Project RESPECT

Project RESPECT was a CDC-funded multi-site randomized trial comparing the effect of a 4-session theory-driven HIV counseling and testing intervention (enhanced counseling), a two-session counseling and testing intervention (brief counseling), and an information and testing only intervention (didactic messages). This study was conducted in five public health department sexually transmitted disease (STD) clinics in the United States, including the Long Beach Department of Health and Human Services. The primary study aims were to determine whether clinic-based HIV counseling and testing was effective in reducing high-risk sexual behaviors and preventing new cases of sexually transmitted infections (STIs) in STD clinic patients. The enhanced counseling included sessions on condom use beliefs, self-efficacy, attitudes, and norms. Both of the counseling interventions focused on actual and perceived risk of HIV/STIs, barriers to risk reduction, and negotiation a risk-reduction plan with sexual partners. Self-reported 100% condom use was higher in both the enhanced counseling and brief counseling arms compared with participants in the didactic messages arm. Through the 6-month interval, 30% fewer participants had new STIs in both the enhanced counseling and brief counseling arms compared with those in the didactic messages arm. Through the 12-month follow-up, 20% fewer participants in each counseling intervention had new STDs compared with those in the didactic messages arm. As a result of this study, Project RESPECT became one of the interventions promoted to prevention practitioners through the CDCs Diffusion of Effective Behavioral Interventions (DEBI) program.