Skip to main content

Advertisement

Log in

Revisiting “Success”: Posttrial Analysis of a Gender-Specific HIV/STD Prevention Intervention

  • Intervention Research
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Alongside the recognized need to foster the development of innovative gender-specific HIV interventions, researchers face the urgent need to further understand how current interventions do or do not work. Few studies build posttrial qualitative analysis into standardized interview assessments in randomized controlled trials in order to bolster an assessment of how interventions work. The current investigation is a posttrial qualitative analysis carried out on a randomly selected subsample (N=180), representing 50% of women who participated in a 3-arm randomized controlled trial known as Project FIO (The Future Is Ours). FIO was a gender-specific HIV prevention intervention carried out with heterosexually active women in a high seroprevalence area of New York City. Posttrial qualitative results extend an understanding of the success of the trial (e.g., reductions in unsafe sex). Qualitative results reflect how the Modified AIDS Risk Reduction Model operated in the expected direction across experimental groups. Results also highlight women's empowerment narratives, reflecting the salience of bodily and sexual rights aspects of the intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  • Altman, D. G. (1995). Sustaining interventions in community systems: On the relationship between researchers and communities. Health Psychology, 14, 526–536.

    Article  PubMed  CAS  Google Scholar 

  • Amaro, H. (1995). Love, sex, and power: Considering women's realities in HIV prevention. American Psychologist, 50, 437–447.

    Article  PubMed  CAS  Google Scholar 

  • Amaro, H., and Raj, A. (2000). On the margin: Power and women's HIV risk reduction strategies. Sex Roles, 42, 723–749.

    Article  Google Scholar 

  • Anderson, G. L., and Prentice, R. L. (1999). Individually randomized intervention trials for disease prevention and control. Statistical Methods in Medical Research, 8, 287–309.

    Article  PubMed  CAS  Google Scholar 

  • Baron, R. M., and Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.

    Article  PubMed  CAS  Google Scholar 

  • Berg, B. (2001). Qualitative research methods for the social sciences. Boston: Allyn and Bacon.

    Google Scholar 

  • Bordo, S. (1993). Unbearable weight: Feminism, Western culture, and the body. Los Angeles: University of California Press.

    Google Scholar 

  • Catania, J. A., Kegeles, S. M., and Coates, T. J. (1990). Towards an understanding of AIDS risk behavior: An AIDS risk reduction model. AIDS and Behavior, 2, 75–85.

    Google Scholar 

  • Centers for Disease Control and Prevention (CDC). (1995). Update: AIDS among women— United States, 1994. Morbidity Mortality Weekly Report, 44, 81–84.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2002). HIV and AIDS cases reported through December 2001. HIV/AIDS Surveillance Report, 13, 1–44.

    Google Scholar 

  • Collins, P. H. (1990). Black feminist thought: Knowledge, consciousness, and the politics of empowerment. New York: Routledge.

    Google Scholar 

  • Collins, P. H. (1999). Shifting the center: Race, class, and feminist theorizing about motherhood. In S. Coontz (Ed.), American families: A multicultural reader (pp. 197–217). New York: Routledge.

  • Connell, R. W. (1999). Making gendered people: Bodies, identities, sexualities. In M. M. Ferree, J. Lorber, and B. Hess (Eds.), Revisioning gender (pp. 449–471). Thousand Oaks, CA: Sage.

  • Connell, R. W., and Dowsett, G. (1999). “The unclean motion of the generative parts”: Frameworks in Western thought on sexuality. In R. Parker and P. Aggleton (Eds.), Culture, health, and sexuality: A reader (pp. 179–196). Philadelphia: Taylor and Francis Group.

  • Denzin, N. K. (1978). Sociological methods: A source book. New York: McGraw-Hill.

    Google Scholar 

  • Dey, I. (1993). Qualitative data analysis: A user-friendly guide for social scientists. London: Routledge.

  • Djulbegovic, B. (2001). Placebo-controlled trials. Annals of Internal Medicine, 135, 62–64.

    PubMed  CAS  Google Scholar 

  • Dowsett, G. (2002). Sexuality and gender: Diversity and difference. Paper presented at the VIV International AIDS meeting, Barcelona, Spain.

  • Ehrhardt, A. A., Exner, T. M., Hoffman, S., Silberman, I., Leu, C.-S., Miller, S., and Levin, B. (2002a). A gender-specific HIV/STD risk reduction intervention for women in a healthcare setting: Short and long-term results of a randomized clinical trial. AIDS Care, 14, 147–161.

    Article  PubMed  CAS  Google Scholar 

  • Ehrhardt, A. A., Exner, T. M., Hoffman, S., Silberman, I., Yingling, S., and Adams-Skinner, J. (2002b). HIV/STD risk and sexual strategies among women family planning clients in New York: Project FIO. AIDS and Behavior, 6, 1–13.

    Article  Google Scholar 

  • Ehrhardt, A. A., Yingling, S., Zawadski, E., and Martinez-Ramirez, M. (1992). Prevention of heterosexual transmission of HIV: Barriers for women. Journal of Psychology and Human Sexuality, 5, 37–67.

