title: Does the quality of safetalk motivational interviewing counseling predict sexual behavior outcomes among people living with HIV?
abstract: Although past research has demonstrated a link between the quality of motivational interviewing (MI) counseling and client behavior change, this relationship has not been examined in the context of sexual risk behavior among people living with HIV/AIDS. We studied MI quality and unprotected anal/vaginal intercourse (UAVI) in the context of SafeTalk, an evidence-based secondary HIV prevention intervention.
  
  
  
  We used a structured instrument (the MISC 2.0 coding system) as well as a client-reported instrument to rate intervention sessions on aspects of MI quality. Then we correlated client-reported UAVI with specific counseling behaviors and the proportion of interactions that achieved MI quality benchmarks.
  
  
  
  Higher MISC-2.0 global ratings and a higher ratio of reflections to questions both significantly predicted fewer UAVI acts at 8-month follow-up. Analysis of client ratings, which was more exploratory, showed that clients who rated their sessions higher in counselor acceptance, client disclosure, and relevance reported higher numbers of UAVIs, whereas clients who selected higher ratings for perceived benefit were more likely to have fewer UAVI episodes.
  
  
  
  Further research is needed to determine the best methods of translating information about MI quality into dissemination of effective MI interventions with people living with HIV.
authors: Department of Medicine, UNC School of Medicine, University of North Carolina, CB# 7030 130 Mason Farm Rd. Chapel Hill, NC 27599-7030, USA. Electronic address: grodensk@med.unc.edu.
authors: Catherine
authors: C
authors: Grodensky
authors: Department of Medicine, UNC School of Medicine, University of North Carolina, CB# 7030 130 Mason Farm Rd. Chapel Hill, NC 27599-7030, USA; UNC Cecil G. Sheps Center for Health Services Research, University of North Carolina, CB# 7590 725 Martin Luther King Jr. Blvd. Chapel Hill, NC 27599-7590, USA; Department of Health Behavior, UNC School of Public Health, University of North Carolina, 135 Dauer Dr, Chapel Hill, NC 27516, USA. Electronic address: carol_golin@med.unc.edu.
authors: Carol
authors: C
authors: Golin
authors: Johns Hopkins University, Bloomberg School of Global Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA. Electronic address: mparikh3@jhu.edu.
authors: Megha A
authors: MA
authors: Parikh
authors: Spark Policy Institute, 2717 Welton St., Denver, CO 80205, USA, USA. Electronic address: Rebecca@sparkpolicy.com.
authors: Rebecca
authors: R
authors: Ochtera
authors: Silber Psychological Services, 1340 SE Maynard Rd, Suite 201, Cary, NC 27511, USA. Electronic address: carlyekincaid@gmail.com.
authors: Carlye
authors: C
authors: Kincaid
authors: UNC Cecil G. Sheps Center for Health Services Research, University of North Carolina, CB# 7590 725 Martin Luther King Jr. Blvd. Chapel Hill, NC 27599-7590, USA. Electronic address: groves@schsr.unc.edu.
authors: Jennifer
authors: J
authors: Groves
authors: Department of Psychology, University of North Carolina, 235 E Cameron Ave, Chapel Hill, NC 27514, USA; NC State Department of Psychology, 640 Poe Hall, Campus Box 7650, Raleigh, NC 27695-7650, USA. Electronic address: lmwidman@ncsu.edu.
authors: Laura
authors: L
authors: Widman
authors: Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, UNC 135 Dauer Dr, Chapel Hill, NC 27516, USA. Electronic address: suchi@bios.unc.edu.
authors: Chirayath
authors: C
authors: Suchindran
authors: Department of Health Behavior, UNC School of Public Health, University of North Carolina, 135 Dauer Dr, Chapel Hill, NC 27516, USA. Electronic address: cmcgirt@live.unc.edu.
authors: Camille
authors: C
authors: McGirt
authors: Department of Medicine, UNC School of Medicine, University of North Carolina, CB# 7030 130 Mason Farm Rd. Chapel Hill, NC 27599-7030, USA; Voice Therapeutic Solutions, 3712 Benson Dr, Raleigh, NC 27609, USA. Electronic address: kemi_amola@med.unc.edu.
authors: Kemi
authors: K
authors: Amola
authors: Department of Medicine, UNC School of Medicine, University of North Carolina, CB# 7030 130 Mason Farm Rd. Chapel Hill, NC 27599-7030, USA. Electronic address: steve_bradley-bull@med.unc.edu.
authors: Steven
authors: S
authors: Bradley-Bull
mesh_terms: D000328:Adult; D003376:Counseling / Q000379:methods; D037001:Directive Counseling / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009042:Motivation; D062405:Motivational Interviewing / Q000379:methods*; D010353:Patient Education as Topic; D016730:Program Development; D015397:Program Evaluation; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D021841:Safe Sex / Q000523:psychology*; D012731:Sex Counseling; D012725:Sexual Behavior / Q000523:psychology*; D055815:Young Adult
keywords: AIDS; Coding; Counseling; Fidelity; HIV; Motivational interviewing; Quality; SafeTalk; Safer sex