Project REACH: a provider-delivered dual protection intervention for women using family planning services in New York City

Abstract

High rates of unintended pregnancies and sexually transmitted infection (STI), including HIV, highlight the importance of promoting dual protection (DP) – i.e., methods that offer concurrent protection against unintended pregnancies and STI – during contraceptive counseling. Using a Phase II quasi-experimental design, this study compared an individualized, clinic-based, nurse-delivered intervention designed to increase DP against standard of care among 101 HIV negative women accessing contraceptive services in medically under-served areas of New York City. Participants were evaluated at baseline, post-counseling, and six months later. Findings indicated that the intervention has possible benefit. At six-month follow-up, there was greater perceived susceptibility to STI and fewer condom-unprotected vaginal sex occasions in the intervention arm. Women in the intervention also had five times the odds of reporting female condom use. Results suggest that this intervention has the potential for a larger population impact and should be more rigorously evaluated in a Phase III trial.

Keywords:

• dual protection
• HIV intervention
• women
• pregnancy prevention
• New York City

Acknowledgements

This research was supported by a grant from NICHD (R01 HD3 7343; Theresa M. Exner, Ph.D., Principal Investigator). The HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University is supported by a center grant from the National Institute of Mental Health (P30-MH43520; Principal Investigator: Anke A. Ehrhardt, Ph.D.). We thank the women who participated in this study for their time and effort and also acknowledge the contributions of study team members. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of NICHD, the NIH, or the Community Healthcare Network.