This 5 year study will conduct a randomized clinical trial of a gender and culturally tailored theory-based behavioral risk reduction intervention for men and women who are receiving sexually transmitted infection (STI) diagnostic and treatment services from two different types of STI treatment providers in two provinces in South Africa. As many as one in five South Africans is HIV positive and there are an estimated 1,500 new HIV infections in South Africa each day. The experimental intervention in this study was developed by South African and US investigators and pilot tested in South Africa. The intervention is grounded in the experience of South African health service providers, Social Constructionist Theory of Gender, empirical research on AIDS-related stigmas, and elements of a social cognitive theory of health behavior change. The intervention consists of a single 60-minute risk reduction counseling session delivered within the context of STI services. The study will recruit 200 men and 200 women from four STI clinics (N = 1600), two dedicated STI clinics in urban centers and two primary care clinics in townships. Participants will be STI clinic patients over age 18 that have been treated for a previous STI. Participants will be baseline assessed and randomized to receive either (a) the 60 min theory-based and culturally tailored risk reduction intervention or (b) a time and contact matched standard of care HIV and health education session. Participants will be followed for 15 months post intervention. Assessments will be conducted using computer assisted interviews (ACASI). The randomized trial will determine the efficacy of the risk reduction intervention for South African men and women receiving STI clinic services. Outcome analyses will include differences between .conditions on new STI diagnoses over 15 months. We will also test the mediating effects of gender attitudes and beliefs, AIDS stigmas, information, motivation, and behavioral skills constructs on intervention outcomes. Results of this research will therefore test a clinic-based HIV prevention intervention model that is urgently needed in South Africa.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH074371-05
Application #
7685278
Study Section
Special Emphasis Panel (ZRG1-AARR-G (02))
Program Officer
Pequegnat, Willo
Project Start
2005-09-05
Project End
2011-08-31
Budget Start
2009-09-01
Budget End
2011-08-31
Support Year
5
Fiscal Year
2009
Total Cost
$535,638
Indirect Cost
Name
University of Connecticut
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
614209054
City
Storrs-Mansfield
State
CT
Country
United States
Zip Code
06269
Pitpitan, Eileen V; Kalichman, Seth C; Garcia, Randi L et al. (2015) Mediators of behavior change resulting from a sexual risk reduction intervention for STI patients, Cape Town, South Africa. J Behav Med 38:194-203
Eaton, Lisa A; Huedo-Medina, Tania B; Kalichman, Seth C et al. (2012) Meta-analysis of single-session behavioral interventions to prevent sexually transmitted infections: implications for bundling prevention packages. Am J Public Health 102:e34-44
Eaton, Lisa A; Cain, Demetria N; Pope, Howard et al. (2012) The relationship between pornography use and sexual behaviours among at-risk HIV-negative men who have sex with men. Sex Health 9:166-70
Kalichman, Seth C; Cain, Demetria; Eaton, Lisa et al. (2011) Randomized clinical trial of brief risk reduction counseling for sexually transmitted infection clinic patients in Cape Town, South Africa. Am J Public Health 101:e9-e17
Eaton, L A; Cain, D N; Agrawal, A et al. (2011) The influence of male circumcision for HIV prevention on sexual behaviour among traditionally circumcised men in Cape Town, South Africa. Int J STD AIDS 22:674-9
Eaton, Lisa A; Cherry, Chauncey; Cain, Demetria et al. (2011) A novel approach to prevention for at-risk HIV-negative men who have sex with men: creating a teachable moment to promote informed sexual decision-making. Am J Public Health 101:539-45
Kalichman, Seth C (2010) Neonatal circumcision for HIV prevention: Cost, culture, and behavioral considerations. PLoS Med 7:e1000219
Kalichman, Seth C; Simbayi, Leickness C; Cloete, Allanise et al. (2009) Measuring AIDS stigmas in people living with HIV/AIDS: the Internalized AIDS-Related Stigma Scale. AIDS Care 21:87-93
Kalichman, Seth C; Simbayi, Leickness C; Cloete, Allanise et al. (2009) Integrated gender-based violence and HIV Risk reduction intervention for South African men: results of a quasi-experimental field trial. Prev Sci 10:260-9
Kalichman, Seth C; Simbayi, Leickness C; Cain, Demetria et al. (2008) Perceived HIV/AIDS prevalence, burden, and risk, Cape Town, South Africa. Am J Health Behav 32:693-700

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