Skip to main content

Advertisement

SpringerLink
Log in

Longitudinal Effects of SafeTalk, a Motivational Interviewing-Based Program to Improve Safer Sex Practices Among People Living with HIV/AIDS

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Programs to help people living with HIV/AIDS practice safer sex are needed to prevent transmission of HIV and other sexually transmitted infections. We sought to assess the impact of SafeTalk, a multicomponent motivational interviewing-based safer sex program, on HIV-infected patients’ risky sexual behavior. We enrolled sexually active adult HIV-infected patients from one of three clinical sites in North Carolina and randomized them to receive the 4-session SafeTalk intervention versus a hearthealthy attention-control. There was no significant difference in the proportion of people having unprotected sex between the two arms at enrollment. SafeTalk significantly reduced the number of unprotected sex acts with at-risk partners from baseline, while in controls the number of unprotected sex acts increased. Motivational interviewing can provide an effective, flexible prevention intervention for a heterogeneous group of people living with HIV.

Resumen

Programas para ayudar a las personas que viven con VIH/SIDA practicar el sexo seguro es necesario para prevenir la transmisión del VIH y otras infecciones de transmisión sexual. Hemos tratado de evaluar el impacto de SafeTalk, un multe-componente motivacional programa basado en el sexo más seguro, sobre el comportamiento de pacientes infectados por VIH-sexuales de riesgo. Se incluyó a adultos sexualmente activos pacientes infectados por VIH de uno de los tres centros clínicos en Carolina del Norte y al azar a recibir la intervención SafeTalk de 4 sesiones en comparación con un corazón sano control de atención. No hubo diferencias significativas en la proporción de personas que tienen relaciones sexuales sin protección entre los dos grupos en la inscripción. SafeTalk redujo significativamente el número de relaciones sexuales sin protección con parejas en situación de riesgo desde el inicio, mientras que en los controles del número de actos sexuales sin protección mayor. La entrevista motivacional puede proporcionar una intervención eficaz, flexible para la prevención de un grupo heterogéneo de personas que viven con el VIH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kalichman SC. Positive prevention: reducing HIV Transmission among people living with HIV/AIDS. New York: Plenum; 2004.

    Google Scholar 

  2. Centers for Disease Control and Prevention. Advancing HIV prevention: new strategies for a changing epidemic, United States, 2003. MMWR. 2003;52:329–32.

    Google Scholar 

  3. Global HIV Prevention Working Group. HIV prevention in the era of expanded treatment. Washington, DC: Kaiser Family Foundation; 2004.

    Google Scholar 

  4. Gordon CM, Stall R, Cheever LW. Prevention interventions with persons living with HIV/AIDS: challenges, progress, and research priorities. J Acquir Immune Defic Syndr. 2004;37:S53–7.

    Article  PubMed  Google Scholar 

  5. Janssen RS, Valdiserri RO. HIV prevention in the United States: increasing emphasis on working with those living with HIV. J Acquir Immune Defic Syndr. 2004;37:S119–21.

    Article  PubMed  Google Scholar 

  6. Eaton LA, Kalichman SC. Changes in transmission risk behaviors across stages of HIV disease among people living with HIV. J Assoc Nurses AIDS Care. 2009;20(1):39–49.

    Article  PubMed  Google Scholar 

  7. Golin CE, Marks G, Wright J, et al. Psychosocial characteristics and sexual behaviors of people in care for HIV infection: an examination of men who have sex with men, heterosexual men and women. AIDS Behav. 2009;13(6):1129–42.

    Article  PubMed  Google Scholar 

  8. Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr. 2005;39:446–53.

    Article  PubMed  Google Scholar 

  9. Weinhardt LS. HIV diagnosis and risk behavior. In: Kalichman SC, editor. Positive prevention. New York: Plenum; 2004. p. 29–64.

    Google Scholar 

  10. Schiltz MA, Sandfort TG. HIV-positive people, risk and sexual behaviour. Soc Sci Med. 2000;50:1571–88.

    Article  PubMed  CAS  Google Scholar 

  11. Celum CL. Sexually transmitted infections and HIV: epidemiology and interventions. Top HIV Med. 2010;18:138–42.

    PubMed  Google Scholar 

  12. Kalichman SC, Rompal D, Cage M. Sexually transmitted infections among HIV seropositive men and women. Sex Transm Infect. 2000;76:350–4.

