title: Randomized clinical trial of brief risk reduction counseling for sexually transmitted infection clinic patients in Cape Town, South Africa.
abstract: OBJECTIVE
  We examined the effects of a brief counseling intervention designed to reduce HIV risk behaviors and sexually transmitted infections (STIs) among patients receiving STI services in Cape Town, South Africa.
  
  
  METHODS
  After randomization to either a 60-minute risk reduction counseling session or a 20-minute HIV-STI educational session, patients completed computerized sexual behavior assessments. More than 85% of the participants were retained at the 12-month follow-up.
  
  
  RESULTS
  There were 24% fewer incident STIs and significant reductions in unprotected vaginal and anal intercourse among participants who received risk reduction counseling relative to members of the control condition. Moderator analyses showed shorter lived outcomes for heavy alcohol drinkers than for lighter drinkers. The results were not moderated by gender.
  
  
  CONCLUSIONS
  Brief single-session HIV prevention counseling delivered to STI clinic patients has the potential to reduce HIV infections. Counseling should be enhanced for heavier drinkers, and sustained outcomes will require relapse prevention techniques. Disseminating effective, brief, and feasible behavioral interventions to those at highest risk for HIV infection should remain a public health priority.
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, 06269, USA. seth.k@uconn.edu
authors.forename: Seth C
authors.initials: SC
authors.lastname: Kalichman
authors.forename: Demetria
authors.initials: D
authors.lastname: Cain
authors.forename: Lisa
authors.initials: L
authors.lastname: Eaton
authors.forename: Sean
authors.initials: S
authors.lastname: Jooste
authors.forename: Leickness C
authors.initials: LC
authors.lastname: Simbayi
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D003376:Counseling / Q000458:organization & administration*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009042:Motivation; D010353:Patient Education as Topic / Q000458:organization & administration; D040242:Risk Reduction Behavior; D020377:Self Efficacy; D012737:Sex Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology