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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
SOUTH AFRICA: Randomized Clinical Trial of Brief Risk Reduction Counseling for Sexually Transmitted Infection Clinic Patients in Cape Town, South Africa
Seth C. Kalichman, PhD; Demetria Cain, MPH; Lisa Eaton, PhD;
November 18, 2011
American Journal of Public Health Vol. 101; No. 9: P.e9-e17

The study authors "examined the effects of a brief counseling intervention designed to reduce HIV risk behaviors and sexually transmitted infections among patients receiving STI services in Cape Town, South Africa." Participants were randomized to either a 60-minute risk reduction counseling session or a 20-minute HIV-STI educational session, completing computerized sexual behavior assessments afterwards. At 12-month follow-up, participant retention was more than 85 percent.

Participants who received risk reduction counseling reported 24 percent fewer incident STIs and significant reductions in unprotected vaginal and anal intercourse, compared to members of the control condition. "Moderator analyses showed shorter- lived outcomes for heavy alcohol drinkers than for lighter drinkers. The results were not moderated by gender," the team reported.

"Brief single-session HIV prevention counseling delivered to STI clinic patients has the potential to reduce HIV infections. Counseling should be enhanced for heavier drinkers, and sustained outcomes will require relapse prevention techniques," the authors concluded, noting that "disseminating effective, brief and feasible behavioral interventions to those at highest risk for HIV infection should remain a public health priority."