HIV Intervention Program Boosts Safe Sex Habits Among High Risk Couples
For Immediate Release
July 12, 2010
New York, NY – Heterosexual, African American couples of serodiscordant HIV status (one HIV positive and one negative) reported a significant increase in safer sex behaviors after taking part in an HIV/STD intervention study Project Eban, funded by the National Institute of Mental Health (NIMH). The findings of the study were published online on July 12, 2010 and will appear in the September 27 print issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Project Eban is the first and largest HIV couples-based study conducted in the U.S. and was designed to reduce sexual risk behaviors among serodiscordant, heterosexual African American couples affected by HIV. The study was conducted in New York, Philadelphia, Atlanta, and Los Angeles, four cities with high rates of HIV incidence.
Sexually transmitted diseases, including HIV, disproportionately affect African Americans, who comprise 12 percent of the U.S. population but 45 percent of all new HIV infections. Research has shown that rates of new HIV infections are about seven times higher among African Americans than their Caucasian counterparts, suggesting the need for culturally specific interventions. In addition, although the majority of infections in African American women have occurred through heterosexual contact with a regular sexual partner, there is a relative lack of research applicable to African American, serodiscordant, heterosexual couples.
Of the 535 couples enrolled in the study, 260 were randomly assigned to receive the Eban HIV/STD risk reduction intervention and 275 received the comparison intervention. The Eban intervention arm was designed not only to reduce sexual risk behaviors, but also to increase a couple’s ability to communicate with each other, make safer behaviors more appealing, stay in healthy relationships and respect their communities. The comparison intervention arm provided information about healthy lifestyle habits, such as eating more fruits and vegetables, and risk behaviors linked to heart disease, hypertension, stroke and certain cancers. Unlike the risk reduction intervention arm, the comparison intervention did not focus on sexual risk behaviors and addressed participants as individuals rather than as couples.
The researchers assessed participants’ histories of sexually transmitted disease and self-reports of sexual behavior at the start of the study, immediately following the eight-week intervention, as well as six and 12 months after the end of the intervention.
Compared to couples in the comparison intervention, those who received the HIV/STD risk reduction intervention reported more frequent and consistent condom use and fewer acts of unprotected sex showing that the intervention is efficacious in encouraging safer sex practices among this group of participants. Couples in the Eban group reported more consistent use of condoms (63 percent of the couples used condoms consistently, vs. 48 percent in the comparison group). In addition, the average number of unprotected intercourse acts was lower in the intervention group than in the comparison group (an average of 1.5 fewer).
“We are very proud at Columbia University to have designed and implemented this important study to help African American communities in New York City and around the country affected by HIV. Project Eban is the only efficacious evidence-based, culturally congruent HIV study to reduce sexual risk behavior that focuses exclusively on African American serodiscordant couples. Access to this HIV prevention model would have a significant impact on reducing the spread of the HIV epidemic among this population,” said Principal Investigator, Dr. Nabila El-Bassel.
The NIMH study was funded to Drs. Nabila El-Bassel (Columbia University, School of Social Work), John Jemmott (University of Pennsylvania, School of Medicine), Gina Wingood (Emory University, School of Public Health), and Gail Wyatt (University of California-Los Angeles, Dept. of Psychiatry & Biobehavioral Sciences). The study was led by the principal investigators and a research team at each site. The investigative research team from CU included Drs. Louisa Gilbert, Susan Witte, and Elwin Wu from the School of Social Work and Dr. Robert Remien from the HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University, and a number of research staff.
El-Bassel N., Jemmott J.B., Wingood G.M., Wyatt G.E., Pequegnat W., Landis J.R., Bellamy S.L. NIMH Multisite Eban HIV/STD Prevention Intervention for African American HIV Serodiscordant Couples: A Cluster Randomized Trial. Archives of Internal Medicine. July 12, 2010. [epub ahead of print]