Clinician-delivered intervention during routine clinical care reduces unprotected sexual behavior among HIV-infected patients.
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.
Fisher
Jeffrey D
JD
Department of Psychology, Center for Health/HIV Intervention and Prevention, University of Connecticut, Storrs, CT 06269-1248, USA. jeffrey.fisher@uconn.edu
Fisher
William A
WA
Cornman
Deborah H
DH
Amico
Rivet K
RK
Bryan
Angela
A
Friedland
Gerald H
GH
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*