Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.

Reuters NewMedia, Inc.; Thursday June 18, 10:56 pm EST
Maggie Fox, Health and Science Correspondent

A study at 37 clinics across the United States shows that no group is too hopeless to help, the researchers, sponsored by the National Institute on Mental Health (NIMH), said.

Writing in the journal Science, they said the 1,800 men and women who took part in "intervention groups" were more likely to use condoms and were more likely to say they were practicing safe sex than 1,800 people who were simply showed a standard AIDS video.

"We are very excited about these developments. We think they are truly significant," Dr. Eric Goosby, director of the HIV/AIDS Policy Office at the Health and Human Services Department (HHS), told a news conference.

"There has been a stigma ... about the ability to reach this disadvantaged population," added NIMH director Steven Hyman, referring to poor black and Hispanic people living in urban areas.

"Sometimes public health authorities have not learned from experience. Clearly, heavy-handed lectures telling people how to behave are not very effective," Hyman added.

In the study, researchers in five cities recruited volunteers from STD (sexually transmitted disease) clinics or public health clinics. All the volunteers had been treated for STDs and most were African-American or Hispanic.

Half took part in the intervention groups, which included educational talks and videos as well as play-acting and group sessions. The rest watched an AIDS video and sat through a question and answer session.

The intervention program had seven sessions, each lasting from 90 minutes to two hours, conducted twice a week on average. Between five and 15 people were in each group.

"They learned how to negotiate certain actions that would protect them over time," said Ellen Stover, who directs the NIMH division that funded the study, Those who took part in the groups used condoms more regularly and engaged in less-risky sexual behavior. The researchers said it was not practical to test for HIV infection, but tested for gonorrhea -- an STD easily passed on by risky sex and more easily caught that HIV.

Incidence of gonorrhea in men -- who are easier to test for the disease -- were cut in half. This held true for as long as a year after the programs ended.

Jeffrey Kelly of the Medical College of Wisconsin, who worked on the study, said the intervention programs worked because people liked them.

"My impression was that people came once to see what it was and came back because it was useful," he said.

"It's not just listening to talk about AIDS. It's taking part in dialogues," he added.

"A lot of it is talking about relationships, a lot of playing the part of a pushy guy and how to handle it, a lot of group support -- 'I encountered this and this is what I did'."

"Reducing high-risk behaviors is still the best way to prevent new HIV infections," said Hyman.

AIDS groups welcomed the study.

"(The study) is a wake-up call for a new era of prevention," said Daniel Zingale, executive director of AIDS Action.

"If we had a medical vaccine, forces would be mobilized to deploy it. Today we have a virtual vaccine -- prevention -- and those forces are paralyzed." Stover estimated the cost per person of seven sessions was $278. "The cost of this intervention is the cost of one week of protease inhibitors," said Hyman, referring to HIV drugs.

Goosby noted that education was a touchy area socially , legally and politically. "We are very committed to trying to work through that delicate dialogue," he said.

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