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October 21, 2002

Full partners

By Rachel Robertson

Most professional couples have trouble finding time to spend with one another; the demands of their careers are such that moments together are few. Not so for Gina Wingood and Ralph DiClemente—their partnership in life extends far beyond their home.

“Her office is right next door to mine,” DiClemente said. “We drive in together. We go home together. We work together. So, we are actually together almost 24 hours a day.”
Wingood and DiClemente, associate professor and Charles Howard Candler Professor, respectively, are prolific researchers at the Rollins School of Public Health. Each of their resumes is long enough to be a small book. And since 1995, most of their published work has been done together; they have cowritten 64 journal articles and have another 14 in press, not to mention writing and editing books together. Of their multiple active grants, the two share seven as principal and co-principal investigators.

Together they have been studying HIV prevention for adolescents and young women, particularly of African American heritage. Their behavioral approach focuses on developing HIV prevention programs that are interactive (as opposed to didactic) and that take individuals into account by including issues of gender and ethnic pride, self-esteem, and self-awareness.

“Other programs focused on what is HIV, what is a condom, how to use a condom,” Wingood said. “We took a much different approach. We said, ‘You know what, you are talking to a person.’ So, what we talked about is issues of gender pride: What does it mean to be a woman? What does it mean to be a strong woman? When you do that, you motivate the individual to be different, to adopt different sexual behaviors.”

Their collaboration began in 1989 when they met while doing research in community-based organizations in San Francisco. They each came into the partnership with a slightly different focus and research interest. With a psychology background, DiClemente focused on adolescents, while Wingood’s educational background is in social behavior and she concentrated on women’s issues. Both feel their work has benefited from their different perspectives.

“Public health is a hybrid field,” DiClemente said. “It’s not a discipline with a long heritage, so the opportunities are great to be multidisciplinary, interdisciplinary, and to address complex public health problems from a variety of vantage points. We could do that by fusing and complementing our backgrounds in terms of theory, research, method, design and analysis.”

When they met, Wingood was working on her master’s and PhD while the two developed a prevention program with young African American women. The program was successful; participants demonstrated increased and consistent condom use. Additionally, they showed improved self-efficacy, as well as better communication with their partners about HIV risk and more assertiveness about HIV protection.

“Most effective HIV prevention programs increase condom use, but our program is actually influential in increasing consistent use of condoms,” Wingood said. “Unfortunately, to prevent HIV, you can’t use a condom every once in a while—you have to use it every time you have sex. And so the idea of being a consistent condom user is very important.”

The Centers for Disease Control and Prevention recognized the effectiveness of their program and included it in the “Compendium of HIV Prevention Interventions with Evidence of Effectiveness.” Not only was it an honor for the pair’s work to be included —only a handful of studies are endorsed—but it also allowed their work to reach a broader audience. Public health departments use the compendium as a guide to developing their programs of HIV prevention. Thus, Wingood and DiClemente’s program was adopted nationally, and more recently it’s taken root internationally with programs in St. Maarten and South Africa.

The husband and wife are equally excited about their impact locally. One of their programs is in collaboration with the Fulton County Health and Wellness STD Clinic, which treats half of all sexually transmitted diseases cases in Georgia.

“The goal is always to design a study large enough to impact the epidemic locally but also to design a study that affects systems,” DiClemente said. “If the health department can show that this program worked, there are lots of STD clinics around the country—maybe they’ll adopt the program. If we train and work with their staff, there is a better likelihood that the program will continue when the grant is over.”

The pair’s combined research has continued to grow and adapt through the years. What began as a single HIV prevention program has expanded to 10 funded projects, many of which are multisite studies. Their focus also has expanded beyond working with individuals.

“We realized that outside of the individual were influences that affect the individual’s sexual behavior,” Wingood said, citing family, partner and the media as some of those factors. “So you still want to work with one person, but you may want to work with a parent and a child to reduce their risk of HIV. And similarly, in terms of women’s risk—you don’t have sex by yourself—we work with a couple to reduce the risk for both partners of HIV.”

It all sounds like quite a bit of work for a married couple, and it is; overseeing multiple programs, along with writing and editing articles, books and grants, keeps them busy 24/7.

“It doesn’t make a difference to us whether it is Saturday, Sunday or Tuesday because you are working every day,” DiClemente said. “You lose the sense of time because it’s not bounded anymore. You go to bed at 2 or 3 a.m., and some nights you don’t go to bed at all, trying to get something done.

“People say, ‘Hey Ralph, don’t you get tired talking about HIV and STDs?’ But, in reality, no,” he continued. “As long as it’s a problem, let’s talk about it and keep talking about it, and maybe other people will hear that conversation. If you change the life of one person, isn’t that enough?”

Managing an incredible workload, the couple appreciates being able to understand one another and work as a team. “It’s nice to be passionate about the same things and to have that kind of fire and interest for being advocates of women and adolescents,” said DiClemente.

Hard to believe that, once upon a time, Wingood’s family was apprehensive about her marriage to DiClemente; they wondered if the two had enough in common.

As it turned out, Wingood said, “We have everything in common.”