HIV/AIDS risk reduction counseling for alcohol using sexually transmitted infections clinic patients in Cape Town, South Africa.
BACKGROUND
HIV is ravaging southern Africa, and HIV transmission risk behaviors are facilitated by alcohol use in sexual contexts. There are no known interventions that directly target HIV risk behavior among people who drink and are at risk for HIV in Africa.


OBJECTIVE
To test a behavioral risk reduction counseling intervention for use in sexually transmitted infection (STI) clinics in southern Africa.


METHODS
A randomized intervention trial was conducted with 143 STI clinic patients in Cape Town, South Africa. Participants received an experimental 60-minute HIV and alcohol risk reduction behavioral skills intervention or a control 20-minute HIV education condition. Participants were followed for 3 and 6 months after the intervention, with 73% retention.


RESULTS
Overall, the experimental intervention demonstrated more than a 25% increase in condom use and a 65% reduction in unprotected intercourse over the 6-month follow-up period, with risk reduction significantly greater for the experimental condition than for the control condition at both follow-ups. Alcohol use in sexual contexts [F(1,94) = 6.2; P < 0.05] and expectancies that alcohol enhances sexual experiences [F(1,94) = 8.3; P < 0.01] were also significantly lower for the experimental condition at the 3-month follow-up.


CONCLUSIONS
An HIV prevention counseling intervention reduced HIV transmission risks for up to 6 months in this STI clinic population. Effects may be sustained with structural interventions to reduce alcohol use in sexual contexts and support risk reduction behavior changes over the long-term.
Kalichman
Seth C
SC
Department of Psychology, University of Connecticut, 406 Babbidge Road, Storrs, CT 06269, USA. seth.k@uconn.edu
Simbayi
Leickness C
LC
Vermaak
Redwaan
R
Cain
Demetria
D
Jooste
Sean
S
Peltzer
Karl
K
D000328:Adult; D000428:Alcohol Drinking; D017280:Condoms / Q000706:statistics & numerical data; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D040242:Risk Reduction Behavior; D013019:South Africa; D047568:Unsafe Sex / Q000517:prevention & control