Reducing Behavior Risks for Causing New HIV Infections

尽管同性恋和双性恋男性在性安全方面取得了早期进展，但最近其他性传播疾病的增加表明，在这一人群中，新的艾滋病毒感染可能正在上升。艾滋病毒阳性男男性行为者继续进行无保护的肛交，通常与他们没有向其透露其抗体状况的伴侣进行。从历史上看，干预工作主要集中在艾滋病毒阴性者身上。随着人们的注意力转向针对艾滋病毒感染者的预防规划，有证据表明，需要新的可接受和有效的模式来参与并向艾滋病毒感染者提供预防服务。我们已经试点测试了一种很有前景的两段式行为评估和动机性访谈反馈干预，对象是性活跃的HIV+ MSM。在114名完成6个月随访的男性中，报告与艾滋病毒抗体为阴性或未知的伴侣进行无保护肛交的比例下降了40%，从基线时的44%下降到随访时的26%。根据这一建议，我们正在寻求支持，在对照试验环境中测试干预措施，将随机分配到动机增强访谈（ME）性行为评估/反馈干预组的男性与分配到非动机增强访谈（ME）性行为评估/反馈干预组的男性进行比较，探讨护理服务的需求和利用。我们将在干预后4个月和12个月评估改变的有效性和持久性。

Despite early gains in sexual safety among gay and bisexual men, recent increases in other STDs indicate that new HIV infections are probably on the rise in this population. HIV+ MSM continue to have unprotected anal sex, often with partners to whom they have not disclosed their serostatus. Historically, intervention efforts have focused primarily on HIV negative persons. As attention shifts to prevention programming for HIV+ individuals, there is evidence to suggest that new acceptable and effective models for engaging and delivering prevention services to HIV+ individuals are needed. We have pilot tested a promising two-session behavior assessment and Motivational Interviewing feedback intervention with sexually active, HIV+ MSM. Among 114 men who completed a 6 month follow-up interview, the proportion of those reporting unprotected anal intercourse with partners whose HIV serostatus was negative or unknown to them fell by 40 percent, from 44 percent at baseline to 26 percent at follow-up. With this proposal, we are seeking support to test the intervention in a controlled trial setting, comparing men randomly assigned to a Motivational Enhancement Interviewing (ME) sexual behavior assessment/feedback intervention with those assigned to a non-ME assessment/discussion condition exploring care service needs and utilization. We will assess effectiveness and durability of change at 4 and 12 months post intervention.