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February 28, 1996

HIV Sexual Risk—Reduction Interventions for African-American Women

Author Affiliations

Centers for Disease Control and Prevention Atlanta, Ga

JAMA. 1996;275(8):593-594. doi:10.1001/jama.1996.03530320017019

To the Editor.  —We commend Drs DiClemente and Wingood1 for their randomized controlled trial of an HIV prevention intervention. Although their intervention and evaluation incorporated many of the recommendations developed by Oakley et al2 in their critical review of HIV prevention research, we have concerns about several methodological issues that bring the study's conclusions into question.It appears that the randomization procedure was unsuccessful in providing similar experimental and control groups. The authors identified disparities in income and duration of long-term relationships between participants in the two groups. In addition, control participants were less likely to return for follow-up examinations and, at baseline, demonstrated considerably less HIV knowledge, sexual self-control, assertiveness skill, and consistent condom use. Although these baseline differences between groups were not statistically significant, perhaps because of small numbers, the desired study outcomes were consistently reported more frequently by the intervention group at baseline. These baseline