Project Summaries

Gonorrhea Community Action Project (GCAP)

A multi-site project to understand and reduce the extremely high rates of gonorrhea and other bacterial sexually transmitted infection in seven communities. read more

Rompe el Silencio - Break the Silence

Rompe el Silencio/Break the Silence was a culturally based intervention to increase HIV/AIDS communication among U.S. Latina families in order to reduce the risk of HIV/STI infection. read more

Long Beach HIV Needs Assessment

A project to help identify HIV/AIDS prevention, care, and treatment needs of diverse populations in Long Beach and surrounding communities. read more

Safe in the City

Evaluated the use of soap-opera style vignettes to promote healthy sexual behaviors. Safe in the city is now one of the CDC’s recommended effective HIV-risk reduction interventions. read more

Project RESPECT

Project RESPECT was a multi-site trial comparing the effect of a theory-driven HIV counseling and testing intervention with the CDC standard intervention and a minimalist intervention. The Project RESPECT is now part of the CDC’s effective HIV prevention interventions. read more

TDF-2

A study of the safety and efficacy of daily oral antiretroviral use for the prevention of HIV infection in heterosexually active young adults in Botswana. read more

RESPECT-2

RESPECT-2 compared a single HIV counseling session plus a rapid HIV test to the intervention found effective in Project RESPECT. The CDC now includes RESPECT-2 as part of its effective HIV prevention interventions. read more

The TIM Project

A project to develop an intervention and to test social-networking-based message delivery to motivate HIV testing among young black men who have sex with men. read more

Project Details

  • Gonorrhea Community Action Project (GCAP) 

    Funded by the Centers for Disease Control and Prevention (CDC) and the National Institute of Mental Health (NIMH), the goal of this multi-site project was to better understand factors related to extremely high gonorrhea (and other bacterial sexually transmitted infection) rates in seven communities (Phase 1), and develop interventions to reduce those rates in three communities (Phase 2). Our local study used a community-based approach to address gonorrhea infection among youth and young adults in the Southwest health district of Los Angeles County.  Phase I, the formative research phase, involved qualitative data collection to:  1) investigate contributing factors to the high incidence of gonorrhea, 2) identify factors that influence the health-seeking behaviors of populations at risk of acquiring and transmitting gonorrhea, and 3) investigate the knowledge and use of health services by these individuals.  The findings from Phase 1 were used to develop the community, client, and provider interventions implemented in Phase 2.  The GCAP Community Advisory Board, established with health and social service providers, community-based organizations, and other entities serving youth and young adults in the target area, played an integral role in successful implementation of study activities.

    The Phase 2 interventions were an individual level intervention directed at STI clinic patients to encourage return for re-testing after treatment for gonorrhea or chlamydia, training of community health care providers to elicit sexual histories from adolescents and test sexually active adolescents and young adults under the age of 25, and a community-level intervention using outreach with peer health leaders and social marketing to increase seeking care for physical examinations (including STI testing) by adolescents, the creation of a community health outreach facility, called “The Positive Source” that provided urine screening for gonorrhea and chlamydia among other services. Evaluation of the community awareness campaign indicated increased awareness of campaign materials and the need for STI testing even in absence of symptoms in the target community compared to a comparison community. Results of the client intervention found that a monetary incentive did not increase return rates compared with a brief recommendation. A reminder phone call seemed to be the most effective method to increase return.

     

  • Long Beach HIV Needs Assessment 

    This project was funded by the Long Beach Department of Health and Human Services to help identify HIV/AIDS prevention, care, and treatment needs of diverse populations in Long Beach and surrounding communities. The assessment assessed gaps between the community needs and available services for individuals living with HIV/AIDS, as well as barriers to receiving services.  CHER assisted in interviewing participants, conducting focus groups, preparing reports, and recommending action steps to reduce the barriers to care.

  • Project RESPECT 

    Project RESPECT was a CDC-funded multi-site randomized trial comparing the effect of a 4-session theory-driven HIV counseling and testing intervention (enhanced counseling), a two-session counseling and testing intervention (brief counseling), and an information and testing only intervention (didactic messages). This study was conducted in five public health department sexually transmitted disease (STD) clinics in the United States, including the Long Beach Department of Health and Human Services. The primary study aims were to determine whether clinic-based HIV counseling and testing was effective in reducing high-risk sexual behaviors and preventing new cases of sexually transmitted infections (STIs) in STD clinic patients. The enhanced counseling included sessions on condom use beliefs, self-efficacy, attitudes, and norms. Both of the counseling interventions focused on actual and perceived risk of HIV/STIs, barriers to risk reduction, and negotiation a risk-reduction plan with sexual partners. Self-reported 100% condom use was higher in both the enhanced counseling and brief counseling arms compared with participants in the didactic messages arm. Through the 6-month interval, 30% fewer participants had new STIs in both the enhanced counseling and brief counseling arms compared with those in the didactic messages arm. Through the 12-month follow-up, 20% fewer participants in each counseling intervention had new STDs compared with those in the didactic messages arm. As a result of this study, Project RESPECT became one of the interventions promoted to prevention practitioners through the CDCs Diffusion of Effective Behavioral Interventions (DEBI) program.

