title: The Effect of Motivational Interviewing-Based Counseling During Outpatient Provider Initiated HIV Testing on High-Risk Sexual Behavior in Rural Uganda.
abstract: Provider-initiated HIV testing and counseling (PITC) has rapidly expanded in many countries including Uganda. However, because it provides HIV prevention information without individualized risk assessment and risk reduction counseling it may create missed opportunities for effective HIV prevention counseling. Our objective was to assess the effect of a brief motivational interviewing-based intervention during outpatient PITC in rural Uganda compared to Uganda's standard-of-care PITC at reducing HIV transmission-relevant sexual risk behavior. We enrolled 333 (160 control, 173 intervention) participants in a historical control trial to test the intervention vs. standard-of-care. Participants received PITC and standard-of-care or the intervention counseling and we assessed sexual risk behavior at baseline and 3 and 6 months follow-up. The intervention condition showed 1.5-2.4 times greater decreases in high risk sexual behavior over time compared to standard-of-care (p = 0.015 and p = 0.004). These data suggest that motivational interviewing based counseling during PITC may be a promising intervention to reduce high-risk sexual behavior and potentially reduce risk of HIV infection.
authors.affiliation: Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA. skiene@mail.sdsu.edu.|Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University, 5500 Campanile Drive (MC-4162), San Diego, CA, 92182, USA. skiene@mail.sdsu.edu.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Kiene
authors.affiliation: Department of Global Health, University of Washington, Seattle, WA, USA.
authors.forename: Moses H
authors.initials: MH
authors.lastname: Bateganya
authors.affiliation: Gombe General Hospital, Gombe, Uganda.
authors.forename: Haruna
authors.initials: H
authors.lastname: Lule
authors.affiliation: Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.
authors.forename: Rhoda K
authors.initials: RK
authors.lastname: Wanyenze
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods*; D000328:Adult; D000553:Ambulatory Care; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing; D010045:Outpatients; D010817:Physician-Patient Relations; D019095:Point-of-Care Systems; D015397:Program Evaluation; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012424:Rural Population / Q000706:statistics & numerical data; D012725:Sexual Behavior; D014454:Uganda
keywords: HIV testing; Motivational interviewing; Sexual risk behavior; Uganda