Self-monitoring helps reduce high-risk behavior among HIV-positive people

July 05, 2007

There are many effective, albeit expensive, intervention programs aimed at encouraging HIV-positive people to practice less risky behavior. But a new UCLA AIDS Institute study has found that self-monitoring by these patients is not only an effective strategy but is inexpensive and easy to implement as well.

By simply having patients answer a series of questions about their sexual behavior while waiting for regularly scheduled medical examinations, researchers found that people living with HIV took steps to change their behavior. The study is published in the July issue of the journal AIDS Care.

The questions brought up issues patients often had not considered, said lead author Marguerita Lightfoot, associate research psychologist at the Semel Institute for Neuroscience and Human Behavior at UCLA.

"In other studies, we often heard participants say, 'Oh, I never really thought about my behavior like that' when they completed study assessments," she said. "It appeared that by completing the self-assessments, people reflected on their own behavior and changed their behavior. It's very easy to implement and very cost effective."

The researchers surveyed 365 people living with HIV recruited from community medical clinics and health maintenance organizations. General requirements were that they be at least 18 years old, speak English, provide written informed consent, be free of severe neuropsychological impairments and psychosis, and not be involved in any other HIV behavioral intervention study.

Participants ranged in age from 19 to 69, with a median age of 41. Ninety-two percent were male, 70 percent were gay and 13 percent were bisexual. More than half were ethnic minorities, with African Americans accounting for 21 percent, Latinos 31 percent and other non-whites 7 percent. Eighty-eight percent were high school graduates, and 62 percent had completed at least one year of college. Seventy-seven percent received services from a non-HMO clinic.

While waiting for regularly scheduled examinations, participants were taken to a private room where they answered questions about their sexual behavior on laptop computers set up for that purpose. Questions addressed the number of participants' sexual partners, the HIV status of each partner and the number of sexual acts performed with them, and the number of times that condoms were used.

Some of the study participants completed more than four self-assessments.

Researchers found that the more self-assessments the patients completed, the higher the odds were that they would use condoms when having sex with HIV-negative partners or partners whose HIV status was unknown. Researchers also found that sexual activity tended to decrease over time as the number of self-assessments increased.

Also, as patients completed more assessments, they became increasingly aware of their risk of contracting other sexually transmitted diseases and their negative feelings about changing risky sexual behavior decreased. But neither the number of sex partners nor the fraction of protected acts with all partners showed any significant changes over time with increases in the number of self-assessments.

"Consequently, it appears that allowing PLH (people living with HIV) to reflect on their sexual behavior influences their subsequent decisions regarding sexual behavior," the researchers wrote. "It is likely that by having the patients acknowledge and report, in a nonconfrontive and nonjudgmental manner, those behaviors that could result in transmission of HIV, their motivation to reduce HIV-transmission-related behavior increased and their attitudes became more conducive to reducing risk behaviors.

"Consequently," they continued, "self-assessments appear to be a promising avenue for promoting behavior change in a setting which PLH regularly interface."
To view the study, see

Other researchers on the study included Mary Jane Rotheram-Borus, Scott Comulada, Cameron Gundersen and Vanessa Reddy, all of UCLA.

A grant from the University of California's Universitywide AIDS Research Program to the UCLA Center for AIDS Research and Education and Lightfoot funded the study.

Established in 1992, the UCLA AIDS Institute is a multidisciplinary think tank drawing on the skills of top-flight researchers in the worldwide fight against HIV and AIDS, the first cases of which were reported in 1981 by UCLA physicians. Institute members include researchers in virology and immunology, genetics, cancer, neurology, ophthalmology, epidemiology, social science, public health, nursing, and disease prevention. Their findings have led to advances in treating HIV, as well as other diseases, such as hepatitis B and C, influenza and, cancer.

University of California - Los Angeles

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to