What Works for Women and Girls

68% male, 52% Black (Healthy Living Project Team, 2007 cited in Gilliam and Straub,2009). Another randomized controlled study with 233 men and 99 women, 48% highschool graduates provided five group sessions, gender and sexual orientation specific ondisclosure and reduction in transmission risk behaviors resulted in significant reductionsin unprotected vaginal and anal intercourse in the previous three months at sixmonth follow-up (Kalichman et al., 2005 cited in Gilliam and Straub, 2009). Anotherstudy found significant reductions in unsafe sex in 214 participants through emphasizingthe negative consequences of unsafe sex for the HIV-positive person, such as “ifyou don’t use clean syringes, you could get hepatitis” (Richardson et al., 2004 cited inGillaim and Straub, 2009). A study with HIV-positive women who received four fourhourinteractive group sessions and a social network intervention, compared to a healthpromotion intervention had significantly lower self-reported vaginal intercourse at12-month follow-up (Wingood et al., 2004 cited in Gilliam and Straub, 2009). Increasedfrequency of counseling about safe sex in several studies was correlated with havingspecific written procedures. Addressing provider attitudes and providing training toproviders is also critical (Gilliam and Straub, 2009). (Gray V) (sexual partners, disclosure,condom use, providers, United States)5. Interventions to support disclosure can increase condom use in discordant couples. [Seealso Chapter 6. HIV Testing and Counseling for Women]A 2003 study in South Africa interviewed 215 HIV-positive individuals (192 women)and found that HIV status disclosure lead to safer sexual behavior and greater socialsupport. After disclosure 82% asked their partners to get tested, 81% decided to bemonogamous, 64% used condoms every time, 56% reduced their number of sexualpartners and 20% abstained from sex. One-third of HIV-positive individuals did notdisclose their status to their sexual partner. Families provided 25% and doctors provided20% of social support. The study measured social support by the patients’ perception asincreased, maintained or decreased depending on to whom they disclosed (Wong et al.,2009). (Gray IV) (disclosure, support programs, sex behavior, sexual partners, South Africa)A study by TASO in Uganda found that support that resulted in sero-disclosure resultedin increased condom use. A total of 3,219 counseling records of sexually active clients,65% female, accessing care in 2007 were analyzed using Epi Info. 3,129 or 40% ofsexually active clients disclosed their HIV-positive serostatus to their sexual partners.Of these, 1,173 or 90.8% reported consistent condom use. Of those who disclosedtheir serostatus, 5% did not use condoms as compared to 19.3% of clients who had notdisclosed their HIV-positive serostatus (Kadando et al., 2008). (Gray V) (sex behavior,disclosure, condom use, Uganda)394 participants recruited through the Caribbean regional network of people living withHIV/AIDS (CRN+) found that 54% of respondents reported that they did not use acondom at last sex, with no difference by sex. Bivariate analysis showed that condomWHAT WORKS FOR WOMEN AND GIRLS197