Twenty Years and Counting

Early findings from Center 1 disease progression and intervention studies underscored the complexity and challenges of sexual risk reduction and sexual health
 Unique emphasis on sexual functioning and pleasure
 Pointed to the need for sexual harm reduction messages and methods beyond the male condom

The Future is Ours (Project FIO)
Had a gender-specific focus
Included components designed to lay out a sexual ‘Bill of Rights’ for women, eroticize safer sex and enhance pleasure
Incorporated the notion of a harm-reduction approach to achieving safer sex
Included promotion of the female condom

A Nurse-delivered Intervention to
Increase Dual Protection
Focused on the potential role of family planning providers in reducing STI/ unintended pregnancy risks of clients
 Exploited existing delivery-agent and context
(nurses within an inner-city FP clinic)
Included a harm-reduction approach, promotion of the female condom, and an exploration with clients of both dual and single method dual protection
 i.e., use of methods that simultaneously prevent
STI and unintended pregnancy

Mpondombili: Promoting Dual
Protection Among South African Youth
14-session curriculum, delivered during a free class period
 Delivered by teams of co-ed peers, teachers, and nurses
Gendered sexual relationships were the critical issue
 More than half of sessions focused on challenging gender role expectancies and stereotypes
Pregnancy risk clearly was an important motivator for condom use

Mobilizing Men as Partners:
Promoting DP Among Nigerian Men
Two 5-hour group-based workshops
Men are reachable, and eager to be partners in protection
Restrictive and destructive gender roles can be challenged
Men are interested in the female condom

A Structural Intervention to Promote the Female Condom
Microbicides are not emerging quickly enough, and male and female condoms need to be more thoughtfully & vigorously promoted
Some barriers to method promotion are structural, reflected in agency policies and widespread counseling practices
 e.g., family planning providers are biased against condoms for pregnancy prevention; STD counselors rarely think about pregnancy
Counselor-level intervention informed by a DP perspective
This collaboration with the NYSDOH positions the intervention, if effective, to be rapidly integrated into an existing statewide public health infrastructure

A Structural Intervention to Integrate
Reproductive Health into HIV Care
Multi-level structural intervention that simultaneously addresses stigma and poor access to contraceptive services and introduces best-practices counseling approaches that maximize sexual risk reduction based on clients’ personal situations
 Exploits existing service-delivery points


Includes men and women
Harm reduction approach


Includes access to contraception including female condoms
Guidelines for those seeking conception

Thank you to all of the many research participants, collaborators and friends who have percolated through the Center and my life for the last 20 years

Drs. Meyer-Bahlburg, Ehrhardt & team
Rhoda Gruen, Terry Dugan, Ronit Field,
Kimberly Sutcliff, Robin Faigeles, Marion
Schwartz, Julie Hannibal, Ramani
Durvasula, Sherri Cohen, Jennifer Hay,
Theresa Exner, Curtis Dolezal, Ralf
Dittman, Christine Nostlinger, Roy Gillis

The Future is Ours (Project FIO)
Planned Parenthood
 Linda Smart-Smith, Amanda Walts, Marion Farrah
Co-Investigators
 Anke Ehrhardt, Theresa Exner, Sutherland Miller, Zena Stein
Project Direction
 Jessica Adams-Skinner, Sandra Yingling
Intervention
 Barbara and Sutherland Miller, Samantha Williams, Blanca Ortiz-Torres,
Claudia Garcia-Leeds
Data
 Rezi Zawadski, Israela Loeb, Cheng-Shiun Leu, Shmuel Lissek, John
Clayton
Interviewers/RAs
 Jennifer Hay, Jocelyn Check,Deborah Beete, Awilda Colon, Andrea
DuBose, Lydia Leon, Diana Naftal, Shahana Koslofsy, Ennette Guzman

A Nurse-delivered Intervention to
Increase Dual Protection
Community HealthCare Network
 Yvette Walker, Kim Atkins, Angela Rita, Wendy Montgomery,
Freddy Milano, Elba Marino, Deborah Seaton
Co-Investigators
 Joanne Mantell, Susie Hoffman, Zena Stein
Project Direction
 Jessica Adams-Skinner
Data
 Greg Kerwin, Stanley Wu Wei Leu, Howard Andrews, Bill
McCaffrey, Myunghee Paik, Cheng-Shiun Leu
Interviewers/RAs
 Ritu Shrotriya, Christina Pili, Latoya Palmer,, Sarah Levine,
Elise Hagen, Kristine L. Morrissey , Iymaani Aytes, Rita
Melendez

Mpondombili: Promoting Dual
Protection Among South African Youth
South Africa team
 Abigail Harrison , Jennifer Smit, Gita Ramjee,
Thobile Nzama, Nelli Ntuli,Pinky Kunene, Muriel
Kubeka, Musa Mpanz , Nonhlanhla Xaba
US team
 Joanne Mantell, Susie Hoffman, Zena Stein,
Theresa Exner, Kavita Parihkh, Christine Nollen,
Ann Gavaghan, Sarah Tyler Roberts

Mobilizing Men as Partners:
Promoting DP Among Nigerian Men
Nigeria team
 Lawrence Adeokun, David Akinpelu, O. A.
Ladipo, Grace L. Delano, J. Faleye, A.
Oyenekan
US team
 Joanne E. Mantell, Curtis Dolezal, Theresa
Exner, Isidore A. Udoh

A Structural Intervention to Promote the Female Condom
NYSDOH team
 James M.Tesoriero, Susan J. Klein, Haven B.
Battles, Dara A. Shapiro, Kirsten A. Rowe, Melissa
M. Frisbie, Rosie Love, Richard A. Cotroneo,
Linnaea Scavone, Lisa Skill, Melody VanAlstyne
HIV Center team
 Joyce Hunter, Jessica-Adams-Skinner, Susie
Hoffman, Joanne E. Mantell, Erin Balch, Sarah
Needham, Kim Sue, Jackie Correale, Jenny
Higgins, Howard Andrews, Cheng-Shiun Leu,
Theresa Exner

A Structural Intervention to Integrate
Reproductive Health into HIV Care
South Africa team
 Diane Cooper, Jennifer Moodley, Chelsea Morroni,
Landon Myer, Karen Jennings,
Virginia Zwiegenthal
HIV Center team:
 Joanne E. Mantell, Theresa M. Exner, Susie
Hoffman, Elizabeth Kelvin, Erin Balch, Tonya
Taylor, Howard Andres, Cheng-Shiun Leu, Mervin
Susser, Zena A. Stein