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  • Title: Evaluation of two AIDS prevention interventions for inner-city adolescent and young adult women.
    Author: Quirk ME, Godkin MA, Schwenzfeier E.
    Journal: Am J Prev Med; 1993; 9(1):21-6. PubMed ID: 8439433.
    Abstract:
    Two hundred and fourteen young women received acquired immunodeficiency syndrome (AIDS) prevention interventions at an inner-city family health center serving minority patients predominantly. The community in which the health center is located has a high incidence of intravenous (IV) drug abuse. Either a peer or a health care provider delivered the intervention. In the peer-delivered intervention, a trained peer educator reviewed with patients an AIDS "Rap" videotape and several AIDS brochures, which imparted information about human immunodeficiency virus (HIV), its transmission, and prevention. In the provider-delivered intervention, family practice residents, attending physicians, and nurse practitioners used a patient-centered counseling approach to convey the same information. Questionnaires administered immediately before and after the intervention and at one month follow-up evaluated changes in knowledge, attitudes, and behavior. Analyses of data from both combined intervention groups revealed significant improvements in several areas of knowledge, including the effectiveness of using a condom and cleaning IV drug implements with bleach to prevent transmission of HIV. Many improvements were retained at the one-month follow-up. In addition, subjects in both groups who were sexually active stated immediately after the intervention that asking a sexual partner about past sexual experience would now be less difficult, and at one-month follow-up they reported a significant decrease in the frequency of vaginal sex. Our findings suggest that counseling by physicians can achieve more changes in knowledge of sexual risks, whereas peer education can achieve greater changes in knowledge about IV drug use. Results show that both approaches to AIDS prevention used in this study can significantly affect knowledge, attitudes, and sexual behavior. 214 women of average age 20.3 years were subject to an AIDS prevention intervention at a family health center in a high IV drug use community in Worcester, Massachusetts. 116 of the women learned about HIV, its transmission, and prevention with trained peer educators in a review of an AIDS "Rap" video and several AIDS brochures. The remaining 98 women were exposed to the same information, but in a patient-centered counseling approach with family practice residents, attending physicians, and nurse practitioners. 25 women were African-American, 105 Caucasian, 76 Hispanic, and 8 of other ethnic backgrounds. They answered questionnaires regarding their AIDS-related knowledge, attitudes, and practices immediately before, immediately after, and 1 month after exposure to either the peer educator or provider-based education sessions; only 97 completed the follow-up survey. The authors found knowledge on the effectiveness of using condoms and cleaning IV drug implements with bleach to prevent HIV transmission to have significantly improved following the interventions. Many improvements remained at the 1-month follow-up. Moreover, sexually active subjects in both groups noted immediately after the interventions that they would find it easier to ask sex partners about past sexual experiences. A significant decrease was also reported in the amount of vaginal sex at the 1-month follow-up. The authors conclude that while physician counseling may effect more change in the knowledge of sexual risks, peer education may better effect change in knowledge about IV drug use.
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