GENDER-SPECIFIC INTERVENTIONS FOR WOMEN AND THEIR MALE PARTNERS

Grant Title:
A Structural Intervention to Promote Women's Health

Funding Source and Project Period:
NIMH R01; to be awarded 2005 - 2009

Collaborating Institutions and Key Personnel:

HIV Center:

Principal Investigator: Theresa Exner, Ph.D.
Co-Principal Investigators: Joanne Mantell, Ph.D.; Susie Hoffman, Dr.P.H.
Co-Investigators: Jessica Adams-Skinner, M.P.H.; Joyce Hunter, D.S.W.

N.Y. State AIDS Institute:

Co-Principal Investigator: James Tesoriero, Ph.D.
Co-Investigators: Richard A. Cotroneo, M.A.; Susan Klein, M.S.;
Alma R. Candelas, M.P.H.

Project Overview:

In this project, which is approved for funding by NIMH, we are proposing an innovative multi-level, multi-component, structural intervention to promote the female condom that will take advantage of the organizational infrastructure, training, and capacity-building mechanisms in place for HIV/STI counselors of a major governmental system – the New York State AIDS Institute. The AIDS Institute coordinates all HIV public health initiatives in New York – a state with one of the highest number of HIV/AIDS cases among women in the U.S.. Our focus on the female condom is driven by women's steadily increasing vulnerability to HIV/AIDS and the lack of methods that enable them to protect themselves from HIV/AIDS and other STIs. Despite the fact the female condom is the only available barrier alternative to the male condom and that numerous studies document its acceptability, utilization of this method remains low. While some user-level barriers have been identified and some effective strategies to reduce these impediments have been implemented, there have been no U.S. interventions addressing the structural barriers, such as agency policies and counseling practices, that may impede female condom adoption and use. This four-year study will test the impact of a statewide female condom promotional intervention, targeted at the level of Agencies and Agency Counselors. We will conduct a randomized controlled trial of 60 Agencies that receive AIDS Institute funding to compare the efficacy of an Enhanced FC promotion intervention to a Minimal intervention among Agency Directors and HIV sexual risk-reduction Counselors (N=400). The Minimal Intervention, targeted to the Agency-level only, consists of a regional Directors' meeting and provision of free female condoms to the Agencies. The Enhanced Intervention, targeted to both the Agency- and Counselor-levels, consists of the same two components, but also includes (1) at the Agency-level, distribution of a "Female Condom Program and Policy Tool-Kit" to Agency Directors and 12 months of technical support; and (2) at the Counselor-level, a one-day FC training workshop, 12 months of technical support, and provision of FC materials to Counselors for use with Clients. Our primary Agency-level outcome will be a composite measure of policies and practices reflecting integration of the FC at the Agency; our primary Counselor-level outcome will be the proportion of Clients reported to have been counseled on the FC. Through a nested case study in two urban areas, we also will directly assess the impact of the intervention at the Client-level (N=640). The study will yield important data on implementation of a large scale structural public health initiative. If effective, the intervention program, integrated into an existing statewide public health infrastructure, could serve as a model for the promotion of the FC as well as for emerging prevention technologies, both in the US and abroad.

Publications and Presentation Abstracts:

None to date.

Update: 5/26/05