develop cohesive groups for successful health interventions; the need to include clients in health interventions; the possible role of alcohol as an impediment to health interventions and the feasibility of using bar/disco security and bar personnel as health educator