AEGiS-14IAC: Repeated assessments as a behavior change strategy for adults living with HIV.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Repeated assessments as a behavior change strategy for adults living with HIV.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. F11732)

Lightfoot MA, Rotheram-Borus MJ, Gunderson G
University of Califonia, Los Angeles, Los Angeles, United States

BACKGROUND: Monitoring one's actions leads to changes in behaviors (e.g., diaries of food eaten, repeated assessments among control groups). Repeated self-assessments of sexual risk acts among persons living with HIV (PLH) may led to reductions in HIV transmission behaviors. A randomized controlled trial was conducted to examine the efficacy of PLH completing computerized assessments in the waiting room during routine visits to medical providers.

METHODS: Four HIV-specialized medical clinics were randomly assigned to an intervention or control condition. 200 PLH repeated an assessment of their sexual and substance use transmission behaviors during their routine medical visit (n=1-3 assessments). During a 20 minute risk assessment, the PLH reported their: 1) sexual risk behavior; 2) motivation for behavior change and behavioral intention; 3) substance use and 4) the context of repeated risk acts.

RESULTS: PLH were 25% African American, 17% Latino and 15% women; most were low income (88%). About 1/3 were homeless; homeless persons were at much higher risk and reported less motivation to change risk behaviors, accepting counseling, disclosing to others their serostatus, and stopping sexual risk acts than other persons. At recruitment, the PLH were similar in demographic profiles and risk behaviors were similar at each setting. At recruitment, 40% of PLH had unprotected sex during the previous three months and 60% used alcohol and drugs repeatedly. The impact of repeated assessments will be reported using hierarchical linear models, including how motivation, intention and background variables mediate change.

CONCLUSIONS: The next generation of HIV interventions must be cost-effective and sustainable over time with staff already employed in the setting; our intervention meet these criteria. Especially for PLH who are homeless and low income, the medical appointment may be the only site to feasibly implement interventions repeatedly over time.

Keywords: AEGIS, HIV Infections, Risk-Taking, Sex Behavior, HIV Seropositivity, Behavior Therapy, Counseling, Homeless Persons, Learning, Safe Sex, Poverty, African Americans, Adult, Human, Female

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F11732