Landmark Study Shows Behavioral Interventions Reduce HIV-Related Sexual Risk Behavior

June 18, 1998

The largest randomized, controlled, HIV behavioral intervention study conducted in the United States found that even among persons considered hardest to reach, such interventions can cut high risk sexual behaviors in half and more than double regular use of condoms.

The National Institute of Mental Health (NIMH) Multisite HIV Prevention Trial enrolled 3,706 men and women in 37 inner-city, community-based clinics. Those who attended HIV prevention sessions that focused on motivation and skills to reduce high-risk sexual behaviors reported significant reductions across a range of sexual risk indicators over a one-year period.

The seven-session intervention reduced the incidence of gonorrhea in men by half. Incidence of gonorrhea is an indicator of unprotected sexual behavior.

NIMH Director Steven E. Hyman, M.D., said, "Reducing high risk behaviors is still the best way to prevent new HIV infections. NIMH has identified an effective strategy that could be adopted by public health and community organizations all across America. If these behavioral changes were maintained for even one year, there would be a profound, cost-effective, public health impact in the communities that adopted this program."

Researchers in seven sites in five metropolitan areas recruited participants from three distinct populations at risk of acquiring HIV and other sexually transmitted diseases (STDs): men and women in public STD clinics and women attending public primary health care clinics. Sixty-eight percent of the participants were African American and twenty percent were Hispanic; most were single, unemployed, and treated previously for STDs, and all were at high behavioral risk for HIV. Rates of HIV infection and AIDS are higher among racial and ethnic minority populations, especially African Americans, who represented 45% of new AIDS cases in 1997. Heterosexual transmission is rising rapidly, especially among ethnic minority women. The Clinton Administration has made elimination of racial disparities in health status a top priority.

The study is unique among trials of group HIV prevention interventions in its examination of change in self-reported sexual risk practices, such as consistent use of condoms, as well as in objective indicators provided by reviewing participants' STD clinic charts.

NIMH initiated the Multisite HIV Prevention Trial in 1990 in response to directives from Congress to develop a risk reduction intervention based on current best practices in HIV prevention, and to test its efficacy with understudied and disadvantaged populations at multiple sites across the U.S.

The research is published in the June 19, 1998 issue of Science. The seven sites were:The study was coordinated by NIMH and the Research Triangle Institute in Durham, North Carolina.

NIMH is one of the 18 institutes that make up the National Institutes of Health (NIH). NIH is part of the Department of Health and Human Services.
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NIH/National Institute of Mental Health

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