title: Clinician-initiated HIV risk reduction intervention for HIV-positive persons: Formative Research, Acceptability, and Fidelity of the Options Project.
abstract: OBJECTIVE
  To conduct research on levels and dynamics of HIV risk behavior among HIV-positive patients in clinical care, use this research to design a clinician-initiated HIV prevention intervention for HIV-positive patients, and evaluate the acceptability of the intervention to clinicians and patients and the fidelity with which it can be delivered by clinicians.
  
  
  METHODS
  Study 1 (elicitation research) involved focus groups with HIV-positive patients and HIV care clinicians to understand the dynamics of HIV risk behavior among HIV-positive patients and how to integrate HIV prevention into routine clinical care. Study 2 (acceptability and intervention fidelity) involved the evaluation of 1455 medical visits by experimental intervention patients (N = 231) for acceptability and fidelity of the clinician-initiated HIV prevention intervention.
  
  
  RESULTS
  Elicitation research with patients and clinicians identified critical HIV prevention information, motivation, and behavioral skills deficits in HIV-positive patients as well as risky sexual behavior. These findings were integrated into a theory-based HIV prevention intervention initiated by clinicians that proved acceptable to clinicians and patients and that clinicians were able to implement with adequate fidelity.
  
  
  CONCLUSIONS
  HIV prevention interventions by clinicians treating HIV-positive patients can and should be integrated into routine clinical care.
authors.affiliation: Center for Health/HIV Intervention and Prevention, The University of Connecticut, Storrs, CT 06269, USA. jfisher@uconnvm.uconn.edu
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Fisher
authors.forename: Deborah H
authors.initials: DH
authors.lastname: Cornman
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
authors.forename: K Rivet
authors.initials: KR
authors.lastname: Amico
authors.forename: William A
authors.initials: WA
authors.lastname: Fisher
authors.forename: Gerald A
authors.initials: GA
authors.lastname: Friedland
mesh_terms: D003237:Connecticut; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D006679:HIV Seropositivity / Q000635:transmission*; D006801:Humans; D009042:Motivation; D010349:Patient Compliance; D010353:Patient Education as Topic; D011203:Poverty; D040242:Risk Reduction Behavior; D019966:Substance-Related Disorders / Q000453:epidemiology