Faculty Collaboration Database

Intervention Reach and Sexual Risk Reduction of a Multi-level, Community-Based HIV Prevention Intervention for Crack Users in San Salvador, El Salvador. AIDS Behav 2019 May;23(5):1147-1157

Date

10/21/2018

Pubmed ID

30341555

Pubmed Central ID

PMC6474837

DOI

10.1007/s10461-018-2314-z

Scopus ID

2-s2.0-85055675117 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

This article examines the effects of a multi-level, community-based HIV prevention intervention for crack users residing in low-income neighborhoods in San Salvador, El Salvador conducted between August 2011 and June 2016. The intervention consisted of three components introduced sequentially: (1) rapid HIV testing in community settings; (2) a social network HIV testing intervention; and (3) small group interventions with crack users who were members of the same social network. The intervention was evaluated with an interrupted time series design in which we used respondent-driven sampling to conduct 7 cross-sectional surveys with crack users along a 3-4 month period for each assessment (total n = 1597). Results revealed a significant increase in exposure to the intervention over time with 50% of the participants reporting exposure to one or more of the three components. Getting an HIV test at the community site was associated with reductions in total times each individual had sex without a condom (p < 0.05) compared to those who had been exposed to no intervention components. Being referred by another crack user through the Social Network HIV intervention was also associated with reductions in total numbers of condomless sex (p < 0.05) The cumulative effect of being exposed to more than one intervention component was associated with reductions in total number of times individuals had condomless sex (p < 0.05). In spite of the high level of intervention reach and that self-reported exposure to intervention components was associated with lower sexual risk, reductions in sexual risk over time were not observed in the full sample, indicating that the penetration of HIV prevention components was not sufficient to produce population level change.

Author List

Dickson-Gomez J, Tarima S, Glasman LR, Lechuga J, Bodnar G, de Mendoza LR

Authors

Julia Dickson-Gomez PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Laura R. Glasman PhD Associate Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Crack Cocaine
Cross-Sectional Studies
Drug Users
El Salvador
Female
HIV Infections
Health Promotion
Humans
Male
Mass Screening
Middle Aged
Risk Reduction Behavior
Safe Sex
Unsafe Sex
Young Adult