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The Research
The Intervention
The Research
The Science Behind the Package
Healthy Relationships is a multisession, small-group, skills-building program
for men and women living with HIV/AIDS. The program is designed to reduce
participants’ stress
related to safer
sexual behaviors and disclosure of their serostatus to family, friends, and
sex partners. The
program is based on Social Cognitive Theory, which states that persons learn
by observing other
people successfully practice a new behavior.
Target Population
HIV-positive heterosexual men and women and HIV-positive men who have sex
with men
Interventions
Groups of 5 to 12 HIV-positive participants of the same sex and sexual orientation
meet in a room
that allows privacy for discussion. The groups are closed to new members and
are similar in style
to support groups. The interactive sessions are facilitated by a licensed counselor
and a peer, who
may be HIV-positive. One facilitator is male, and the other is female. During
the five 120-minute
sessions, participants learn problem-solving and decision-making skills to
address coping with
stress related to safer sexual behaviors and disclosure of serostatus. Participants
observe the
facilitators model the skills, watch scenes from popular movies portraying
characters using similar
skills, and role play the scenes as though the situation pertained to safer
sex negotiation or
serostatus disclosure. Participants receive feedback from the facilitators
and each other to
encourage self-efficacy, self-evaluation, and behavior change.
Research Results
Six months after taking part in Health Relationships, significant numbers
of participants reported:
- Less unprotected sex with non-HIV-positive partners
- Fewer sexual contacts
overall
- Having refused to engage in unsafe sex
For Details on the Research
Design
Kalichman, S.C., Rompa, D., Cage, M., DiFonzo, K., Simpson, D., Austin,
J., Luke, W., Buckles,
J., Kyomugisha, F., Benotsch, E., Pinkerton, S., and Graham, J. (2001).
Effectiveness of an
intervention to reduce HIV transmission risks in HIV-positive people.
American Journal of
Preventive Medicine 21(2), 84-92.
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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. Healthy Relationships is one of the REP interventions
and is the product of extensive collaboration among researchers who originally
developed and evaluated the intervention and the community based
agencies who implemented the intervention. The package has been field tested in six HIV prevention
agencies by non-research staff.
Core Elements
Core elements are intervention components that must
be maintained without alteration to ensure program effectiveness. The core elements of Healthy Relationships include:
- Defining stress and reinforcing coping skills with HIV-positive people
across three life areas: 1)
disclosing to family and friends, 2) disclosing to
sex partners, and 3) building healthier and safer
relationships.
- Using modeling, role-play, and feedback to teach and practice skills
related to coping with stress.
- Teaching decision-making skills around the issue of disclosure of
HIV status.
- Providing participants with personal feedback reports to motivate
change of risky behaviors and
continuance of protective behaviors.
- Using popular movie clips to set up scenarios around disclosure and
risk reduction to stimulate
discussions and role plays.
Package Contents -
An intervention
manual to guide organizations through planning, implementation, maintenance,
and evaluation of the intervention, including detailed recommendations
on selecting movie clips.
- Intervention overview
video and a collection of HIV education and male and female condom-use
videos on a single tape.
- Risk continuum
banner and cards; initial participant assessment, personal
feedback, and session evaluation forms; samples of other materials;
and a CD containing all written materials.
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Package Contents
Intervention Orientation
Two program staff attend a 4-day training in which they learn how
to conduct the intervention, practice intervention delivery skills, and identify agency-specific implementation
strategies.
Technical Assistance
Capacity-building assistance providers problem-solve with adopting
agencies to achieve an effective
balance between maintaining core elements and tailoring to local
needs. Assistance providers address implementation concerns, answer questions, and provide advice.
Timeline for
Availability
The package is available from CDC along with training on program
implementation and technical assistance.
For More Information on the Community PROMISE Package
To find out more about future trainings, please visit
http://effectiveinterventions.org,
e-mail interventions@aed.org,
or telephone 1-800-462-9521 or 1-202-884-8712.
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