Supporting Positive Living and Sexual Health (SPLASH): a clinician and behavioral counselor risk-reduction intervention in a university-based HIV clinic.
Effective HIV prevention interventions with HIV-positive persons are paramount to stemming the rate of new infections. This paper describes an HIV-clinic-based demonstration project aimed at decreasing patient HIV-transmission risk behaviors and sexually transmitted infections. Systematic, computer-assisted assessment of patient risk aided primary care providers in delivering prevention messages. Patients at greater risk were referred to an HIV Prevention Specialist for behavioral counseling. Patients completed a computerized behavioral staging assessment to self-identify risk behaviors and readiness to change behaviors and counseling messages were individually tailored based on computer assessment. Challenges to project implementation: primary care provider buy-in, patient privacy concerns during risk assessment, and low participation in behavioral counseling. Forty-six percent of persons completing a risk assessment (2,124) were at risk for HIV transmission. Of 121 patients who scheduled counseling appointments, 42% completed at least one session. Despite challenges, successful implementation of a clinic-based prevention intervention is feasible, particularly with attention to patient and provider concerns.
Zúñiga
María Luisa
ML
Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0927, USA. mzuniga@ucsd.edu
Baldwin
Heather
H
Uhler
Daniel
D
Brennan
Jesse
J
Olshefsky
Alisa María
AM
Oliver
Erin
E
Mathews
William Christopher
WC
D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D003376:Counseling; D003936:Diagnosis, Computer-Assisted; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011320:Primary Health Care / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000517:prevention & control / Q000523:psychology; D013333:Student Health Services / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014481:United States