A Randomized Controlled Trial to Investigate Impact of Site-Based Safer Sex Programs in Kingston, Jamaica: Trial Design, Methods, and Results

Author(s): Weir SS, Figueroa JP, Byfield L, Hall A, Cummings S, Hobbs M, Suchindran CM

Year: 2009

Abstract:

In 2001, a Priorities for Local AIDS Control Efforts (PLACE) study identified over 400 public sites in Kingston where persons meet new sexual partners. People attending these sites had higher rates of new and concurrent sexual partnerships than persons in the general population. The Jamaica Ministry of Health developed and piloted a package of site-based prevention program components that could be tailored for use at sites as diverse as commercial sex street sites, fast food restaurants, bars, and night clubs; and 147 of the 400 sites were grouped into 50 geographic clusters. The clusters were randomized to receive or not receive site-based prevention program components. Following a baseline survey in 2005, follow-up surveys with site patrons were conducted in 2006 and 2007 to estimate the proportion of patrons with recent, new, or concurrent partnerships and inconsistent condom use. Baseline and follow-up characteristics of sites and patrons were similar at intervention and control sites, both at baseline and follow-up. In spite of sustained efforts by outreach workers,implementation of intervention components proved very difficult. At follow-up, only 56% of the 75 intervention sites reported having condom promotion activities at the site since March 2006; only 17% reported on-site efforts to promote HIV testing; and only 30% reported regular visits by health ministry staff since March 2006. Among the 1,383 men and 1,475 women interviewed on-site at follow-up, there were no differences in reported condom use at intervention compared to control sites among men (36% and 33%) and women (20% in both groups) who reported new or multiple partnerships in the past year.