title: HIV intervention for providers study: a randomized controlled trial of a clinician-delivered HIV risk-reduction intervention for HIV-positive people.
abstract: Clinician-delivered prevention interventions offer an opportunity to integrate risk-reduction counseling as a routine part of medical care. The HIV Intervention for Providers study, a randomized controlled trial, developed and tested a medical provider HIV prevention training intervention in 4 northern California HIV care clinics. Providers were assigned to either the intervention or control condition (usual care). The intervention arm received a 4-hour training on assessing sexual risk behavior with HIV-positive patients and delivering risk-reduction-oriented prevention messages to patients who reported risk behaviors with HIV-uninfected or unknown-status partners. To compare the efficacy of the intervention versus control on transmission risk behavior, 386 patients of the randomized providers were enrolled. Over six-months of follow-up, patients whose providers were assigned the intervention reported a relative increase in provider-patient discussions of safer sex (OR = 1.49; 95% CI = 1.06 to 2.09), assessment of sexual activity (OR = 1.60; 95% CI = 1.05 to 2.45), and a significant decrease in the number of sexual partners (OR = 0.49, 95% CI = 0.26 to 0.92). These findings show that a brief intervention to train HIV providers to identify risk and provide a prevention message results in increased prevention conversations and significantly reduced the mean number of sexual partners reported by HIV-positive patients.
authors.affiliation: UCSF, Center for AIDS Prevention Studies, School of Nursing, CA 94105, USA. Carol.Dawson-Rose@ucsf.edu
authors.forename: Carol Dawson
authors.initials: CD
authors.lastname: Rose
authors.forename: Cari
authors.initials: C
authors.lastname: Courtenay-Quirk
authors.forename: Kelly
authors.initials: K
authors.lastname: Knight
authors.forename: Starley B
authors.initials: SB
authors.lastname: Shade
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Cynthia
authors.initials: C
authors.lastname: Gomez
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Lum
authors.forename: Oliver
authors.initials: O
authors.lastname: Bacon
authors.forename: Grant
authors.initials: G
authors.lastname: Colfax
mesh_terms: D000328:Adult; D003376:Counseling / Q000379:methods*; D003695:Delivery of Health Care; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology* / Q000635:transmission; D006266:Health Education; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010820:Physicians; D012306:Risk; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012725:Sexual Behavior; D011795:Surveys and Questionnaires