Long-term effectiveness of a peer-based intervention to promote condom andcontraceptive use among HIV-positive and at-risk women

Objective. The authors used data from a larger study to evaluate the longte rm effects of a peer advocate intervention on condom and contraceptive use among HIV-infected women and women at high risk for HIV infection. Methods. HIV-infected women in one study and women at high risk for HIV inf ection in a second study were selected from the Women and Infants Demonstra tion Project and assigned to a standard or an enhanced HIV prevention treat ment group. The enhanced intervention included support groups and one-on-on e contacts with peer advocates tailored to clients' needs. The authors inte rviewed women at baseline and at 6-, 12- and 18-months, and measured change s in consistency of condom and contraceptive use and in self-efficacy and p erceived advantages and disadvantages of condom and contraceptive use. Results. Of HIV-infected women, the enhanced group had improved consistency in condom use, increased perceived advantages of condom use, and increased level of self-efficacy compared with the standard group. Of women at risk, the enhanced intervention group at six months maintained consistent condom use with a main partner and perceived more benefit of condom use compared with the standard group. These differences diminished at 12 months. Conclusions. The enhanced intervention was generally effective in the HIVstudy. In the at-risk study, however, intervention effects were minimal and short-lived. Factors related to the theory, intervention design, and Sampl e characteristics help explain these differences.