HIV Infections Clinical Trial
Official title:
Safer Sex Intervention for At-risk Women in Mexico
This study will evaluate the effectiveness of the Share Safer Sex Program in reducing sexual risk behaviors among female sex workers in four Mexican cities close to the U.S. border.
Mexican female sex workers (FSWs) represent a large portion of the reported cases of AIDS
and other sexually transmitted diseases (STDs) in Mexico. Despite the imbalance in the
distribution of reported cases, there have been few efforts to change high-risk sexual
behaviors in this population. There has been a dramatic increase in HIV and other STDs over
the past decade, especially in Mexican cities along the United States border. Border cities
often have a thriving sex trade industry, and some are considered "sexual tourist"
destinations. FSWs in these border cities, however, often do not know how to practice safe
sex. A previous study showed that a culturally sensitive risk reduction counseling program
was effective in reducing sexual risk behavior in FSWs in Tijuana, Mexico. It may therefore
be possible to implement the same program, with similar efficacy, in other Mexican cities
near the U.S. border. This study will evaluate the effectiveness of the Share Safer Sex
Program versus a standard counseling program in reducing sexual risk behaviors among FSWs in
the Mexican cities of Tijuana, Ciudad Juarez, Nuevo Laredo, and Matamoros.
Participants in this open label study will be randomly assigned to either the Share Safer
Sex Program or a standard counseling program. Both programs will last for 6 months and will
consist of a single counseling session lasting between 35 and 40 minutes. All participants
will undergo blood collection and a gynecological exam upon study entry and 6 months later.
The standard counseling program will be based on a sexual risk reduction counseling program
developed by the Centers for Disease Control and Prevention, and will focus on personal risk
assessment and strategies for risk reduction. Additionally, it will incorporate risk
reduction materials provided by CENSIDA, Mexico's National Center for AIDS Studies. The
Share Safer Sex Program will be tailored to the needs, values, beliefs, and behaviors of the
participants, and will take into account gender and cultural differences. Counselors will
work with participants to increase personal awareness of their current unsafe behaviors and
the associated risks, help them understand their motivation to change, and increase their
knowledge about how to practice safe sex. Demonstrations and practice exercises will be used
to improve participants' attitudes about, as well as intentions to practice, condom use. The
counseling session will include the following activities: assessing readiness for change;
building motivation for change; and performing exercises in decisional balance,
identification of problem and problem-solving, and knowledge and skill-building. Outcomes
for both treatment groups will be assessed after 6 months. Participants in the standard
counseling program will be offered an opportunity to participate in the Share Safer Sex
Program upon completion of the study.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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