A Pilot Trial of a Sexual Health Counseling Intervention for HIV-Positive Gay and Bisexual Men Who Report Anal Sex without Condoms

Abstract

BackgroundEven in the presence of promising biomedical treatment as prevention, HIV incidence among men who have sex with men has not always decreased. Counseling interventions, therefore, continue to play an important role in reducing HIV sexual transmission behaviors among gay and bisexual men and other men who have sex with men. The present study evaluated effects of a small-group counseling intervention on psychosocial outcomes and HIV sexual risk behavior.MethodHIV-positive (HIV+) peer counselors administered seven 2-hour counseling sessions to groups of 5 to 8 HIV+ gay and bisexual men. The intervention employed information provision, motivational interviewing, and behavioral skills building to reduce sexual transmission risk behaviors.ResultsThere was a significant reduction in condomless anal sex (CAS) with HIV-negative and unknown HIV-status partners, from 50.0% at baseline to 28.9% of the sample at 3-month follow-up. Findings were robust even when controlling for whether the participant had an undetectable viral load at baseline. Significant reductions were also found in the two secondary psychosocial outcomes, loneliness and sexual compulsivity.ConclusionsThe findings provide preliminary evidence that this intervention may offer an efficient way of concurrently reducing CAS and mental health problems, such as sexual compulsivity and loneliness, for HIV+ gay and bisexual men.Trial RegistrationClinicalTrials.gov NCT02546271

Changing the odds: motives for and barriers to reducing HCV-related sexual risk behaviour among HIV-infected MSM previously infected with HCV

“…However, strategies effective for increasing condom use to prevent HIV and other STI may also be effective in preventing HCV. Motivational interviewing and skills training, combined with tailored cognitive behavioral interventions, are several of these evidence - based strategies [33].…”

Efficacy of Psychological Interventions Towards the Reduction of High-Risk Sexual Behaviors Among People Living with HIV: A Systematic Review and Meta-analysis, 2010–2020

“…The studies differed substantially in their design. Eleven studies of them were randomized controlled trials (RCTs) with randomization at either the individual or group (facility/community) level [ 18 , 21 – 28 , 32 , 33 ], while six studies employed non-randomized trials (pilot study/quasi-experimental study) or a randomized trial with no control [ 19 , 20 , 29 – 31 , 34 ]. Studies varied in the number of interventions adopted, with fourteen reported a two-armed design, one reported a three-armed design, and two reported no control design.…”

“…Almost all studies had one or more underlying theoretical basis. Information, motivation and behavior skills model (IMB) [ 21 , 26 , 28 , 30 , 34 ], protection motivation theory/social Cognitive theory [ 22 , 25 , 27 , 28 , 31 , 33 ] were the first two theories that founded the basis of intervention, others including Motivational interviewing [ 19 , 24 , 30 , 34 ], Transtheoretical Model [ 32 ], self-directed behavioral skills practice [ 34 ], relationship-oriented ecological framework [ 22 , 27 ], Integrated Behavioral Model (IBM) [ 23 ], cognitive-behavior therapy (CBT) [ 20 ], Modified AIDS Risk Reduction Model [ 32 ], and the Theory of Gender and Power [ 32 ].…”

“…Included studies used different measures. Six studies provided proportions of condom use [ 18 , 22 , 24 , 27 , 30 , 32 ], five studies used RR or OR as the intervention effect size [ 21 , 23 , 26 , 28 , 32 ], and others provided proportions of condomless anal sex (CAS) [ 19 , 25 , 30 ], frequencies of CAS [ 29 , 34 ], and condom use intention [ 31 ]. These studies’ follow-up time points were generally post-intervention, three and six months after completing the intervention.…”

“…Some studies compared condom use between different sex partners, including HIV-positive, HIV-negative, or unknown status. It showed that there were differences when had sex with HIV-positive partners compared with HIV-negative or unknown status partners [ 18 , 21 , 23 , 34 ]. In Trevor A. Hart et al study, they aimed to use IMB, MI to enhance condom use among HIV-positive MSM.…”