Counseling reduces risky behavior in HIV-positive people

April 29, 2003

A year after receiving behavioral counseling about risky sexual behavior, HIV-positive people had two-thirds fewer episodes of unprotected sex with HIV-negative individuals or those who do not know their status, according to new research.

In the four months before any behavioral intervention, the 387 HIV-positive individuals in the study reported having an average of 14 unprotected sex acts. Twelve months later, the average had dropped to four unprotected sex acts.

Three different counseling interventions were tested in the study, and all produced the same average decrease in unprotected sex a year later, say Thomas L. Patterson, Ph.D., of the University of California, San Diego, and colleagues.

Few studies have measured the success of behavioral interventions with HIV-positive individuals, say the researchers, but targeting this relatively small population might make HIV prevention efforts more cost-effective.

"Vaccines to protect against infections with HIV remain elusive, and behavioral interventions continue to be the best hope for slowing the AIDS pandemic," Patterson says.

The 387 individuals, mostly white, male and gay or bisexual, were chosen at random to receive one of three different behavioral interventions that focused on using condoms, negotiating safer sex practices and telling their partners about their HIV-positive status.

One group participated in a single intensive counseling session that discussed all three issues, one group received a more targeted session discussing only the issues that were identified as a problem by the participant, and a third group received intensive counseling plus two similar "booster" sessions.

Although each group reported the same average number of unprotected sex acts a year later, the group receiving the booster sessions reported an upswing in unprotected sex eight months after intervention.

The booster group had the largest percentage of individuals taking antiretroviral drugs, which may help explain the increase, say Patterson and colleagues. Previous studies suggest that the availability of antiretrovirals and other improvements in AIDS treatments have led to less frequent safe sex among some individuals.

"However, the changing pattern of results revealed over the 12-month period emphasizes the need for longer term follow-up to provide adequate time to examine the possible deterioration of intervention effects," Patterson says.

The researchers say they still don't know whether these behavior changes were related to HIV infection rates among the participants' partners.

"Although it is impossible to estimate the number of new infections averted by our intervention, we assert that prevention success even in small numbers is significant in terms of reduced human suffering," the researchers say.

The study was published in the Annals of Behavioral Medicine and supported by the National Institute of Mental Health and the Department of Veterans Affairs.
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FOR MORE INFORMATION
Health Behavior News Service: 202-387-2829 or http://www.hbns.org.
Interviews: Contact Thomas L. Patterson at 858- 534-3354.
Annals of Behavioral Medicine: Contact Robert Kaplan, Ph.D., 619-534-6058.

By Becky Ham, Staff Writer
Health Behavior News Service

Center for Advancing Health

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