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The Research
The Intervention The Research
The Science Behind the Package
Project RESPECT has two, one-on-one, client-focused, HIV prevention counseling
interventions; “brief counseling” (two sessions) and “enhanced
counseling” (four
sessions). The interventions seek to reduce
high-risk sexual behaviors and prevent new sexually transmitted infections.
RESPECT is based on the
Theory of Reasoned Action, which explains how behaviors are guided by attitudes,
beliefs, experiences, and expectations of other persons’ reactions,
and on Social Cognitive Theory, which states that persons learn by observing
other people successfully practice a new behavior.
Target Population
Heterosexual persons (14 years and older) attending STD clinics
Interventions
The “Brief Counseling” intervention consists of two, 20-minute,
one-on-one, interactive counseling
sessions. The counselor uses a structured protocol to guide delivery
of the intervention as it was
researched. In session one, the counselor seeks to enhance a client’s
perception of their risk for HIV
infection and their level of concern related to possible infection
and to elicit the details of recent risk
incidents. In discussion with the client, the counselor points out
the client’s
triggers, circumstances,
vulnerabilities, and patterns of risk-taking behavior. The session
leads to a negotiated plan for reducing
risk, including referrals to resources to support risk reduction. HIV
antibody testing is offered to the client at the end of the
first session. In session 2, the counselor provides the result of the
HIV test, helps the client understand the test result, discusses
implications of the result for the client’s health and future
HIV risk or referral needs, and provides additional support
for risk reduction plans and partner counseling and
referral.
The “Enhanced Counseling” consists of one 20-minute and
three 60-minute, one-on-one, interactive,
counseling sessions delivered over four weeks. Session one is similar
to the first session of the “Brief
Counseling” intervention. Session two emphasizes increasing condom
use self-efficacy. Session three
provides HIV test results and focused discussion on condom attitudes.
Session 4 focuses on perception of norms regarding condom
use. Each session ends with a goal-setting exercise and encouragement
of condom use as a long-term risk-reduction goal.
Research Results
Compared with participants in the comparison condition, men and women
in both interventions:
- Reported significantly greater condom use and reduction of risk behaviors
- Had fewer new sexually-transmitted infections
For Details on the Research Design
Kamb, M.L., Fishbein, M., Douglas, J.M., Rhodes, F., Rogers, J.,
Bolan, G., Zenilman, J., Hoxworth, T., Malotte, K., Iatesta,
M., Kent, C., Lentz, A., Graziano, S., Beyers, R.H., Peterman, T.A.,
for the Project RESPECT Study Group. (1998). Efficacy
of Risk-Reduction Counseling to Prevent Human Immunodeficiency
Virus and Sexually Transmitted Diseases: A Randomized Controlled
Trial. Journal of the American Medical Association, 280:1161-67.
Or visit the Project RESPECT web page at
http://www.cdc.gov/hiv/topics/research/respect/default.htm
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The Intervention
A Package Developed from Science
Replicating Effective Programs (REP) is a CDC-initiated project
that identifies HIV/AIDS prevention
interventions with demonstrated evidence of effectiveness.
REP supports the original researchers in
developing a user-friendly package of materials designed
for prevention providers. Project RESPECT are two
of the REP interventions and are the product of extensive
collaboration among researchers who
originally developed and evaluated the interventions and the
health departments who implemented the interventions.
The package has been field-tested by prevention program
staff.
Core Elements
Core elements are intervention components that must
be maintained without alteration to ensure program effectiveness. The core elements of brief and enhanced
RESPECT interventions include:
- Conducting one-on-one counseling focusing on the client’s risk
- Offering HIV-antibody testing with the intervention
- Following the protocol completely
-
Focusing on the client’s specific risk behaviors that put
them at risk for HIV and other STDs
- Negotiating a realistic and achievable risk-reduction step
- Developing, implementing, and maintaining quality assurance procedure
For the enhanced intervention only: - Focusing on the client’s beliefs, self-efficacy,
attitudes, and norms regarding safe-sex
Package Contents
- A manual of the brief, 2-session RESPECT with a step-by-step protocol
- A manual of the enhanced, 4-session RESPECT with a step-by-step protocol
- A 60-minute video that demonstrates correct RESPECT model counseling
skills
- A quality assurance protocol
View
Package Contents
Intervention Orientation
HIV counselors from user organizations attend a 2- to 3-day training
in which they learn how to conduct
the interventions
Technical Assistance
To be determined
Timeline for
Availability
The package is available from CDC along with training on program implementation and technical assistance.
For More Information
on Project RESPECT Package
Charles Collins, CDC’s Division of HIV/AIDS Prevention, Phone: 404-639-0966. E-mail:
cwc4@cdc.gov.
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