One session of TTM-tailored condom use feedback: a pilot study among at-risk women in the Bronx

There is an urgent need to implement interventions to curb the spread of sexually transmitted infections (STIs), especially HIV. Consistent condom use is an effective preventive strategy, yet especially among those at highest risk, condom use remains too low. This paper describes changes in condom use and stages of condom use over two–three months time following a single session with an interactive multimedia computer-delivered Transtheoretical Model (TTM)-tailored expert system originally designed for at-risk adolescents. The intervention provided immediate TTM-tailored feedback to diverse urban women based on their stage of condom use and other TTM variables. Previous work found this system was acceptable. These data showed that 89% of women returned for a second session two–three months later, further supporting this system\u27s utility. After just one feedback session, 21% of women not using condoms at baseline started using condoms consistently at follow-up, with a trend for a relationship to baseline stage of condom use. These results support further randomized controlled research on the reach and efficacy of computer-based TTM-tailored and individualized condom use interventions

Acceptability of a stage-matched expert system intervention to increase condom use among women at high risk of HIV infection in New York City

There is an urgent need to develop and implement effective methods for sexual behavior change to curb the spread of HIV. Condoms remain one of the most effective strategies for achieving this, yet consistent condom use is generally low, especially among those at highest risk. This article describes the acceptability of an interactive computer-based expert system designed to increase condom use in women at high risk of HIV infection. The expert system is based on the transtheoretical stages of change model. Using a computer, participants respond to questions about their attitudes and behavior toward using condoms and receive immediate feedback which is matched to their readiness to use condoms. The women were found to be at all stages of change for condom use, although a large proportion of the women (42%) were at early stages of behavior change because they were considering but not using condoms every time during sex with men. The expert system was found to be acceptable to this high-risk group of women. They almost unanimously agreed that they found the feedback useful, would return to use the system again, and would recommend it to a friend. These findings indicate that traditional intervention strategies which assume individuals are ready to use condoms consistently would be appropriate for only about one third of these women, underscoring the importance and potential utility of stage-matched interventions