Rapid vs. standard HIV testing in bathhouses: what is gained and lost?

Previous research demonstrates that standard voluntary counseling and testing (VCT) in bathhouses is feasible, and is an effective means for identifying new HIV cases and producing short term change in risk and precautionary behaviors. Less is known about whether the promise shown in standard VCT will be maintained as rapid testing is disseminated into outreach settings such as bathhouses. This study aimed to compare the risk and demographic profiles of men presenting for rapid vs.

The efficacy of female condom skills training in HIV risk reduction among women: a randomized controlled trial.

Objectives: We evaluated the efficacy of skills training designed to increase female condom use among women.

Methods: We conducted a randomized controlled trial of 409 women, recruited from family planning clinics in northern California, who were randomly assigned to the experimental 4-session female condom skills training intervention or the comparison 4-session women's general health promotion intervention. Participants received condom use instructions at baseline and male and female condoms during the study.

Bringing it home: design and implementation of an HIV/STD intervention for women visiting incarcerated men.

Incarceration has been identified as a key variable to be addressed in halting the HIV epidemic among African Americans. Our research team has been conducting and evaluating HIV prevention interventions for prisoners and their families since the early 1990s, including interventions specifically tailored to the needs of women with incarcerated partners. This article describes the development and implementation of a multicomponent HIV prevention intervention for women with incarcerated partners, and presents qualitative data from women who participated as peer educators in this intervention.

Building stakeholder partnerships for an on-site HIV testing programme.

Because of the large number of individuals at risk for HIV infection who visit gay saunas and sex clubs, these venues are useful settings in which to offer HIV outreach programmes for voluntary counselling and testing (VCT). Nevertheless, establishing a successful VCT programme in such a setting can be a daunting challenge, in large part because there are many barriers to managing the various components likely to be involved. Using qualitative data from a process evaluation of a new VCT programme at a gay sauna in California, USA, we describe how the various stakeholders overcame barriers of disparate interests and responsibilities to work together to successfully facilitate a regular and frequent on-site VCT programme that was fully utilized by patrons.

Making sure research is used: community-generated recommendations for disseminating research.

Academic research, no matter how innovative, will never make a difference in the lives of people unless it is disseminated in an appropriate and timely manner to providers and organizations serving the public. Yet many researchers are not trained, rewarded, or supported to disseminate research findings. The Community Advisory Board (CAB) of the University of California, San Francisco, Center for AIDS Prevention Studies (CAPS) developed a set guidelines to support researchers' intentions to disseminate their findings through nontraditional venues.

Responsibility for HIV prevention: patterns of attribution among HIV-seropositive gay and bisexual men.

The Seroconversion Narratives for AIDS Prevention (SNAP) study elicited narratives from recently infected seropositive gay and bisexual men that described the circumstances of their own seroconversion. This analysis of the narratives explored participants' attributions of responsibility for HIV prevention before and after they became infected. Before becoming infected with HIV, responsibility for prevention was often attributed to HIV-negative individuals themselves.

Bathhouse-based voluntary counseling and testing is feasible and shows preliminary evidence of effectiveness.

The goal of this study was to provide evidence for the feasibility and effectiveness of conducting voluntary counseling and testing (VCT) for HIV in a bathhouse setting. Four hundred ninety-two men participated in bathhouse-based VCT offered at a single venue over a 13-month period. A convenience sample of 133 of these testers was assessed at 2 points: immediately before and 3 months after testing.

Uncovering implicit theories of HIV prevention providers: it takes a community.

The Implicit Theories Project was a formative research study about what HIV prevention providers believe promotes risk behavior and facilitates behavior change. The study focused on providers who worked directly with clients to uncover providers' implicit theories. We conducted this work across several communities and targeted "risk groups" to uncover any commonalties among these various groupings.

Unprotected sex with multiple partners: implications for HIV prevention among young men with a history of incarceration.

Objectives: The objectives of this study were to describe preincarceration risk behaviors of young men and identify correlates of unprotected sex with multiple partners during the 3 months before incarceration.

Study: Data on preincarceration risk behaviors were obtained from 550 men, aged 18 to 29 years, in state prisons in California, Mississippi, Rhode Island, and Wisconsin. Correlates of unprotected sex with multiple partners were determined by logistic regression.

HIV, STD, and hepatitis risk to primary female partners of men being released from prison.

Incarcerated men in the US are at increased risk for HIV, STDs and hepatitis, and many men leaving prison have unprotected sex with a primary female partner immediately following release from prison. This paper addresses risk to the primary female partners of men being released from prison (N = 106) by examining the prevalence of men's concurrent unprotected sex with other partners or needle sharing prior to and following release from prison (concurrent risk). Rates of concurrent risk were 46% prior to incarceration, 18% one month post release, and 24% three months post release.

"You cannot do nothing in this damn place": sex and intimacy among couples with an incarcerated male partner.

