title: Motivational interviewing by HIV care providers is associated with patient intentions to reduce unsafe sexual behavior.
abstract: OBJECTIVE
  Motivational interviewing (MI) can promote behavior change, but HIV care providers rarely have training in MI. Little is known about the use of MI-consistent behavior among untrained providers. This study examines the prevalence of such behaviors and their association with patient intentions to reduce high-risk sexual behavior.
  
  
  METHODS
  Audio-recorded visits between HIV-infected patients and their healthcare providers were searched for counseling dialog regarding sexual behavior. The association of providers' MI-consistence with patients' statements about behavior change was assessed.
  
  
  RESULTS
  Of 417 total encounters, 27 met inclusion criteria. The odds of patient commitment to change were higher when providers used more reflections (p=0.017), used more MI consistent utterances (p=0.044), demonstrated more empathy (p=0.049), and spent more time discussing sexual behavior (p=0.023). Patients gave more statements in favor of change (change talk) when providers used more reflections (p<0.001) and more empathy (p<0.001), even after adjusting for length of relevant dialog.
  
  
  CONCLUSIONS
  Untrained HIV providers do not consistently use MI techniques when counseling patients about sexual risk reduction. However, when they do, their patients are more likely to express intentions to reduce sexual risk behavior.
  
  
  CONCLUSIONS
  MI holds promise as one strategy to reduce transmission of HIV and other sexually transmitted infections.
authors: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. tflicki1@jhmi.edu
authors: Tabor E
authors: TE
authors: Flickinger
authors: Gary
authors: G
authors: Rose
authors: Ira B
authors: IB
authors: Wilson
authors: Hannah
authors: H
authors: Wolfe
authors: Somnath
authors: S
authors: Saha
authors: Philip Todd
authors: PT
authors: Korthuis
authors: Michele
authors: M
authors: Massa
authors: Stephen
authors: S
authors: Berry
authors: Michael Barton
authors: MB
authors: Laws
authors: Victoria
authors: V
authors: Sharp
authors: Richard D
authors: RD
authors: Moore
authors: Mary Catherine
authors: MC
authors: Beach
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003376:Counseling / Q000193:education / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D012044:Regression Analysis; D040242:Risk Reduction Behavior; D013637:Tape Recording; D047568:Unsafe Sex / Q000523:psychology*
keywords: Counseling; HIV/AIDS; Motivational interviewing; Physicians; Sexual risk reduction
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