Beyond the most willing audiences: a meta-intervention to increase exposure to HIV-prevention programs by vulnerable populations.

OBJECTIVE Enrollment in HIV-prevention interventions is more likely when the audience has safer rather than riskier HIV-relevant behavior. Thus, a meta-intervention was designed to increase participation by an audience of infrequent condom users in Florida. DESIGN Participants (N = 400) were randomly assigned to 1 of 4 conditions varying the introduction to a counseling program. In the experimental condition, participants were told that the intervention gave participants options but might not change their behavior. In a standard-introduction condition, participants were told that the program was highly effective at changing participants' behaviors. There was also an information-control group containing a description of the program, and a no-information-control group solely containing an invitation. MAIN OUTCOME MEASURES The outcome measure was actual participation in the offered counseling. RESULTS Findings indicated that the experimental introduction was the most successful at yielding participation in the counseling program when the audience had low intentions to use condoms in the future. CONCLUSION Intervention introductions countering participants' resistance to change increase participation in HIV-prevention counseling among reluctant clients. Other meta-interventions may be explored to systematically augment the effectiveness of evidence-based health-promotion interventions.