Behavioral interventions can increase condom use, reduce sexually transmitted infections

December 15, 2011

PROVIDENCE, R.I. - Behavioral interventions aimed at reducing sexual risk behaviors, such as unprotected sex, are effective at both promoting condom use and reducing sexually transmitted infections (STIs) long after the initial intervention, according to a new report in the December 15 issue of the Journal of Acquired Immune Deficiency Syndromes.

Lead author Lori A. J. Scott-Sheldon, Ph.D., of The Miriam Hospital's Centers for Behavioral and Preventive Medicine, and colleagues at the University of Connecticut conducted a meta-analysis of 42 studies evaluating the effectiveness of HIV-related behavioral interventions. The studies included in the meta-analysis assessed behavior changes, including increased condom use, and biological outcomes, such as a subsequent STI or HIV diagnosis. The studies were conducted worldwide and included a number of at-risk populations.

Researchers found that behavioral interventions - which included HIV education, motivation and skills-based training aimed at negotiating safer sex behaviors - were successful at improving condom use and reducing incident STIs, including HIV, for up to four years. This meta-analysis is believed to be the first to examine the incidence of HIV in a wide range of at-risk populations.

Scott-Sheldon says that while it may seem intuitive that behavioral changes, such as increased condom use, will result in fewer STIs, previous studies have been unable to support that assertion.

"The association between behavioral and biological outcomes is complex, since transmission of STIs depends on a number of factors, including partner type, characteristics, and perceptions of partner safety," she says. "Examining both outcomes, and factors associated with sexual risk behaviors, should be important in determining the efficacy of behavioral interventions."

The meta-analysis evaluated the findings of 67 behavioral interventions in 42 studies. While most studies were conducted in North America, 17 percent took place in Asia, 14 percent in Africa, 5 percent in Europe and 2 percent in South America. In most cases, participants were randomized to receive an HIV-related behavioral intervention or a control group. Interventions were provided in both group and individual settings.

Interventions were found to be more successful at improving condom use when social, cultural and economic barriers were addressed. Researchers also observed that, contrary to expectations, self-management training targeting risky sexual behavior did not significantly impact condom use one year after the initial intervention.

They also noted that participants were less likely to acquire STIs following the behavioral intervention if they were diagnosed with an STI or HIV at the time they entered the study. In addition, interventions were more successful at reducing the incidence of HIV when they sampled more Latinos. The authors note that, globally, Latinos are disproportionately affected by HIV and interventions targeting this group are urgently needed to prevent HIV infection in this population.

"HIV infections cost the United States billions of dollars annually," Scott-Sheldon says. "In the absence of an effective HIV vaccine, safer sexual practices and expanded prevention efforts are required to prevent new infections and reduce the burden of HIV. Translation and widespread dissemination of effective behavioral interventions within a wide range of population groups should be a high priority."
-end-
Co-authors include Michael P. Carey, Ph.D., director of The Miriam Hospital's Centers for Behavioral and Preventive Medicine; and Tania B. Huedo-Medina, Ph.D., Michelle R. Warren and Blair T. Johnson, Ph.D., of the University of Connecticut.

The principal affiliation of Lori A. J. Scott-Sheldon, Ph.D., is The Miriam Hospital (a member hospital of the Lifespan health system in Rhode Island). Dr. Scott-Sheldon also is an assistant professor of psychiatry & human behavior (research) at The Warren Alpert Medical School of Brown University.

The Miriam Hospital (http://www.miriamhospital.org) is a 247-bed, not-for-profit teaching hospital affiliated with The Warren Alpert Medical School of Brown University. It offers expertise in cardiology, oncology, orthopedics, men's health, and minimally invasive surgery and is home to the state's first Joint Commission-certified Stroke Center and robotic surgery program. The hospital is nationally known for its HIV/AIDS and behavioral and preventive medicine research, including weight control, physical activity and smoking cessation. The Miriam Hospital has been awarded Magnet Recognition for Excellence in Nursing Services four times and is a founding member of the Lifespan health system.

Lifespan

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
Brightsurf.com 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 Amazon.com.