Researcher fights HIV and AIDS with fortune cookies

Kathleen Sikkema is one of the few scientists who recommend using fortune cookies to promote AIDS prevention and research.

Sikkema, an epidemiology and public health professor at the Yale School of Medicine, recently led a study that employed fortune cookie messages and other unconventional methods in an attempt to reduce adolescent risks for HIV infection. The study, which analyzed approximately 1,200 subjects, focused primarily on community intervention.

During group workshops, adolescents identified influential people in the community as peer leaders. Investigators asked these leaders to help address the prevention of HIV and AIDS through education within their communities, including advocating condom use and abstinence.

The study found that community intervention proved effective in increasing both condom use and abstinence more than other methods such as education alone, according to the findings published in the September 2005 issue of the Journal of AIDS.

Sikkema served as the principal investigator in the study, which she coordinated with five other universities. The multisite trial was conducted from 1998 to 2000 in 15 housing developments in Seattle and Tacoma, Wash., Milwaukee and Racine, Wis., and Roanoke, Va.

“[The study is] based on the model that popular and influential people can influence each other,” Sikkema said.

The community intervention method has been employed before in some gay communities and in communities of low-income women, but never before with adolescents, Sikkema said. Focusing on adolescents created unique challenges, she said, since communities of adolescents were not originally as aware or open to addressing the topics of HIV and sexual intercourse as the gay bars where some earlier studies were held.

Nearly three-quarters of the participants had not engaged in sexual intercourse, Sikkema said, so the study focused largely on delaying sexual debut.

Sikkema said she focused on the adolescent community because teens and young adults are the most likely to be affected by the AIDS epidemic in the future.

Closer to Yale, the University’s home state reported the nation’s highest rate of infection among injection-drug users, Leif Mitchell, a staffer at the Center for Interdisciplinary Research on AIDS, said.

But Sikkema and her colleagues said they see promise in the future of community intervention for adolescents. Sikkema said the studies displayed some measure of success.

Contacting parents and gaining permission for their children to participate added another layer of difficulty to the study’s operation, study co-author Roger Roffman — a professor of social work at the University of Washington — said.

Despite parental reticence, Sikkema said adolescents often wanted to participate in the study, and it often helped improve their social conditions and confidence, which led to community building, Sikkema said. Getting participants together to talk over food allowed them to develop social connections that promoted healthy habits.

From the point of view of an adolescent, Roffman said, “AIDS risk reduction requires lots of pizza.”

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