    Article  PubMed  CAS  Google Scholar 

  13. Erbelding EJ, Stanton D, Quinn TC, et al. Behavioral and biologic evidence or persistent high-risk behavior in an HIV primary care population. AIDS. 2000;14:297–301.

    Article  PubMed  CAS  Google Scholar 

  14. Brewer TH, Metsch LR, Zenilman JM. Use of a public sexually transmitted disease clinic by known HIV-positive adults: decreased self-reported risk behavior and increased disease incidence. J Acquir Immune Defic Syndr. 2002;29:289–94.

    PubMed  Google Scholar 

  15. Kissinger P, Clark R, Dumestre J, et al. Incidence of three sexually transmitted diseases during a safer sex promotion program for HIV-infected women. J Gen Intern Med. 1996;11:750–2.

    Article  PubMed  CAS  Google Scholar 

  16. Capps L, Peng G, Doyle M, et al. Sexually transmitted infections in women infected with the human immunodeficiency virus. Sex Transm Dis. 1998;25:443–7.

    Article  PubMed  CAS  Google Scholar 

  17. Milam J, Richardson JL, Espinoza L, Stoyanoff S. Correlates of unprotected sex among adult heterosexual men living with HIV. J Urban Health. 2006;83(4):669–81.

    Article  PubMed  Google Scholar 

  18. Kalichman SC, Eaton L, White D, et al. Beliefs about treatments for HIV/AIDS and sexual risk behaviors among men who have sex with men, 1997–2006. J Behav Med. 2007;30(6):497–503.

    Article  PubMed  Google Scholar 

  19. Crepaz N, Hart T, Marks G. Highly active antiretroviral therapy and sexual risk behavior: a meta-analytic review. JAMA. 2004;292:224–36.

    Article  PubMed  CAS  Google Scholar 

  20. van Kesteren NM, Hospers HJ, Kok G. Sexual risk behavior among HIV-positive men who have sex with men: a literature review. Patient Educ Couns. 2007;65:5–20.

    Article  PubMed  Google Scholar 

  21. Stall R, Mills TC, Williamson J, Hart T, et al. Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. Am J Public Health. 2003;93(6):939–42.

    Article  PubMed  Google Scholar 

  22. Metsch LR, Pereyra M, Messinger S, et al. HIV transmission risk behaviors among HIV infected persons who are successfully linked to care. Cl Infect Dis. 2008;47(4):577–84.

    Article  Google Scholar 

  23. Folkman S, Chesney M, Pollack L, Coates T. Stress, control, coping, and depressive mood in human immunodeficiency virus-positive and -negative gay men in San Francisco. J Nerv Ment Dis. 1993;181(7):409–16.

    Article  PubMed  CAS  Google Scholar 

  24. Wolitski RJ, Pals SL, Kidder DP, Courtenay-Quirk C, Holtgrave D. The effects of HIV stigma on health, disclosure of HIV status, and risk behavior of homeless. AIDS Behav. [serial online]. 2008 Sep 4.

  25. Kalichman SC. Psychological and social correlates of high-risk sexual behaviour among men and women living with HIV/AIDS. AIDS Care. 1999;11(4):415–27.

    Article  PubMed  CAS  Google Scholar 

  26. Crepaz N, Passin WF, Herbst JH, et al. Meta-analysis of cognitive-behavioral interventions on HIV-positive persons’ mental health and immune functioning. Health Psychol. 2008;27(1):4–14.

    Article  PubMed  Google Scholar 

  27. Crepaz N, Lyles CM, Wolitski RJ, et al. Do prevention interventions reduce HIV risk behaviours among people living with HIV? A meta-analytic review of controlled trials. AIDS. 2006;20(2):143–57.

    Article  PubMed  Google Scholar 

  28. Noar SM. Behavioral interventions to reduce HIV-related sexual risk behavior: review and synthesis of meta-analytic evidence. AIDS Behav. 2008;12(3):335–53.

    Article  PubMed  Google Scholar 

  29. DiIorio C, McCarty F, Resnicow K, et al. Using motivational interviewing to promote adherence to antiretroviral medications: a randomized controlled study. AIDS Care. 2008;20(3):273–83.

