Self-monitoring of behaviour as a risk reduction strategy for persons living with HIV

Abstract

To reduce the HIV-related transmission behaviours of persons living with HIV (PLH), a few efficacious interventions have been designed and evaluated. However, these interventions were delivered at relatively high cost, both in terms of time and resources. Given the challenges for health providers and community agencies in delivering these interventions, alternatives are needed. One possible intervention is allowing PLH to self-monitor their HIV transmission risk behaviour. Previous research suggests that self-monitoring of HIV-risk related behaviours may be a useful risk reduction strategy. This paper examines the impact of repeated risk assessments for behavioural self-monitoring as an intervention strategy for reducing sexual and substance use risk behaviours. A total of 365 PLH, recruited from community clinics, health management organizations, and health departments, completed self-assessments over time. Increased self-monitoring resulted in increases in protected sex with sexual partners of HIV-negative or unknown serostatus, and changes in attitudes conducive to reducing risk. Self-monitoring is a relatively low cost and easily implementable strategy for reducing the HIV-related transmission risk of PLH.

The Unanticipated Benefits of Behavioral Assessments and Interviews on Anxiety, Self-Esteem and Depression Among Women Engaging in Transactional Sex

“…Structural barriers (e.g., travel costs, office hours, and social stigma) also deter women from obtaining social service (Kurtz et al 2005;Mojtabai et al 2011;Roth et al 2013). While programs to reduce these barriers are clearly needed, researchers have also begun to consider how therapeutic benefits, associated with research participation, can be harnessed to improve health outcomes (Clifford and Maisto 2000;Epstein et al 2005;Lightfoot et al 2007;Kurtz et al 2013). Taking part in in-depth interviews and discussing personal experiences have been shown to improve one's sense of purpose, self-awareness, and empowerment (Hutchinson et al 1994).…”

Smartphone Self-Monitoring to Support Self-Management Among People Living With HIV

“…35,36 A larger RCT of computer-based self-monitoring at routine medical visits compared to standard care found some support for reducing sexual risk behaviors by PLH over time. 37 The study also found that improvements positively correlated with the number of assessments completed, indicating that self-monitoring frequency and intersecting motivational factors may moderate self-monitoring effects. 37 Another recent study of reactivity (i.e., behavior changes) in response to web-based daily diary assessments by gay and bisexual men found a heterogeneity of effects based on motivational factors, suggesting that different mechanisms of self-monitoring function at various stages of activation and motivation.…”

Lessons Learned from “Integrating” Intensive Family-based Interventions into Medical Care Settings for Mothers Living with HIV/AIDS and their Adolescent Children

“…Although other researchers have had success linking targeted safer sex interventions for persons living with HIV to primary medical care settings (Fisher et al 2006;Lightfoot et al 2007;Knauz et al 2007;Koester et al 2007;Richardson et al 2004), HIV/AIDS care sites were not the preferred location for this more intensive family-based intervention. With the exception of the university campus location (which was not very popular), all of the intervention locations were "integrated" into medical care, even the community-based settings.…”

“…In response, the Centers for Disease Control and Prevention (CDC) issued recommendations in 2003 that HIV prevention interventions for persons living with HIV/ AIDS (PLH) be "integrated into medical practice" (CDC 2003). There have been a small number of prevention programs delivered and/or piloted at HIV clinical care settings of varying success which give credence to the CDC recommendations (Fisher et al 2006;Knauz et al 2007;Lightfoot et al 2007;Richardson et al 2004;Knauz et al 2007). In addition, Koester and colleagues conducted a cross site evaluation of 15 other clinic basedprojects that implemented similar interventions and/or demonstration projects funded under the Health Resources and Services Administration's HIV Prevention with Positives in Clinical Settings Initiative (Koester et al 2007).…”