    Google Scholar 

  • Eisenstein, Z. (1986). The radical future of liberal feminism. Boston: Northeastern University Press.

    Google Scholar 

  • Eitzen, D. S., and Baca-Zinn, M. (1995). Structural transformation and systems of inequality. In M. Andersen and P. H. Collins (Eds.), Race, class, and gender (pp. 202–206). New York: Wadsworth.

  • Exner, T. M., Gardos, P. S., Seal, D., and Ehrhardt, A. A. (1999). HIV sexual risk reduction interventions with heterosexual men: The forgotten group. AIDS and Behavior, 3, 347–358.

    Article  Google Scholar 

  • Firestone, S. (1970). The dialectic of sex. New York: Bantam Books.

    Google Scholar 

  • Friedan, B. (1974). The feminine mystique. New York: Dell.

    Google Scholar 

  • Fullilove, M. T., Fullilove, R. E., Haynes, K., and Gross, S. (1990). Black women and AIDS prevention: A view towards understanding the gender rules. The Journal of Sex Research, 27, 47–64.

    Article  Google Scholar 

  • Gollub, E. L., Brown, E., Savouillan, M., Waterlot, J., and Coruble, G. (2002). A community-based safer sex intervention for women: Results of a pilot study in southeastern France. Culture, Health, and Sexuality, 4, 21–41.

    Article  Google Scholar 

  • Hansen, W., and McNeal, R. (1997). How dare works: An examination of program effects on mediating variables. Health Education and Behavior, 24, 165–176.

    Article  PubMed  CAS  Google Scholar 

  • Haug, F. (1987). Female sexualization. London: Verso.

    Google Scholar 

  • Heywood, L. (1998). Bodymakers: A cultural anatomy of women's bodybuilding. New Brunswick: Rutgers University Press.

    Google Scholar 

  • Heywood, L., and Dworkin, S. L. (2003). Built to win: The female athlete as cultural icon. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Jenkins, S. R. (2000). Introduction to the special issue: Defining gender, relationships, and power. Sex Roles, 42, 751–780.

    Article  Google Scholar 

  • Krull, J. L., and MacKinnon, D. P. (1999). Multilevel mediation modeling in group-based intervention studies. Evaluation Review, 23, 418–444.

    Article  PubMed  CAS  Google Scholar 

  • Lobo, C. M., Frijling, B. D., Hulscher, M. E., Braspenning, J. L., Grol, J. C., Prins, A. R. P., and van der Wouden, J. C. (2002). Organizing cardiovascular preventive care in general practice: Determinants of a successful intervention. Preventive Medicine, 35, 430–436.

    Article  PubMed  Google Scholar 

  • Lofland, J., and Lofland, L. H. (1995). Analyzing social settings: A guide to qualitative observation and analysis. Belmont, MA: Wadsworth.

    Google Scholar 

  • Logan, T. K., Cole, J., and Leukefeld, C. (2002). Women, sex, and HIV: Social and contextual factors, meta-analysis of published interventions, and implications for practice and research. Psychological Bulletin, 128, 851–885.

    Article  PubMed  CAS  Google Scholar 

  • Lorber, J. (2001). Gender inequality: Feminist theories and politics. Los Angeles: Roxbury.

    Google Scholar 

  • MacKinnon, C. (1989). Towards a feminist theory of the state. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • MacKinnon, D. P. (1994). Analysis of mediating variables in prevention and intervention research. NIDA Research Monograph, 139, 127–153.

    PubMed  CAS  Google Scholar 

  • MacKinnon, D. P., Johnson, C. A., Pentz, M. A., Dwyer, J. H., Hansen, W. B., Flay, B. R., and Wang, E. (1991). Mediating mechanisms in a school-based drug prevention program: First year effects of the Midwestern prevention project. Health Psychology, 10, 164–172.

    Article  PubMed  CAS  Google Scholar 

  • MacKinnon, D. P., Weber, M. D., and Pentz, M. A. (1988). How do school-based drug prevention programs work and for whom? Drugs and Society, 3, 125–143.

    Article  Google Scholar 

  • Madriz, E. I. (1998). Using focus groups with lower socioeconomic Latina women. Qualitative Inquiry, 4, 114–128.

    Article  Google Scholar 

  • Mane, P., and Aggleton, P. (2000). Cross-national perspectives on gender and power. In R. Parker, R. M. Barbosa, and P. Aggleton (Eds.), Framing the sexual subject: The politics of gender, sexuality, and power (pp. 104–116). Berkeley: University of California Press.

  • Martin, E. (1987). The woman in the body: A cultural analysis of reproduction. Boston: Beacon.

    Google Scholar 

  • Messner, M. A. (1997). The politics of masculinity: Men in movements. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Meyer-Bahlburg, H. F. L., and Gruen, R. S. (1992). Training manual for psychosexual interviewing. Unpublished paper, Columbia University, Department of Psychiatry, New York.

