July 23, 2010
Black HIV-discordant couples participating in an HIV/STD risk-reduction intervention program demonstrated lower rates of risky behavior, according to a new study by researchers at the National Institute of Mental Health.
Willo Pequegnat and colleagues conducted a cluster-randomized trial of couples taking the "Eban" intervention program. Of the 535 discordant couples enrolled, 260 took part in Eban, which included eight weekly two-hour sessions led by trained African-American facilitators. The remaining 275 couples participated in a similarly structured general health-promotion program targeting individual -- not couple-focused -- health and behaviors linked to heart disease, hypertension, and certain cancers. The main behavioral outcome was couple?s reported use of condoms, while the primary biological outcome was cumulative incidence of STDs.
The baseline average proportion of condom-protected intercourse for each group was 44 percent. At the end of one year, Eban participants reported significant increases in condom use and more consistent condom use. After adjustment for baseline measure, the rate was 77 percent in the Eban group compared with 47 percent in the control group. The adjusted percentage of couples consistently using condoms was 63 percent in the intervention group and 48 percent in the control group.
Two HIV-negative partners in the intervention group seroconverted compared with three in the control group, a total of five seroconversions among the 535 couples, translating to 935 infections per 100,000 population. This observed seroconversion rate is "substantially larger" than the annual HIV incidence estimate overall for blacks (approximately 83.8 per 100,000), suggesting that HIV-negative members of such couples are at very high risk, the researchers warned.
The study, "National Institute of Mental Health Multisite Eban HIV/STD Prevention Intervention for African-American HIV Serodiscordant Couples: A Cluster Randomized Trial," was published early online in the Archives of Internal Medicine (2010;doi:10.1001/archinternmed/2010/261.
07.12.2010; Michael Smith
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