A behavioral intervention reduces HIV transmission risk by promoting sustained serosorting practices among HIV-infected men who have sex with men.
OBJECTIVE
To examine factors that explain the effect of a cognitive-behavioral intervention on reductions in HIV transmission risk among HIV-infected men who have sex with men (MSM).


METHODS
Of the 1910 HIV-infected MSM screened, 616 participants considered to be at risk of transmitting HIV were randomized to a 15-session, individually delivered cognitive-behavioral intervention (n=301) or a wait-list control (n=315).


RESULTS
Consistent with previous intent-to-treat findings, there was an overall reduction in transmission risk acts among MSM in both intervention and control arms, with significant intervention effects observed at the 5-, 10-, 15-, and 20-month assessments (risk ratios=0.78, 0.62, 0.48, and 0.38, respectively). These intervention-related decreases in HIV transmission risk acts seemed to be partially due to sustained serosorting practices. MSM in the intervention condition reported a significantly greater proportion of sexual partners who were HIV infected at the 5- and 10-month assessments (risk ratios=1.14 and 1.18).


CONCLUSIONS
The Healthy Living Project, a cognitive-behavioral intervention, is efficacious in reducing transmission risk acts among MSM. This seems to have been due in large part to the fact that MSM in the intervention condition reported sustained serosorting practices.
Morin
Stephen F
SF
Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA 94105, USA. steve.morin@ucsf.edu
Shade
Starley B
SB
Steward
Wayne T
WT
Carrico
Adam W
AW
Remien
Robert H
RH
Rotheram-Borus
Mary Jane
MJ
Kelly
Jeffrey A
JA
Charlebois
Edwin D
ED
Johnson
Mallory O
MO
Chesney
Margaret A
MA
D000328:Adult; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D012307:Risk Factors; D012309:Risk-Taking; D021841:Safe Sex; D012747:Sexual Partners