title: Sexually active HIV-positive patients frequently report never using condoms in audio computer-assisted self-interviews conducted at routine clinical visits.
abstract: HIV prevention has become a new priority for HIV clinicians, as their patients live longer and more sexually active lives. Prevention interventions can be effective in clinical settings, but first patients must be screened and inconsistent condom use must be disclosed. Audio computer-assisted self-interviews (ACASI) are an effective way to elicit this sensitive information. We assessed condom use by ACASI among 198 English- or Spanish-speaking HIV patients at 2 community hospital-based HIV clinics in Queens and the Bronx, New York. Among 120 patients reporting sex with a regular partner in the past 4 weeks, 41 (34%) reported not using a condom every time and 22 (18%) reported never using a condom. Among 81 reporting sex with a casual partner in the past 4 weeks, 21 (26%) reported not using a condom every time and 12 (15%) reported never using a condom. Overall, 24 of 129 sexually active patients (19%) reported never using a condom. In a multivariable model controlling for age, race/ethnicity, gender, and HIV exposure category, depression symptoms (Center for Epidemiological Studies Depression Scale [CES-D] score >/= 16; p = 0.03) and self-reported antiretroviral medication non-adherence (</=95% doses in past 3 days; p = 0.03) were significantly associated with never using a condom with a regular or casual partner. ACASI interviews may be an effective way of identifying patients in clinical settings who require prevention counseling as well as other psychosocial services.
authors.affiliation: Department of Public Health, Weill Cornell Medical College, New York, New York 10021, USA. brs2006@med.cornell.edu
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Schackman
authors.forename: Zubin
authors.initials: Z
authors.lastname: Dastur
authors.forename: Quanhong
authors.initials: Q
authors.lastname: Ni
authors.forename: Mark A
authors.initials: MA
authors.lastname: Callahan
authors.forename: Judith
authors.initials: J
authors.lastname: Berger
authors.forename: David S
authors.initials: DS
authors.lastname: Rubin
mesh_terms: D000328:Adult; D000367:Age Factors; D000554:Ambulatory Care Facilities; D000704:Analysis of Variance; D001294:Attitude to Health; D015331:Cohort Studies; D003201:Computers; D017280:Condoms / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D006679:HIV Seropositivity; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011336:Probability; D011788:Quality of Life; D018570:Risk Assessment; D012309:Risk-Taking; D012737:Sex Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control; D014741:Video Recording