Influencing sexual practices among HIV-positive Zambian women

Abstract

This study assessed and compared the efficacy of culturally tailored behavioral interventions to increase use and acceptability of sexual barrier products among HIV-positive women in Zambia. It also sought to evaluate cultural preferences as facilitators or impediments to potential use of vaginal chemical barriers for sexual risk reduction within the Zambian context. Women (N=240), recruited from the University Teaching Hospital HIV Voluntary Counseling and Testing Center, were randomized into group or individual intervention arms. Participants attended a baseline assessment, three intervention sessions and follow up assessments at six and 12 months. All participants increased use and acceptability of female condoms and vaginal products and maintained male condom use at six and 12 months. Preliminary data indicated that group participants increased male condom use at six months and trial use and acceptability of female condoms and lubricants predicted their use in the group condition. Results support group interventions to increase sexual barrier use and acceptability in HIV-positive women within the Zambian context. From a public health standpoint, groups may represent a cost-effective and culturally congruent intervention.

Acknowledgments

We would like to dedicate this manuscript to Dr. Ganapati J. Bhat, who passed away in March 2005, without whom this research would not have been possible. We would also like to acknowledge all those in our research team at the University Teaching Hospital in Lusaka, community clinics providing referrals, KARA Counselling, the National Association for Zambian People Positive and, most importantly, the women participating in this research. This research was support by a grant from the National Institute of Mental Health RO1MH63630.