TY - JOUR
T1 - Horizons and Group Motivational Enhancement Therapy
T2 - HIV Prevention for Alcohol-Using Young Black Women, a Randomized Experiment
AU - DiClemente, Ralph J.
AU - Rosenbaum, Janet E.
AU - Rose, Eve S.
AU - Sales, Jessica M.
AU - Brown, Jennifer L.
AU - Renfro, Tiffaney L.
AU - Bradley, Erin L.P.
AU - Davis, Teaniese L.
AU - Capasso, Ariadna
AU - Wingood, Gina M.
AU - Liu, Yu
AU - West, Stephen G.
AU - Hardin, James W.
AU - Bryan, Angela D.
AU - Feldstein Ewing, Sarah W.
N1 - Funding Information:
Of the eligible women, 96% (n=560) enrolled, completed baseline assessments, and were randomized to study conditions ( Figure 1 ). A power calculation determined the sample size using Power Analysis and Sample Size 2008 software to detect an absolute difference of 10 percentage points in STI incidence between the Horizons + GMET and control, yielding a power of 81% for 85% retention for repeated-measures logistic regression analyses. Participants were compensated up to $445 for completing all intervention sessions and assessments during the 12-month study. No unintended adverse events were noted during the course of this study. The Emory University IRB approved all study protocols. The trial is registered as NCT01553682. The full trial protocol can be requested from the corresponding author. The study was funded by the U.S. National Institute on Alcohol Abuse and Alcoholism (5R01AA018096).
Funding Information:
The study sponsor (NIH) had no role in any aspect of the research, interpretation, analysis, writing, or decision to submit for publication. This work was supported by the U.S. NIH (5R01AA018096). RJD conceived the study. ESR, JMS, JLB, TR, ELPB, TLD, JER, and AC carried out the literature review. ESR, JMS, JLB, TR, ELPB, TLD, and GMW carried out the intervention and collected the data. JER analyzed the data, created the figures and tables, and wrote the manuscript. JER, RJD, JLB, JMS, and TLD interpreted the results and revised the paper. All authors approved the final submission. No financial disclosures were reported by the authors of this paper.
Funding Information:
This work was supported by the U.S. NIH (5R01AA018096).
Publisher Copyright:
© 2021 American Journal of Preventive Medicine
PY - 2021/5
Y1 - 2021/5
N2 - Introduction: Black women are at disproportionately greater risk for HIV and sexually transmitted infections than women of other ethnic/racial backgrounds. Alcohol use may further elevate the risk of HIV/sexually transmitted infection acquisition and transmission. Study Design: A random-assignment parallel-group comparative treatment efficacy trial was conducted with random assignment to 1 of 3 conditions. Setting/participants: The sample comprised 560 Black or African American women aged 18–24 years who reported recent unprotected vaginal or anal sex and recent alcohol use. Participants were recruited from community settings in Atlanta, Georgia, from January 2012 to February 2014. Intervention: A Group Motivational Enhancement Therapy module was designed to complement a Centers for Disease Control and Prevention–designated evidence-based intervention (Horizons) to reduce sexual risk behaviors, alcohol use, and sexually transmitted infections, with 3 comparison groups: (1) Horizons + Group Motivational Enhancement Therapy intervention, (2) Horizons + General Health Promotion intervention, and (3) enhanced standard of care. Main outcome measures: Outcome measures included safe sex (abstinence or 100% condom use); condom nonuse; proportion of condom use during sexual episodes; incident chlamydia, gonorrhea, and trichomonas infections; and problematic alcohol use measured by Alcohol Use Disorders Identification Test score. Treatment effects were estimated using an intention-to-treat protocol‒generalized estimating equations with logistic regression for binomial outcomes and Poisson regression for count outcomes. Analyses were conducted between October 2018 and October 2019. Results: Participants assigned to Horizons + Group Motivational Enhancement Therapy had greater odds of safe sex (AOR=1.45, 95% CI=1.04, 2.02, p=0.03), greater proportion of condom use (AOR=1.68, 95% CI=1.18, 2.41, p=0.004), and lower odds of condom nonuse (AOR=0.57, 95% CI=0.38, 0.83, p=0.004). Both interventions had lower odds of problematic alcohol use (Horizons: AOR=0.57, 95% CI=0.39, 0.85, p=0.006; Horizons + Group Motivational Enhancement Therapy: AOR=0.61, 95% CI=0.41, 0.90, p=0.01). Conclusions: Complementing an evidence-based HIV prevention intervention with Group Motivational Enhancement Therapy may increase safer sexual behaviors and concomitantly reduce alcohol use among young Black women who consume alcohol. Trial registration: This study is registered at www.clinicaltrials.gov NCT01553682.
AB - Introduction: Black women are at disproportionately greater risk for HIV and sexually transmitted infections than women of other ethnic/racial backgrounds. Alcohol use may further elevate the risk of HIV/sexually transmitted infection acquisition and transmission. Study Design: A random-assignment parallel-group comparative treatment efficacy trial was conducted with random assignment to 1 of 3 conditions. Setting/participants: The sample comprised 560 Black or African American women aged 18–24 years who reported recent unprotected vaginal or anal sex and recent alcohol use. Participants were recruited from community settings in Atlanta, Georgia, from January 2012 to February 2014. Intervention: A Group Motivational Enhancement Therapy module was designed to complement a Centers for Disease Control and Prevention–designated evidence-based intervention (Horizons) to reduce sexual risk behaviors, alcohol use, and sexually transmitted infections, with 3 comparison groups: (1) Horizons + Group Motivational Enhancement Therapy intervention, (2) Horizons + General Health Promotion intervention, and (3) enhanced standard of care. Main outcome measures: Outcome measures included safe sex (abstinence or 100% condom use); condom nonuse; proportion of condom use during sexual episodes; incident chlamydia, gonorrhea, and trichomonas infections; and problematic alcohol use measured by Alcohol Use Disorders Identification Test score. Treatment effects were estimated using an intention-to-treat protocol‒generalized estimating equations with logistic regression for binomial outcomes and Poisson regression for count outcomes. Analyses were conducted between October 2018 and October 2019. Results: Participants assigned to Horizons + Group Motivational Enhancement Therapy had greater odds of safe sex (AOR=1.45, 95% CI=1.04, 2.02, p=0.03), greater proportion of condom use (AOR=1.68, 95% CI=1.18, 2.41, p=0.004), and lower odds of condom nonuse (AOR=0.57, 95% CI=0.38, 0.83, p=0.004). Both interventions had lower odds of problematic alcohol use (Horizons: AOR=0.57, 95% CI=0.39, 0.85, p=0.006; Horizons + Group Motivational Enhancement Therapy: AOR=0.61, 95% CI=0.41, 0.90, p=0.01). Conclusions: Complementing an evidence-based HIV prevention intervention with Group Motivational Enhancement Therapy may increase safer sexual behaviors and concomitantly reduce alcohol use among young Black women who consume alcohol. Trial registration: This study is registered at www.clinicaltrials.gov NCT01553682.
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U2 - 10.1016/j.amepre.2020.11.014
DO - 10.1016/j.amepre.2020.11.014
M3 - Article
C2 - 33678517
AN - SCOPUS:85103241315
VL - 60
SP - 629
EP - 638
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
SN - 0749-3797
IS - 5
ER -