title: Supporting Positive Living and Sexual Health (SPLASH): a clinician and behavioral counselor risk-reduction intervention in a university-based HIV clinic.
abstract: 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.
authors.affiliation: Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0927, USA. mzuniga@ucsd.edu
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Zúñiga
authors.forename: Heather
authors.initials: H
authors.lastname: Baldwin
authors.forename: Daniel
authors.initials: D
authors.lastname: Uhler
authors.forename: Jesse
authors.initials: J
authors.lastname: Brennan
authors.forename: Alisa María
authors.initials: AM
authors.lastname: Olshefsky
authors.forename: Erin
authors.initials: E
authors.lastname: Oliver
authors.forename: William Christopher
authors.initials: WC
authors.lastname: Mathews
mesh_terms: 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