The Context of HIV Risk Among Drug Users and Their Sexual Partners

coherence—the sense that life is controllable and meaningful—were
practicing more protective behavior than their low–self-esteem and lowcoherence
counterparts (Nyamathi 1991). The implications of these
findings for AIDS intervention are unclear, as changes in these global
personality traits may be difficult to effect, at least in brief intervention.
EVALUATED AIDS PREVENTION PROGRAMS FOR WOMEN
A small number of published studies have evaluated prevention programs
for women. The theoretical approaches that have been applied in the area
of AIDS prevention include social cognitive theory and the theory of
reasoned action. Such programs typically combine risk education with
individualized skill-building for condom use and negotiation. One study
with a pretest-posttest design demonstrated increases in condom use
intentions among African-American adolescent women following a single
session intervention (Jemmott and Jemmott 1992); another with a similar
design increased intended behavior change among low-income adult
women attending Women, Infants, and Children (WIC) clinics (Flaskerud
and Nyamathi 1990).
Two studies have used randomized experimental designs to demonstrate
intervention effects. One, by Schilling and colleagues (1991),
randomized women on methadone maintenance to receive a five-session
skill-building intervention or to a control condition. Significant increases
in condom use and in perceptions of control over AIDS risk were
obtained, although the number of sexual partners did not change.
Further, condom use remained significantly more frequent among
intervention participants at a 15-month followup (El-Bassel and Schilling
1992). Another study in which a similar intervention was delivered to
inner-city women attending a primary care clinic also demonstrated
substantial reductions in risk behavior at a 3-month followup (Kelly et al.,
in press). These studies illustrate that inner-city women can reduce their
behavioral risk for HIV infection if properly trained in negotiation and
condom use skills.
AIDS PREVENTION TECHNOLOGY
The female condom, which is undergoing safety and efficacy evaluation
in the United States, may confer superior protection both because it is
made of polyurethane, a material tougher than latex, and possibly also
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