Efficacy of risk-reduction counseling to prevent the spread of HIV A Randomized Clinical Controlled Trial In the united state an estimated 1.7 million people are infected with HIV. The CDC estimates that one in five of those people are unaware of their infection. Around 340,000 Americans have no idea they have a deadly disease, a staggering number. One average, 50,000 new HIV infections are documented each year. This is due to a lack of knowledge about the disease and its risks and also not knowing their infection status. Of the 619,000 people that have died since the epidemic has begun, more than 17,000 have died since 2009. Those aged 15-24 years old account for almost half of all new HIV infections. These numbers are huge for a disease that is easily prevented. The numbers are so high due to lack of education among the public and people living with HIV/AIDS not properly reducing their risks. HIV is a sexually transmitted infection. It can spread by contact with infected blood, semen, vaginal fluid, or from mother to child during pregnancy, child birth, or breast milk. HIV weakens your immune system and interferes with your body’s ability to fight pathogens. After so long, HIV develops into AIDS. AIDS is a chronic potentially life threating condition. There is no cure for this disease, but there are medications that can be taken to slow down the progression. Receiving the news that you have such a disease can take its toll on someone. The emotional, social, and financial consequences make it especially difficult for someone to cope with on their own. Fortunately, there are a wide range of services and resources available to help people cope with their recent diagnosis and help these people from spreading the infection further. Risk-reduction counseling can be extremely helpful in this process and allow a person to open up to someone who understands their situation and can help them reduce their risks. Risk is defined as a situation involving exposure to danger. Risk-reduction counseling focuses on reducing these exposures or helping the client work them through crises. Riskreduction sessions should be client centered prevention counselling. at a minimum, prevention counselor should be trained in basic client centered pre- and post – test prevention counseling before conducting comprehensive risk counseling and services, CRCS. At all times, you will be choosing the kinds of counseling approaches and scenarios that best fit the needs of each client, and you may include other intervention approaches to address particular need as needed. risk-reduction counseling can be structured or unstructured or a combination of the two. some sessions may need to have standard protocols or be more flexible and allowing the client to state the issues they want to address and the risks they believe they have. individual sessions are the main focus on risk-reduction counseling, but group sessions are an important aspect of CRCS. group therapy allows you to tell your story among people who are in a similar situation. this emphasize the fact that you are not along on your struggle. In this study, we hypothesized that people aged 15-24 receiving brief riskreduction counseling are more likely to exhibit increased condom use and demonstrate more protected sex than those who did not receive counseling. The trial was conducted from January 2010 through January 2013 involving patients from health clinics and Centers for Disease Control and prevention across Washington, D.C.; Denver, Colorado; Evansville, Indiana; San Francisco, California; and Baltimore, Maryland. Subjects were recruited using flyers and acquaintance referrals. Eligible participants were men and women aged 15-24 who came to the clinic for an HIV test and exhibited at least one risk factor (e.g., ‘’ Had a sexual encounter with a new partner ‘’ or ‘’ Had sexual intercourse with multiple partners within one month’’). Race and HIV status were not factors in this study. Participants who could not communicate in English or who had no sexual experience were excluded from the study. Participants who were under the age 18 had to get signed parental consent and all other participants had to give written informed consent. The institutional review board reviewed and approved the protocols. The research study staff was required to have a master’s degree in psychology or social work. To ensure consistency from session to session, the staff underwent approximately 40 hours of education from a single trainer on topics ranging from proper procedures to effective communication skills prior to the study. At the initial visit and each follow up visit the participants were given a 20-point questionnaire. they were asked to rate their condom use and other risk factors (e.g., ‘’ I insist on using condoms for every sexual encounter ‘’ or ‘’ I get to know each potential partner before sleeping with them ‘’) on a scale of 1-10 with 1 being never and 10 being always. Anonymity was preserved by nit using the subjects’ names at any point in the study. Participants were randomly assigned to one of two groups; either the control group or the experimental group, by using a computer generated sorting application. Randomization took place after enrollment and before the baseline interviews and examinations. As participants were unaware of what exactly was being studied and the facilitators did not know which group each participant was in, so it was possible to conduct it in a double-blind manner. The experimental group received a brief 20 minute, participant tailored risk reduction counseling with the offering of an onsite HIV rapid test. The control group received nothing but the explanation of how the rapid HIV test works. Of the 9,385 patients who were eligible to enroll in the study 4,251 declined enrollment due to lack of interest or need. 5,134 agreed to participate and were randomly sorted into two groups. In the control group there were 1,183 men and 1,384 women and in the experimental group there were 1,489 women and 1,078 men. The experimental group received an HIV rapid test with 20 minutes of individualized risk-reduction counseling which consisted of HIV/STD 101 and a condom-use barrier assessment. Participants were given basic information regarding STD transmission, myths about HIV/AIDS, and were encouraged to use condoms during every sexual encounter. An obstacle we faced while conducting this study was getting the subjects to return for the follow up visit. An incentive system was implemented to encourage participants to com back for two follow up sessions after six and twelve months. $20 was given to each subject who returned for the follow up sessions and ‘’ goodie-bags’’ that consisted of condoms, dental dams, and personal lubricant were offered at all three sessions. Any participants who came to all three were also given $10 Walmart gift cards upon leaving the final visit. These gift cards were all funded by The Aids Resource Group of Atlanta, GA. I anticipated a P value of less than .05 to be significant. Chi-square test would also be used to examine the difference between the tow groups. based on the case studies I’ve read, I expect to find a significant increase in condom use and a marked decrease in risky sexual behaviors. Almost every study preformed on this topic showed these results when some amount of risk-reduction counseling was used. Overall, I figured around 80% of participants would complete all the follow up sessions and roughly 4,107 participant’s information would be used to produce accurate results. The information gathered from participants who did not complete all the follow ups would be thrown out to avoid having skewed results. Gender did not appear to have a significant impact in the results. Research in this area is imperative to reducing HIV infection rate and therefore beginning to stop the pandemic. Education is the easiest and most effective way to prevent infection. When people know the risks and how to avoid them, they are far more likely to be smarter about their habits, there are around 34 million people around the world who are currently living with HIV. Such a prevalent disease deserves, especially research on how to affectively prevent infection. Efficacy of risk-reduction counseling to prevent the spread of HIV A Randomized Clinical Controlled Trial By Manal Mansour Introduction  In the united state an estimated 1.7 million people are infected with HIV.  The CDC estimates that one in five of those people are unaware of their infection.  Around 340,000 Americans have no idea they have a deadly disease, a staggering number.  One average, 50,000 new HIV infections are documented each year. This is due to  a lack of knowledge about the disease and its risks and also not knowing their infection status.  Of the 619,000 people that have died since the epidemic has begun, more than 17,000 have died since 2009.  Those aged 15-24 years old account for almost half of all new HIV infections. It can spread by:  HIV is a sexually transmitted infection.  contact with infected blood,  semen,  vaginal fluid,  or from mother to child during pregnancy,  child birth,  or breast milk. What is the AIDS ?  HIV weakens your immune system and interferes with your body’s ability to fight pathogens.  After so long, HIV develops into AIDS.  AIDS is a chronic potentially life threating condition.  There is no cure for this disease, but there are medications that can be taken to slow down the progression. Risk-reduction counseling focuses on reducing these exposures or helping the client work them through crises.  Individual sessions are the main focus on risk-reduction counseling, but group sessions are an important aspect of CRCS.  group therapy allows you to tell your story among people who are in a similar situation.  In this study, we hypothesized that people aged 15-24 receiving brief risk-reduction counseling are more likely to exhibit increased condom use and demonstrate more protected sex than those who did not receive counseling. The trial was conducted from January 2010 through January 2013  involving patients from health clinics and Centers for Disease Control and prevention across Washington, D.C.; Denver, Colorado; Evansville, Indiana; San Francisco, California; and Baltimore, Maryland.  Subjects were recruited using flyers and acquaintance referrals.  Eligible participants were men and women aged 15-24 who came to the clinic for an HIV test and exhibited at least one risk factor (e.g., ‘’ Had a sexual encounter with a new partner ‘’ or ‘’ Had sexual intercourse with multiple partners within one month’’).  Race and HIV status were not factors in this study.  Participants who could not communicate in English or who had no sexual experience were excluded from the study.  Participants who were under the age 18 had to get signed parental consent and all other participants had to give written informed consent.  The institutional review board reviewed and approved the protocols. Assessment  The research study staff was required to have a master’s degree in psychology or social work.  To ensure consistency from session to session, the staff underwent approximately 40 hours of education from a single trainer on topics ranging from proper procedures to effective communication skills prior to the study.  At the initial visit and each follow up visit the participants were given a 20point questionnaire.  they were asked to rate their condom use and other risk factors  (e.g., ‘’ I insist on using condoms for every sexual encounter ‘’ or ‘’ I get to know each potential partner before sleeping with them ‘’)  on a scale of 1-10 with 1 being never and 10 being always Study design  Of the 9,385 patients who were eligible to enroll in the study 4,251 declined enrollment due to lack of interest or need.  5,134 agreed to participate and were randomly sorted into two groups.  In the control group there were 1,183 men and 1,384 women  in the experimental group there were 1,489 women and 1,078 men.  The experimental group received an HIV rapid test with 20 minutes of individualized riskreduction counseling which consisted of HIV/STD 101 and a condom-use barrier assessment.  Participants were given basic information regarding STD transmission, myths about HIV/AIDS, and were encouraged to use condoms during every sexual encounter. we faced while conducting this study was getting the subjects to return for the follow up visit.  An incentive system was implemented to encourage participants to com back for two follow up sessions after six and twelve months.  $20 was given to each subject who returned for the follow up sessions and ‘’ goodie-bags’’ that consisted of condoms, dental dams, and personal lubricant were offered at all three sessions.  Any participants who came to all three were also given $10 Walmart gift cards upon leaving the final visit.  Research in this area is imperative to reducing HIV infection rate and therefore beginning to stop the pandemic.  Education is the easiest and most effective way to prevent infection.  When people know the risks and how to avoid them, they are far more likely to be smarter about their habits, there are around 34 million people around the world who are currently living with HIV.  Such a prevalent disease deserves, especially research on how to affectively prevent infection.
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