  • Miles, M. B., and Huberman, A. M. (1994). Qualitative data analysis. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Miller, W. L., and Crabtree, B. F. (2000). Clinical research. In N. K. Denzin and Y. S. Lincoln (Eds.), Handbook of qualitative research (pp. 607–631). Thousand Oaks, CA: Sage.

  • Millet, K. (1970). Sexual politics. New York: Doubleday.

    Google Scholar 

  • Newman, T. B., Browner, T. B., Cummings, S. R., and Hulley, S. B. (2001). Designing an observational study: Cross-sectional and case-control studies. In S. B. Hully, S. R. Cummings, W. S. Browner, D. G. Norman Hearst, and T. B. Newman (Eds.), Designing clinical research (pp. 107–121). Philadelphia: Lippincott, Williams, and Wilkins.

  • Ortiz-Torres, B., Williams, S. P., and Ehrhardt, A. A. (2003). Urban women's gender scripts: Implications for HIV. Culture, Health, and Sexuality, 5, 1–17.

    Article  Google Scholar 

  • Parsons, H. M. (1974). What happened at Hawthorne? Science, 4128, 922–932.

    Article  Google Scholar 

  • Pulerwitz, J., Gortmaker, S. L., and Dejong, W. (2000). Measuring sexual relationship power in HIV/STD research. Sex Roles, 42, 637–660.

    Article  Google Scholar 

  • Reynolds, K. D., Yaroch, A. L., Franklin, F. A., and Maloy, J. (2002). Testing mediating variables in a school-based nutritional intervention program. Health Psychology, 21, 51–60.

    Article  PubMed  Google Scholar 

  • Rogers, E. M. (1995). Diffusion of innovations. New York: Free.

    Google Scholar 

  • Sandelowski, M. (1998). Using qualitative methods in intervention studies. Research in Nursing and Health, 9, 359–364.

    Google Scholar 

  • Schwartz, P., and Rutter, V. (1998). The gender of sexuality. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Seal, D. W., and Ehrhardt, A. A. (2003). Masculinity and urban men: Perceived scripts for courtship, romantic, and sexual interactions with women. Culture, Health, and Sexuality, 5, 295–319.

    Article  Google Scholar 

  • Segal, L. (1994). Straight sex: Rethinking the politics of pleasure. Berkeley: University of California Press.

  • Sherman, S. G., Gielen, A. C., and McDonnell, K. A. (2000). Power and attitudes among a sample of low-income, African American women: Implications for HIV/AIDS prevention. Sex Roles, 42, 283–294.

    Article  Google Scholar 

  • Simon, W., and Gagnon, J. (1999). Sexual scripts. In R. Parker and P. Aggleton (Eds.), Culture, society, and sexuality: A reader (pp. 29–38). London: UCL.

  • Sormanti, M., Pereira, L., El-Bassel, N., Witte, S., and Gilbert, L. (2001). The role of community consultants in designing an HIV intervention. AIDS Education and Prevention, 13, 311–328.

    Article  PubMed  CAS  Google Scholar 

  • Spradley, J. P. (1979). The ethnographic interview. New York: Harcourt Brace.

    Google Scholar 

  • Thornton-Dill, B. (1988). Our mother's grief: Racial ethnic women and the maintenance of families. Journal of Family History, 13, 415–431.

    Article  Google Scholar 

  • Wingood, G. M., and DiClemente, R. J. (1996). HIV sexual risk reduction interventions for women: A review. American Journal of Preventive Medicine, 12, 209–217.

    PubMed  CAS  Google Scholar 

  • Wingood, G. M., and DiClemente, R. J. (1998). Partner influences and gender-related factors associated with noncondom use among young adult African American women. American Journal of Community Psychology, 26, 29–51.

    Article  PubMed  CAS  Google Scholar 

  • Wingood, G. M., and DiClemente, R. J. (2000). Application of the theory of gender and power to examine HIV-related exposures, risk factors, and effective interventions for women. Health Education and Behavior, 27, 539–565.

    Article  PubMed  CAS  Google Scholar 

Download references

ACKNOWLEDGMENTS

This research was supported by center grants P50-MH43520 and P30-MH43520 from NIMH to the HIV Center for Clinical and Behavioral Studies, Anke A. Ehrhardt, PhD, Principal Investigator, and by NRSA training grant T32-MH19139, to Behavioral Sciences Research Training in HIV Infection. The opinions expressed in this paper do not necessarily reflect those of Planned Parenthood Federation of America, Inc. We thank the study participants for their involvement. The authors gratefully acknowledge theoretical comments provided by Theo Sandfort and Zena Stein, methodological insights offered by Robert Kertzner and postdoctoral research fellows at the HIV Center, and the careful editing provided by Vanessa Haney and Isabel Howe.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shari L. Dworkin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dworkin, S.L., Exner, T., Melendez, R. et al. Revisiting “Success”: Posttrial Analysis of a Gender-Specific HIV/STD Prevention Intervention. AIDS Behav 10, 41–51 (2006). https://doi.org/10.1007/s10461-005-9023-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-005-9023-0

KEY WORDS:

Navigation