Reducing Behavior Risks for Causing New HIV Infections

尽管男同性恋和双性恋男性的性安全性在早期有所提高，但最近其他性病的增加表明，这一人群中新的艾滋病毒感染可能正在增加。 艾滋病毒阳性的男男性行为者继续进行无保护的肛交，通常与他们没有透露血清状况的伴侣进行肛交。 从历史上看，干预工作主要侧重于艾滋病毒阴性者。 随着注意力转向针对艾滋病毒阳性者的预防方案拟订，有证据表明，需要采用新的可接受和有效的模式，让艾滋病毒阳性者参与并向其提供预防服务。 我们已经试点测试了一个有前途的两个会话的行为评估和动机访谈反馈干预性活跃，艾滋病毒+男男性接触者。 在完成6个月随访的114名男性中，报告与艾滋病毒血清状态为阴性或未知的伴侣进行无保护肛交的比例下降了40%，从基线的44%下降到随访的26%。有了这个建议，我们正在寻求支持，以测试在对照试验设置的干预措施，比较随机分配到动机增强访谈（ME）的性行为评估/反馈干预与那些分配到非ME评估/讨论条件探索护理服务的需求和利用的男性。 我们将在干预后4个月和12个月评估变化的有效性和持久性。

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.