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Reflections on the HIV Center

Reflections on the HIV Center. Twenty Years and Counting. Psychosexual Assessment Core. Early findings from Center 1 disease progression and intervention studies underscored the complexity and challenges of sexual risk reduction and sexual health

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Reflections on the HIV Center

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  1. Reflections on the HIV Center Twenty Years and Counting

  2. Psychosexual Assessment Core • Early findings from Center 1 disease progression and intervention studies underscored the complexity and challenges of sexual risk reduction and sexual health • Unique emphasis on sexual functioning and pleasure • Pointed to the need for sexual harm reduction messages and methods beyond the male condom

  3. The Future is Ours (Project FIO) • Had a gender-specific focus • Included components designed to lay out a sexual ‘Bill of Rights’ for women, eroticize safer sex and enhance pleasure • Incorporated the notion of a harm-reduction approach to achieving safer sex • Included promotion of the female condom

  4. A Nurse-delivered Intervention to Increase Dual Protection • Focused on the potential role of family planning providers in reducing STI/ unintended pregnancy risks of clients • Exploited existing delivery-agent and context (nurses within an inner-city FP clinic) • Included a harm-reduction approach, promotion of the female condom, and an exploration with clients of both dual and single method dual protection • i.e., use of methods that simultaneously prevent STI and unintended pregnancy

  5. Mpondombili: Promoting Dual Protection Among South African Youth • 14-session curriculum, delivered during a free class period • Delivered by teams of co-ed peers, teachers, and nurses • Gendered sexual relationships were the critical issue • More than half of sessions focused on challenging gender role expectancies and stereotypes • Pregnancy risk clearly was an important motivator for condom use

  6. Mobilizing Men as Partners: Promoting DP Among Nigerian Men • Two 5-hour group-based workshops • Men are reachable, and eager to be partners in protection • Restrictive and destructive gender roles can be challenged • Men are interested in the female condom

  7. A Structural Intervention to Promote the Female Condom • Microbicides are not emerging quickly enough, and male and female condoms need to be more thoughtfully & vigorously promoted • Some barriers to method promotion are structural, reflected in agency policies and widespread counseling practices • e.g., family planning providers are biased against condoms for pregnancy prevention; STD counselors rarely think about pregnancy • Counselor-level intervention informed by a DP perspective • This collaboration with the NYSDOH positions the intervention, if effective, to be rapidly integrated into an existing statewide public health infrastructure

  8. A Structural Intervention to Integrate Reproductive Health into HIV Care • Multi-level structural intervention that simultaneously addresses stigma and poor access to contraceptive services and introduces best-practices counseling approaches that maximize sexual risk reduction based on clients’ personal situations • Exploits existing service-delivery points • Includes men and women • Harm reduction approach • Includes access to contraception including female condoms • Guidelines for those seeking conception

  9. HIV Center for Clinical & Behavioral Studies Thank you to all of the many research participants, collaborators and friends who have percolated through the Center and my life for the last 20 years

  10. Psychosexual Assessment Core • Drs. Meyer-Bahlburg, Ehrhardt & team Rhoda Gruen, Terry Dugan, Ronit Field, Kimberly Sutcliff, Robin Faigeles, Marion Schwartz, Julie Hannibal, Ramani Durvasula, Sherri Cohen, Jennifer Hay, Theresa Exner, Curtis Dolezal, Ralf Dittman, Christine Nostlinger, Roy Gillis

  11. The Future is Ours (Project FIO) • Planned Parenthood • Linda Smart-Smith, Amanda Walts, Marion Farrah • Co-Investigators • Anke Ehrhardt, Theresa Exner, Sutherland Miller, Zena Stein • Project Direction • Jessica Adams-Skinner, Sandra Yingling • Intervention • Barbara and Sutherland Miller, Samantha Williams, Blanca Ortiz-Torres, Claudia Garcia-Leeds • Data • Rezi Zawadski, Israela Loeb, Cheng-Shiun Leu, Shmuel Lissek, John Clayton • Interviewers/RAs • Jennifer Hay, Jocelyn Check,Deborah Beete, Awilda Colon, Andrea DuBose, Lydia Leon, Diana Naftal, Shahana Koslofsy, Ennette Guzman

  12. A Nurse-delivered Intervention to Increase Dual Protection • Community HealthCare Network • Yvette Walker, Kim Atkins, Angela Rita, Wendy Montgomery, Freddy Milano, Elba Marino, Deborah Seaton • Co-Investigators • Joanne Mantell, Susie Hoffman, Zena Stein • Project Direction • Jessica Adams-Skinner • Data • Greg Kerwin, Stanley Wu Wei Leu, Howard Andrews, Bill McCaffrey, Myunghee Paik, Cheng-Shiun Leu • Interviewers/RAs • Ritu Shrotriya, Christina Pili, Latoya Palmer,, Sarah Levine, Elise Hagen, Kristine L. Morrissey, Iymaani Aytes, Rita Melendez

  13. Mpondombili: Promoting Dual Protection Among South African Youth • South Africa team • Abigail Harrison, Jennifer Smit, Gita Ramjee, Thobile Nzama, Nelli Ntuli,Pinky Kunene,Muriel Kubeka, Musa Mpanz , Nonhlanhla Xaba • US team • Joanne Mantell, Susie Hoffman, Zena Stein, Theresa Exner, Kavita Parihkh, Christine Nollen,Ann Gavaghan, Sarah Tyler Roberts

  14. Mobilizing Men as Partners: Promoting DP Among Nigerian Men • Nigeria team • Lawrence Adeokun, David Akinpelu,O. A. Ladipo, Grace L. Delano, J. Faleye, A. Oyenekan • US team • Joanne E. Mantell, Curtis Dolezal, Theresa Exner, Isidore A. Udoh

  15. A Structural Intervention to Promote the Female Condom • NYSDOH team • James M.Tesoriero, Susan J. Klein, Haven B. Battles, Dara A. Shapiro, Kirsten A. Rowe, Melissa M. Frisbie, Rosie Love, Richard A. Cotroneo, Linnaea Scavone, Lisa Skill, Melody VanAlstyne • HIV Center team • Joyce Hunter, Jessica-Adams-Skinner, Susie Hoffman, Joanne E. Mantell, Erin Balch, Sarah Needham, Kim Sue, Jackie Correale, Jenny Higgins, Howard Andrews, Cheng-Shiun Leu, Theresa Exner

  16. A Structural Intervention to Integrate Reproductive Health into HIV Care • South Africa team • Diane Cooper, Jennifer Moodley, Chelsea Morroni, Landon Myer, Karen Jennings, Virginia Zwiegenthal • HIV Center team: • Joanne E. Mantell, Theresa M. Exner, Susie Hoffman, Elizabeth Kelvin, Erin Balch, Tonya Taylor, Howard Andres, Cheng-Shiun Leu, Mervin Susser, Zena A. Stein

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