NEW YORK, Feb 07 (Reuters Health) -- Results of a study of low-income
American women living in inner city areas show that many women at risk for
becoming infected with HIV are still having unprotected sex.
Community-based intervention programs that teach about the role of condoms
in reducing HIV risk can increase condom use among these women, the researchers
suggest.
Compared with women who did not participate in intervention programs,
women who participated in such programs were more likely to use condoms and
discuss condom use with their partners, according to the report.
"The results of this study have implications for other community-level HIV
prevention interventions," write Dr. Jennifer L. Lauby of the Philadelphia
Health Management Corporation in Pennsylvania, and colleagues.
Study interventions included developing HIV prevention materials,
instituting networks of community-based volunteers and organizations, and
training people to discuss HIV with individuals and small groups.
According to the report published in the February issue of the American
Journal of Public Health, AIDS cases are rising faster overall among women than
men in the US. Among African-American women between 25 and 44 years old, AIDS is
the leading cause of death.
Certain community-based intervention programs have increased condom use
among gay men and can potentially reduce risky behaviors among female commercial
sex workers and partners of IV drug users, study findings have shown.
To investigate the effect of intervention programs on condom use among
low-income, sexually active women, Lauby's team implemented an HIV prevention
program in four urban communities. After 2 years, the investigators compared
changes in condom use among women who took part in the program with those of
women who did not participate in a program.
Women in both groups were at increased risk of HIV, the authors report.
Many women had used drugs or had two or more sexual partners in the past 6
months, had exchanged sex for money or drugs, or had been told they had a
sexually transmitted disease (STD).
Nearly 75% of women were African American and the mean age of participants
was 25 years old. More than half had received public assistance in the past
year.
At the beginning of the study, 68% of women said they had no intention of
using condoms with their main partner and 70% said they did not use condoms
consistently with other partners.
Two years later, more women who had participated in an intervention
program reported talking with their main partner about condoms and encouraging
their main partner to use condoms.
However, the interventions did not affect women's behavior in regards to
other partners, the researchers note.
The authors write that their findings support the need for more long-term
programs, since the effects of intervention began to appear only after 2 years.
"To be successful in low-income neighborhoods, interventions need to
address social, economic, and cultural issues that affect the target
population's access to information and its ability to focus on health-related
behaviors," Lauby and colleagues conclude.
