title: Start Talking About Risks: development of a Motivational Interviewing-based safer sex program for people living with HIV.
abstract: The epidemiology of HIV infection in the US in general, and in the southeast, in particular, has shifted dramatically over the past two decades, increasingly affecting women and minorities. The site for our intervention was an infectious diseases clinic based at a university hospital serving over 1,300 HIV-infected patients in North Carolina. Our patient population is diverse and reflects the trends seen more broadly in the epidemic in the southeast and in North Carolina. Practicing safer sex is a complex behavior with multiple determinants that vary by individual and social context. A comprehensive intervention that is client-centered and can be tailored to each individual's circumstances is more likely to be effective at reducing risky behaviors among clients such as ours than are more confrontational or standardized prevention messages. One potential approach to improving safer sex practices among people living with HIV/AIDS (PLWHA) is Motivational Interviewing (MI), a non-judgmental, client-centered but directive counseling style. Below, we describe: (1) the development of the Start Talking About Risks (STAR) MI-based safer sex counseling program for PLWHA at our clinic site; (2) the intervention itself; and (3) lessons learned from implementing the intervention.
authors: Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Carol_Golin@med.unc.edu
authors: Carol E
authors: CE
authors: Golin
authors: Shilpa
authors: S
authors: Patel
authors: Katherine
authors: K
authors: Tiller
authors: E Byrd
authors: EB
authors: Quinlivan
authors: Catherine A
authors: CA
authors: Grodensky
authors: Maureen
authors: M
authors: Boland
mesh_terms: D000328:Adult; D003142:Communication; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006293:Health Promotion; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009042:Motivation; D016730:Program Development; D012307:Risk Factors; D021841:Safe Sex
references: J Adolesc Health. 2001 May;28(5):421-31
references: 11336873
references: Addiction. 2001 Dec;96(12):1725-42
references: 11784466
references: AIDS Patient Care STDS. 2004 Apr;18(4):229-38
references: 15142353
references: South Med J. 1997 Jul;90(7):697-701
references: 9225891
references: J Acquir Immune Defic Syndr. 2005 Sep 1;40(1):34-40
references: 16123679
references: Fam Pract. 2004 Apr;21(2):150-4
references: 15020383
references: J Consult Clin Psychol. 2003 Oct;71(5):862-78
references: 14516235
references: AIDS Educ Prev. 2006 Apr;18(2):116-31
references: 16649957
references: Patient Educ Couns. 2006 Jul;62(1):64-71
references: 16023824
references: Am J Public Health. 2001 Oct;91(10):1686-93
references: 11574336
references: J Consult Clin Psychol. 1997 Aug;65(4):531-41
references: 9256553
references: Addiction. 2001 Dec;96(12):1769-70; discussion 1774-5
references: 11784469
references: J Consult Clin Psychol. 1997 Aug;65(4):542-6
references: 9256554
references: MMWR Morb Mortal Wkly Rep. 2005 Feb 4;54(4):89-94
references: 15689856
references: AIDS Care. 1994;6(5):559-70
references: 7711089
references: AIDS. 1993 Feb;7(2):247-56
references: 8466688
references: Health Psychol. 1998 Nov;17(6):546-50
references: 9848805
references: Am J Prev Med. 2001 Aug;21(2):84-92
references: 11457627
references: Health Educ Res. 2002 Feb;17(1):43-57
references: 11890176
references: J Assoc Nurses AIDS Care. 2003 Mar-Apr;14(2):52-62
references: 12698766
references: Am J Prev Med. 2001 Jan;20(1):68-74
references: 11137778
references: J Consult Clin Psychol. 1998 Oct;66(5):856-61
references: 9803706
references: JAMA. 2001 Mar 7;285(9):1186-92
references: 11231749
references: J Acquir Immune Defic Syndr. 2006 May;42(1):42-51
references: 16763491
references: AIDS Care. 1995;7(4):429-38
references: 8547358
references: AIDS Educ Prev. 1996 Dec;8(6):499-515
references: 9010510
references: J Infect Dis. 2005 Feb 1;191 Suppl 1:S115-22
references: 15627221
references: Behav Res Ther. 2001 Oct;39(10):1151-62
references: 11579986
references: J Acquir Immune Defic Syndr. 2004 Oct 1;37 Suppl 2:S58-67
references: 15385901
references: J Acquir Immune Defic Syndr. 2006 Apr 15;41(5):616-23
references: 16652036