In an effort to deepen our understanding of how circumstances of forced separation and the interdiction of physical contact affect women's sexual behavior, we investigated the development and maintenance of heterosexual couples' intimacy when the male partner is incarcerated. As HIV-prevention scientists who work with women visiting men at a California state prison, we recognize that correctional control extends to these women's bodies, both when they are within the facility's walls visiting their mates and when they are at home striving to remain connected to absent men. This paper analyzes the impact of a peculiar public "place", a penitentiary, on couples' romantic and sexual interactions, drawing out the implications of imprisonment for relationship decision making, sexual health, and HIV risk.

HIV and STD testing in prisons: perspectives of in-prison service providers.

Because individuals at risk for HIV and STDs are concentrated in prisons and jails, incarceration is an opportunity to provide HIV and STD testing. We interviewed 72 service providers working in U.S.

Patterns and predictors of female condom use among ethnically diverse women attending family planning clinics.

Background: The female condom is a viable option for women to protect themselves from HIV infection and other sexually transmitted diseases.

Goal: The goal was to examine the level of female condom use and factors associated with frequency of use among US women living in San Francisco and Oakland, California.

Study Design: Of 238 women recruited from family planning clinics from July 1998 to April 1999, 206 were interviewed at both baseline and 3-month follow-up (a 92% retention rate).

HIV infection and pregnancy status among adults attending voluntary counseling and testing in 2 developing countries.

Objectives: This study investigated the impact of HIV voluntary counseling and testing (VCT) on reproduction planning among 1634 adults in 2 sub-Saharan countries.

Methods: Data were obtained from a multisite randomized controlled trial.

Results: At 6 months post-VCT, the women more likely to be pregnant were younger (odds ratio [OR] = 2.

Positive and negative life events after counselling and testing: the Voluntary HIV-1 Counselling and Testing Efficacy Study.

Introduction: The results of the Voluntary HIV-1 Counselling and Testing Efficacy Study support the efficacy and cost-effectiveness of HIV voluntary counselling and testing (VCT) for reducing risk behaviors in three developing countries.

Methods: This report explores the social consequences of HIV VCT by examining the incidence of positive and negative life events at the first follow-up (an average of 7.3 months after recruitment).

Reducing postrelease risk behavior among HIV seropositive prison inmates: the health promotion program.

The prevalence of AIDS is five times higher among prison inmates than in the general population. Because recidivism is common and many inmates are serving short sentences for parole violation, HIV-seropositive inmates move frequently between prison and their home communities. We designed an eight-session prerelease intervention for HIV seropositive inmates to decrease sexual and drug-related risk behavior and to increase use of community resources after release.

Counsellors' perspectives on the experience of providing HIV counselling in Kenya and Tanzania: the Voluntary HIV-1 Counselling and Testing Efficacy Study.

Demand for HIV counselling services is increasing in developing counties, but there have been few previous studies that describe counsellors' roles and experiences providing HIV-related counselling in developing countries. Such information can be used to better supervise and support counsellors and thereby improve counselling services. As a sub-study of the Voluntary Counseling and Testing Efficacy Study, we conducted focus groups and individual interviews with 11 counsellors and counselling supervisors providing HIV counselling services in Kenya and Tanzania.

Cost-effectiveness of voluntary HIV-1 counselling and testing in reducing sexual transmission of HIV-1 in Kenya and Tanzania.

Background: Access to HIV-1 voluntary counselling and testing (VCT) is severely limited in less-developed countries. We undertook a multisite trial of HIV-1 VCT to assess its impact, cost, and cost-effectiveness in less-developed country settings.

Methods: The cost-effectiveness of HIV-1 VCT was estimated for a hypothetical cohort of 10000 people seeking VCT in urban east Africa.

Facilitators and barriers to use of the female condom: qualitative interviews with women of diverse ethnicity.

Women in the United States, particularly African-Americans and Hispanics, are at increased risk for HIV. The female condom now offers women a potentially important option for HIV prevention, yet few efforts have been made to increase its use. To elucidate strategies to promote the use of the female condom, we conducted in-depth interviews with 62 women recruited from the four major racial/ethnic groups of the U.

Collaborative research to prevent HIV among male prison inmates and their female partners.

Despite the need for targeted HIV prevention interventions for prison inmates, institutional and access barriers have impeded development and evaluation of such programs. Over the past 6 years, the authors have developed a unique collaborative relationship to develop and evaluate HIV prevention interventions for prison inmates. The collaboration includes an academic research institution (the Center for AIDS Prevention Studies at the University of California, San Francisco), a community-based organization (Centerforce), and the staff and inmate peer educators inside a state prison.

Antibody testing and condom use among heterosexual African Americans at risk for HIV infection: the National AIDS Behavioral Surveys.

Objectives: This study describes predictions of condom use and human immunodeficiency virus (HIV) antibody testing in a population-based sample of African-American heterosexuals who reported HIV risk behavior.

Methods: Data were taken from the National AIDS Behavioral Surveys.

Results: Of the African-American respondents, 22% reported some risk for HIV infection; of those, 24% had been tested for HIV.

HIV counseling for behavior change.

The purpose of this paper was to provide a framework for discussion in the working group on HIV Counseling for Behavior Change at the Third USAID HIV/AIDS Prevention Conference. The paper begins with a section defining HIV counseling and describing different types of HIV counseling. Next, points of consensus and controversy regarding the conduct and evaluation of HIV counseling are discussed.