mental health AIDS

Winter 2007 Newsletter / Volume 8, Issue 2

HIV Prevention News

About Men

Wolitski and the Project START Writing Group (2006) compared the effects of a single-session intervention and an enhanced multisession intervention on sexual risk behavior reported by young men (ages 18 to 29 years) released from U.S. prisons in four states. The men were systematically assigned to one of these two intervention conditions.1 Assessment data were collected prior to release, as well as 1, 12, and 24 weeks following release. "A total of 522 men were included in intent-to-treat analyses. Follow-up rates ranged from 76% to 87%. Unprotected vaginal or anal sex during the 90 days before incarceration was reported by 86% of men in the enhanced intervention and 89% in the single-session intervention ... . At 24 weeks [after release], 68% of men assigned to the enhanced intervention reported unprotected vaginal or anal sex compared with 78% of those assigned to the single-session intervention ..." (p. 1854). According to the investigators,

Project START demonstrated that a multisession community-reentry intervention can lead to lower rates of sexual risk behavior among young men who are released from prison. Significantly lower rates of unprotected intercourse were observed at 24 weeks for men assigned to the enhanced intervention compared with those assigned to the single-session intervention. These differences continued to be present even when differences in the amount of time since the last intervention contact were taken into account. This success is noteworthy given the difficulties inherent in working in correctional settings, including restricted access to participants, limited private space, negative attitudes toward prevention activities among some correctional staff, and restrictions on HIV-prevention materials in prison. ... (p. 1858)

Wolitski and colleagues conclude that "[t]he enhanced intervention tested in Project START provides an evidence-based strategy for reducing sexual risk and should be considered for use with other young men in correctional settings. Given the disproportionate burden of disease in this population, … health departments and community-based organizations [need] to work with correctional institutions to improve the health of these men, their partners, and their communities" (p. 1859).

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