Violence and HIV Risk Among Women
Condition: HIV Risk Reduction
Study type: Interventional

Summary: 
      The purpose of the study is to test the feasibility, acceptability, and efficacy of an
      adapted intervention that is theoretically and empirically guided by the
      Information-Motivation-Behavioral skills model (IMB) and aims at reducing sexual risk
      behavior among women who have experienced Intimate Partner Violence (IPV), as well as such an
      intervention.
    

Detailed description: 
      The two foremost health problems impacting young adult women are STDs/HIV infection and
      intimate partner violence (IPV). STDs pose a significant public health issue in the US,
      particularly among women. The consequences of some STDs are more severe for women, and
      include infertility, pelvic inflammatory disease, and brain, cardiovascular, and organ
      damage. Women with STDs are at increased risk for HIV. The proportion of AIDS cases among US
      adult and adolescent women has more than tripled since 1985. Approximately 12,000 US women
      are infected with HIV annually, primarily through heterosexual contact. Also, in the US HIV
      is particularly affecting women of color and those in low-income urban areas.

      IPV also affects many women. While the causal links between IPV and HIV risk or infection
      have not yet been established, emerging empirical evidence has drawn connections between IPV
      with HIV risk. Several researchers have highlighted the importance of developing sexual risk
      reduction interventions that address the growing concern of gender-based violence against
      women. Also, scholars are calling for HIV prevention programs aimed at women to be more
      comprehensive; for example, by combining them with STD screening or with programs designed to
      reduce violence against women. Despite this call, there are very few empirically tested
      interventions for prevention and treatment targeting women who are at risk for STDs/HIV and
      experience IPV in their intimate relationships. To address high risk sexual behaviors among
      women who experience gender-based violence in their intimate relationships, I have adapted an
      existing information-motivation-behavioral skills (IMB) STD/HIV prevention intervention for
      reducing high sexual risk-taking behaviors. The STD/HIV and IPV comprehensive intervention
      will address both sexual risk reduction and IPV risk; the intention is to help women to
      acquire knowledge, skills, and strategies that will reduce their risk for both STDs/HIV and
      IPV.

      Aim 1: To assess the feasibility and acceptability of the adapted IMB STD/HIV prevention
      intervention by implementing the intervention with a sample of women who are at risk for
      HIV/STDs and experience IPV. To achieve this aim:

        1. 120 women who are at risk for HIV/STDs and have experienced IPV will be randomized
           either to receive the experimental prevention intervention or to attend a structurally
           similar drop-in enhanced support group at a domestic violence agency.

        2. Enrollment, attendance, and attrition data will be used to determine the feasibility of
           the intervention.

        3. The acceptability of the intervention will be appraised by analyzing pre- and
           post-intervention acceptability ratings completed by subjects and interventionists.

      Aim 2: To gather preliminary evidence of the efficacy of the theoretically guided
      intervention using a controlled design. To achieve this aim:

        1. Women in the experimental and control groups will be assessed at baseline,
           post-intervention, and at a 3-month follow-up.

        2. Outcome analyses to calculate effect sizes for use in future power analyses for a larger
           RCT of the proposed intervention will include measures on primary variables of
           hypothesized risk antecedents, standard measures of protected and unprotected sex, and
           secondary variables such as mental health, self esteem, and IPV experiences.
    

Intervention name(s): supporting positive and healthy relationships; community support group
Intervention type(s): Behavioral; Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention