title: Clinician-delivered intervention during routine clinical care reduces unprotected sexual behavior among HIV-infected patients.
abstract: OBJECTIVE
  To evaluate the effectiveness of a clinician-delivered intervention, implemented during routine clinical care, in reducing unprotected sexual behavior of HIV-infected patients.
  
  
  METHODS
  A prospective clinical trial comparing the impact of a clinician-delivered intervention arm vs. a standard-of-care control arm on unprotected sexual behavior of HIV-infected patients.
  
  
  METHODS
  The 2 largest HIV clinics in Connecticut.
  
  
  METHODS
  A total of 497 HIV-infected patients, aged > or =18 years, receiving HIV clinical care.
  
  
  METHODS
  HIV clinical care providers conducted brief client-centered interventions at each clinical encounter that were designed to help HIV-infected patients reduce unprotected sexual behavior.
  
  
  METHODS
  Unprotected insertive and receptive vaginal and anal intercourse and unprotected insertive oral sex; unprotected insertive and receptive vaginal and anal intercourse only.
  
  
  RESULTS
  HIV-infected patients who received the clinician-delivered intervention showed significantly reduced unprotected insertive and receptive vaginal and anal intercourse and insertive oral sex over a follow-up interval of 18 months (P < 0.05). These behaviors increased across the study interval for patients in the standard-of-care control arm (P < 0.01). For the measure of unprotected insertive and receptive vaginal and anal sex only, there was a trend toward a reduction in unprotected sex among intervention arm participants over time (P < 0.09), and a significant increase in unprotected sex in the standard-of-care control arm (P < 0.01).
  
  
  CONCLUSIONS
  A clinician-delivered HIV prevention intervention targeting HIV-infected patients resulted in reductions in unprotected sex. Interventions of this kind should be integrated into routine HIV clinical care.
authors.affiliation: Department of Psychology, Center for Health/HIV Intervention and Prevention, University of Connecticut, Storrs, CT 06269-1248, USA. jeffrey.fisher@uconn.edu
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Fisher
authors.forename: William A
authors.initials: WA
authors.lastname: Fisher
authors.forename: Deborah H
authors.initials: DH
authors.lastname: Cornman
authors.forename: Rivet K
authors.initials: RK
authors.lastname: Amico
authors.forename: Angela
authors.initials: A
authors.lastname: Bryan
authors.forename: Gerald H
authors.initials: GH
authors.lastname: Friedland
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015658:HIV Infections / Q000534:rehabilitation* / Q000635:transmission; D020010:Heterosexuality; D006716:Homosexuality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012725:Sexual Behavior; D047568:Unsafe Sex / Q000517:prevention & control*