  • RESPECT-2 

    Project RESPECT (see above) showed that two risk-reduction counseling sessions can prevent sexually transmitted diseases (STDs); however, return rates for test results were often low in standard clinic practice at the time this study was conducted. Thus, RESPECT-2 was a randomized, controlled trial that compared rapid HIV testing and counseling in 1 visit with standard Project RESPECT HIV testing and counseling in 2 visits. Main outcomes were STDs within 12 months. Participants were 15- to 39-year-old STD clinic patients in Denver, Long Beach, and Newark. Counseling was completed by 99% of the rapid-test group and 69% of the standard-test group. Self-reported behavior was similar in both groups and there was no significant difference in STD rates between the two groups overall at 12 months. However, STD incidence was significantly higher in the rapid-test group than in the standard-test group among men, and approached significance for men who had sex with men, and persons with no STDs at enrollment. This led to the conclusion that counseling with either test had similar effects on

    STD incidence, but that for some persons, counseling with standard testing may be more effective than counseling with rapid testing. RESPECT-2 also became one of the interventions promoted to prevention practitioners through the CDCs Diffusion of Effective Behavioral Interventions (DEBI) program.

  • Rompe el Silencio - Break the Silence 

    Rompe el Silencio, funded by the Office of Women’s Health, sought to reduce the risk of HIV infection among U.S. Latinas by creating and strengthening an HIV/AIDS prevention intervention targeting Latinas and their families throughout the lifespan. This culturally based intervention was designed to help Latinas in East Los Angeles to decrease barriers to HIV/AIDS communication within the family and across generations. The intervention included discussions between mothers and daughters, and activities conducted in a culturally appropriate way.  Findings suggest Rompe el Silencio was effective at increasing open discussions about sex, increasing comfort level with communication, and increasing HIV knowledge.

  • Safe in the City 

    This was a CDC-funded, 5-year, multi-site trial to evaluate the effectiveness of a brief 23 minute HIV/STI educational video, Safe in the City, which used soap-opera style vignettes to promote consistent and correct condom use and safer sex behaviors, on sexually transmitted infection (STI) incidence in sexually transmitted disease clinic patients in three cities. A controlled trial design, in which the intervention (i.e., “Safe in the City” video, supplemented by movie-style posters) and control conditions (i.e., standard waiting room experience) were systematically administered to all waiting room patients in alternating four-week blocks of time was used. A statistically significant approximate 10% reduction in new STIs was found among those who attended the clinic during the intervention periods. The CDC determined that the intervention met the rigorous criteria for 'Best Evidence' of an effective intervention, and Safe in the City joined the RESPECT interventions (see below) as one of the interventions promoted to prevention practitioners through the CDCs Diffusion of Effective Behavioral Interventions (DEBI) program.

     

  • TDF-2 

    Dr. Malotte, CHER Director, was a co-investigator for a project entitled, “Study of the Safety and Efficacy of Daily Oral Antiretroviral Use for the Prevention of HIV Infection in Heterosexually Active Young Adults in Botswana (TDF-2).” The purpose of this trial was to determine whether antiretroviral medication (in this case the drug Truvada) taken as daily oral prophylaxis (pre-exposure prophylaxis or PrEP) is safe on a long-term basis and whether it significantly reduces the rate of acquisition of HIV infection when used in addition to standard risk reduction methods. Participants in this study were randomized to receive either the antiretroviral medication or its placebo and were followed for any adverse effects of the agent, any changes in their sexual risk behavior, and HIV incidence. Dr. Malotte assisted in the development of risk-reduction, support, and adherence counseling guidelines and in the training and observation of counseling staff. The results of this trial, indicating a reduction of HIV acquisition of approximately 63% among those on PrEP, generated worldwide press coverage, and the results of this and several other trials were used by the United States Food and Drug Administration in their decision to approve Truvada for prevention of HIV infection. An article in the New England Journal of Medicine describes the study and its outcomes.

  • The TIM Project 

    This on-going study, “Exploring an HIV Testing Intervention Model (TIM Project) Among Black Men Who Have Sex with Men” is led by Dr. Alex Washington from the School of Social Work and funded by the National Institute on Drug Abuse. The specific aims of this project are to develop an intervention to motivate HIV testing among young black men who have sex with men (BMSM) and to examine the feasibility and effectiveness of using social networking to encourage testing. In this study, the intervention group will get access to the study online social network group which will include videos and hosted discussions in addition to online surveys. The control group will only receive the online surveys and reading material about HIV prevention, drug use, and sexual risk behavior. It is hoped that this project will provide information that will assist in efforts to increase HIV testing in this high risk group of men.