UMass Amherst Community Health Education faculty members Drs. Krishna Poudel and David Buchanan, along with adjunct faculty member Dr. Kalpana Poudel-Tandukar, recently published the results of a study on community-based HIV risk reduction intervention program in Nepal. The article, titled “Effects of a Community-Based HIV Risk Reduction Intervention Among HIV-Positive Individuals: Results of a Quasi-Experimental Study in Nepal”, appears in the June issue of AIDS Education and Prevention.

 
[Photo: Dr. Krishna Poudel (left) and Dr. David Buchanan]

Dr. Poudel’s previous research has shown that nearly half of sexually active HIV-positive individuals in Nepal continue to engage in unsafe sexual practices even after knowing their HIV-positive status; the authors also note that little information was available regarding the feasibility and effectiveness of theory-based behavioral change interventions among HIV-positive individuals in resource-limited countries where over 90 percent of HIV-positive individuals are residing. Therefore, the researchers sought to develop and test the efficacy of a culturally appropriate theory-guided behavioral intervention to improve safer sex practices among HIV-positive individuals.

Using protection motivation and social cognitive theories as theoretical frameworks, Dr. Poudel and colleagues developed a series of six participatory educational intervention sessions. Sessions included short video presentations, information sharing sessions, proper condom use demonstrations, condom negotiation role play, and group discussions to share strategies on such things as stress reduction, social support, and safer sex negotiation skills.

277 participants were assigned to either an intervention group (which received the sessions on sexual risk reduction strategies) or a control group (who attended sessions on medication adherence, smoking, and mental health). Data collected at baseline and immediately after the intervention indicate that the sexual risk reduction intervention produced a significant increase in HIV transmission knowledge, perceived threat and coping appraisals, and intentions to use condoms with regular, HIV-positive, and HIV-negative partners.

The positive effects of the intervention remained significant after adjusting for baseline scores and other potential confounders, the authors note. They conclude that further studies are needed to evaluate the long-term efficacy of the intervention in increasing protection motivation and maintaining preventive behaviors.