Is a general women's health promotion program as effective as an HIV-intensive prevention program in reducing HIV risk among Hispanic women?

OBJECTIVE: This study aimed to assess whether participants in an HIV-intensive prevention program and participants in a general women's health promotion program reported greater HIV risk-reduction than participants in a wait-list control group immediately following program participation and at three-month follow-up. METHODS: The authors studied 162 Hispanic women ages 18 to 35 years, most of them immigrants. Three-fourths of the sample (74%) reported earning less than $800 a month, 29% did not have a high school degree, and 90% had children. Data were gathered through surveys at baseline, at intervention completion, and at three-month follow-up. Information was collected on sociodemographics, HIV risk factors, and risk behaviors. Crude and adjusted (for demographics and dose) logistic regression analyses were used to assess program effects on participants' risk reduction. RESULTS: Crude logistic regression analyses reveal that both programs resulted in increased condom use at post-test and follow-up. Only participants in the HIV-intensive prevention program reported increased safer sex negotiation at post-test and follow-up, however, and only participants in the women's health promotion program reported increased HIV testing at post-test. CONCLUSION: Both interventions increased condom use. The HIV-intensive prevention program appeared to be more effective in promoting safer sex negotiation, and the women's health promotion program appeared more effective in promoting HIV testing. The findings suggest that both approaches may be viable ways to package HIV prevention for short-term behavior change in this population.

Correlates of same-sex sexual behavior in a random sample of Massachusetts high school students.

OBJECTIVES: This study documented risk behaviors among homosexually and bisexually experienced adolescents. METHODS: Data were obtained from a random sample of high school students in Massachusetts. Violence, substance use, and suicide behaviors were compared between students with same-sex experience and those reporting only heterosexual contact. Differences in prevalence and standard errors of the differences were calculated. RESULTS: Students reporting same-sex contact were more likely to report fighting and victimization, frequent use of alcohol, other drug use, and recent suicidal behaviors. CONCLUSIONS: Students with same-sex experience may be at elevated risk of injury, disease, and death resulting from violence, substance abuse, and suicidal behaviors.

Condom availability in a small town: lessons from Falmouth, Massachusetts.

PIP: Condom availability was approved October 1991 by the Falmouth, Massachusetts School Committee. In early 1992, condom vending machines were installed in high school restrooms in Falmouth. The Massachusetts Education Board in August 1991 urged local schools to make condoms available; in 1990 the policy was to integrate HIV/AIDS education within comprehensive health education and human services programs. Cambridge was the first to adopt a condom availability plan, which was in effect in March 1990. The debate was contentious and a group has protested with a law suit to stop condoms availability. Advice is provided on some of the lessons in providing condoms, staff training, and suggestions for holding public hearings on condom availability. The HIV/AIDS training team for Falmouth is discussed along with a description of the differences in focus for administrators, nursing staff, support staff, faculty, non certified staff, and school committees. The history of the endeavor to provide condoms is documented. Information collection centered on the efficacy of condoms in HIV and sexually transmitted disease (STD) prevention, the legal liability associated with school based distribution, and experiences from other school systems. 16 lesions were learned. 1) taking time yields the best outcome; 2) the public hearing format should be highly structured; 3) know your opposition and remember that it is likely to be a small group; 4) set the arguments for support on you own terms; 5) the argument that protecting the public health is a moral issued should be used; 6) before introducing condom availability, build consensus around STD/HIV prevention; 7) students are the most natural allies; 8) strong leadership is required; 9) an individual should be placed in charge; 10) obtain support from other communities with existing programs; 11) do not give up if you fail; 12) obtain allies well in advance; 13) national organizations are allies; 14) comprehensive health education wins wherever condom availability loses; 15) use media; and 16) legal liability is a red herring, so be prepared to defend your position.^ieng

HIV education for gay, lesbian, and bisexual youth: personal risk, personal power, and the community of conscience.

Adolescent gay and bisexual males face a higher risk of infection with HIV than most other young people because of their behaviors and because HIV prevention programs have failed to address their unique concerns. Ironically, current efforts to heighten public awareness about the AIDS pandemic may be nullifying the potential for gay, lesbian, and bisexual young persons at high risk to form the support networks needed to modify their behavior. The personal and group empowerment of gay, lesbian, and bisexual young people is a necessary prerequisite to their ability to make healthy behavioral choices around HIV and other health issues. This paper proposes a comprehensive health education model for HIV prevention for gay, lesbian, and bisexual adolescents. Current health education efforts would be augmented by broader self and group empowerment training that would develop self-esteem, social skills, support networks, and access to risk reduction materials. An integrated system of care involving school-based programs, multi-service youth agencies, and self-help groups would be in a position to deliver appropriate educational, mental health, medical, and social support services. Such a system of care presents gay, lesbian, and bisexual youth with their best chance to reduce their risk of infection with HIV and develop into emotionally healthy individuals.