Reducing Behavior Risks for Causing New HIV Infections

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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.