Intervention Description
Intervention Package Information
Evaluation Study and Results
References and Contact Information
Intervention Description
Target Population
Sexually active, HIV negative, STD clinic patients
Goals of Intervention
- Eliminate or reduce sex risk
behaviors
- Prevent new STD infections
Brief Description
The RESPECT Brief Counseling +
Booster intervention is a
one-on-one, client-focused HIV/STD
prevention intervention, consisting of
two 20-minute interactive counseling
sessions and one 20-minute booster
session approximately 6 months later.
The intervention is based on the
2-session model used in Project RESPECT
Brief Counseling Intervention. HIV
counselors help STD clinic patients
identify personal risk factors and
barriers to risk reduction, work with
patients to develop an achievable
personalized risk-reduction plan, and
support patient-initiated behavioral
change. At the initial clinic visit, STD
clinic patients receive the first
counseling session and are tested for
HIV with either a rapid or standard HIV
test. HIV test results and the second
counseling session are given at the end
of the initial clinic visit (rapid test
group) or 1 week later (standard test
group). The additional booster
counseling session reinforces the
previous counseling and includes a
review of the risk-reduction plan, a
revised risk assessment, the negotiation
of a new risk-reduction plan, and
identification of sources of support in
carrying out the risk-reduction plan. |
Theoretic Basis
- Social Cognitive Theory
- Motivational interviewing principles
- Theory of Reasoned Action
Intervention Duration
Two 20-minute sessions delivered in one day
(rapid test group) or 1 week apart (standard
test group) and a single 20-minute booster
session delivered 6 months after the initial
clinic visit
Intervention Settings
Public STD clinics
Deliverer
Trained HIV/STD Counselors
Delivery Methods
- Counseling
- Goal setting
- Exercise
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Intervention Package Information
An intervention package is not available at this time. Please contact Dr.
Thomas A. Peterman, Centers for Disease Control and Prevention, Mailstop E-02,
1600 Clifton Road NE, Atlanta, GA 30333, for details on intervention materials.
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Evaluation Study and Results
The original evaluation study was
conducted in Denver, Colorado; Long Beach,
California; and Newark, New Jersey between
1999 and 2002.
Key Intervention Effects
- Reduced unprotected sex with
non-primary partner
- Reduced number of sex partners
- Reduced sex with new partner or one
time partner
Study Sample
The analytic study sample of 3,297 STD clinic patients is characterized by
the following:
- 51% African American, 22% White, 18% Hispanic, 9% Other
- 54% Male, 46% Female
- 95% heterosexual, 5% homosexual or bisexual
- Mean age of 26 years, range: 15-39 years
- 75% completed high school education or more
Recruitment Settings
Public STD clinics
Eligibility Criteria
STD clinic patients were eligible if they
tested HIV-negative, were between 15 and 39
years old, and had vaginal or anal sex in
the preceding 3 months
Assignment Method
STD
clinic patients (N = 3,297) were randomly
assigned to 1 of 2 groups: Brief Counseling
+ Booster intervention (n = 1,653) or Brief
Counseling only comparison (n = 1,644).
Comparison Group
The
comparison group received the same
two-interactive Brief Counseling sessions as
the intervention group, but did not receive
the Booster counseling session.
Relevant Outcomes Measured and Follow-up Time
- Incident STDs (including
gonorrhea, chlamydia, trichomonas) were
confirmed by laboratory tests and
measured at 3, 6, 9, and 12 months after
the HIV testing at enrollment or at any
other clinic visits during the 12-month
period. The 9- and 12-month assessments
translate to approximately 3 and 6
months after intervention.
- Sex behaviors during past 3 months
(including having ≥ 2 sex partners,
unprotected sex overall, with
non-primary partner or while drunk or
high, sex with a new partner on day of
meeting, and sex with a 1-time partner)
were measured at 3, 6, 9, and 12 months
after the HIV testing at enrollment. The
9- and 12-month assessments translate to
approximately 3 and 6 months after
intervention.
Participant Retention
- Brief Counseling + Booster:
74% retained at 3 months after intervention
73% retained at 6 months after intervention
- Brief Counseling only:
72% retained at 3 months after intervention
73% retained at 6 months after intervention
Significant Findings
- At 3 months after intervention, a significantly smaller percentage of
intervention participants than comparison participants reported the
following sex risk behaviors: ≥ 2 sex partners, unprotected sex with
non-primary partner, sex with a new partner on day of meeting, and sex with
a 1-time partner (all p’s < .05).
- Among female clinic patients, a significantly smaller percentage of
intervention participants reported sex with a 1-time partner than comparison
participants at 3 months after intervention (p < .05).
- Among men who did not have male partners at enrollment, a significantly
smaller percentage of intervention participants than comparison participants
reported ≥ 2 sex partners and unprotected sex with non-primary partner at 3
months after intervention (all p’s < .05).
Considerations
- The Brief Counseling + Booster
intervention was not more effective than
Brief Counseling alone in reducing new
STD infections during the 6-month period
after booster counseling.
- The intervention effect was
significant in reducing sex risk
behaviors at 3 months, but not at 6
months after intervention.
- Participants were tested for HIV at
enrollment using either a rapid or
standard HIV test. The type of testing
method did not significantly modify the
intervention effects, so the effects of
the booster counseling reported above
are based on all subjects combined,
regardless of type of HIV test.
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References and Contact Information
- Metcalf, C. A., Malotte, C. K., Douglas Jr., J. M., Paul, S. M., Dillon, B. A., Cross, H., et al. (2005). Efficacy of a booster counseling session 6 months after HIV testing and counseling: A randomized, controlled trial (RESPECT-2). Sexually Transmitted Diseases, 32, 123-129.
- Metcalf, C. A., Douglas Jr., J. M., Malotte, C. K., Cross, H., Dillon, B. A., Paul, S. M., et al. (2005). Relative efficacy of prevention counseling with rapid and standard HIV testing: A randomized, controlled trial (RESPECT-2). Sexually Transmitted Diseases, 32, 130-138.
Researcher: Dr. Thomas A. Peterman, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E-02, Atlanta, GA 30333, for details on intervention materials.
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