Influence of partner participation on sexual risk behavior reduction among HIV-positive Zambian women.

Sexual risk behavior interventions in sub-Saharan Africa focus predominantly on individual and couples counseling. This cognitive-behavioral group intervention was adapted from an urban US context to urban Zambia. Preliminary data analyses assessed the influence of partner participation on sexual risk behavior among HIV-positive Zambian women. Female participants (n=180) attended four group intervention sessions and received sexual behavior skill training and male and female condoms; male partners (n=152) were randomly assigned to high- or low-intensity gender-concordant group intervention sessions. Sexual risk behavior, strategies, attitudes, and knowledge were assessed at baseline, 6, and 12 months. At baseline, 19% of males reported using alcohol before sex, 10% reported using alcohol to cope, and negative coping was associated with sexual risk behavior. In contrast, 1% of women reported using alcohol before sex, and 15% used alcohol as an HIV-coping strategy. Consistent barrier use was reported by 48% of women and 74% of men. After intervention, female high intensity participants reported higher rates of condom use (F=5.68, P=.02), more positive condom attitudes, safer sex intentions, and less alcohol use. These findings highlight the influence of male partners in implementation of effective risk reduction interventions.