    Article  PubMed  CAS  Google Scholar 

  30. Bandura A. Self-efficacy: the exercise of control. New York: W.H. Freeman and Company; 1997.

    Google Scholar 

  31. Golin CE, Davis RA, Przybyla SM, et al. SafeTalk, a multicomponent, motivational interviewing-based, safer sex counseling program for people living with HIV/AIDS: a qualitative assessment of patients’ views. AIDS Patient Care STDS. 2010;24(4):237–45.

    Article  PubMed  Google Scholar 

  32. Rosamond WD, Ammerman AS, Holliday JL, et al. Cardiovascular disease risk factor intervention in low-income women: the North Carolina WISEWOMAN project. Prev Med. 2000;31(4):370–9.

    Article  PubMed  CAS  Google Scholar 

  33. Golin CE, Patel S, Tiller K, Quinlivan EB, Grodensky CA, Boland M. Start talking about risks: development of a motivational interviewing-based safer sex program for people living with HIV. AIDS Behav. 2007;11(5 Suppl):S72–83.

    Article  PubMed  Google Scholar 

  34. Keyserling TC, Samuel-Hodge CD, Jilcott SB, et al. Randomized trial of a clinic-based, community-supported, lifestyle intervention to improve physical activity and diet: the North Carolina enhanced WISEWOMAN project. Prev Med. 2008;46:499–510.

    Google Scholar 

  35. Jilcott SB, Keyserling TC, Samuel-Hodge CD, et al. Linking clinical care to community resources for cardiovascular disease prevention: the North Carolina enhanced WISEWOMAN project. J Women’s Health. 2006;15(5):569–83.

    Article  Google Scholar 

  36. Gribble JN, Miller HG, Rogers SM, Turner CF. Interview mode and measurement of sexual behaviors: methodological issues. J Sex Res. 1999;36:16–24.

    Article  Google Scholar 

  37. Turner CF, Ku L, Rogers SM, Lindberg LD, Pleck JH, Sonenstein FL. Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology. Science. 1998;280(5365):867–73.

    Article  PubMed  CAS  Google Scholar 

  38. Ware JE, Sherbourne CD. The MOS 36-items short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–83.

    Article  PubMed  Google Scholar 

  39. Rubin DB. Multiple imputations for nonresponse in surveys. New York: J.Wiley & Sons, Inc.; 1987.

    Book  Google Scholar 

Download references

Acknowledgments

We would like to thank Sarah Przybyla, LaToya White, Meheret Mamo, Megan Kays, Robert Michael, Jessica Kadis, and Kathy Ramsey for their assistance in data collection, cleaning, and management. We would also like to thank Dr. Ronald Strauss, DDM, PhD for providing consultation in survey development as well as Carol Carr, Beth Fowler, and Regina McCoy for assistance with materials development. We would like to acknowledge Roger Akers for his technical assistance designing our data management system. We thank Niasha Brown, Rebecca Davis, Tyndall Harris, and Katherine Tiller for their delivery of counseling to study participants, Andrea Wong for statistical support, and Ross Oglesbee for her outstanding administrative assistance and support. This work would not have been possible without the enthusiastic support from the clinic staff in which the study was conducted. This work was supported by National Institute of Health (NIH) grants R01-MH069989, DK56350 and AI50410.

Author information

Authors and Affiliations

  1. Division of General Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Carol E. Golin

  2. Department of Health Behavior and Health Education, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Carol E. Golin, Jo Anne Earp & Zulfiya Chariyeva

  3. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Carol E. Golin, Catherine A. Grodensky, Shilpa N. Patel, Kemi Amola & Jennifer Groves

  4. University of North Carolina Center for AIDS Research, Chapel Hill, NC, USA

    Carol E. Golin & E. Byrd Quinlivan

  5. Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Chirayath Suchindran & Megha Parikh

  6. Department of Psychology, University of Connecticut, Storrs, CT, USA

    Seth Kalichman

  7. Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Kristine Patterson, Heidi Swygard & E. Byrd Quinlivan

  8. UNC Sheps Center for Health Services Research, 725 MLK Jr. Blvd., Campus Box 7590, Chapel Hill, NC, 27599-7590, USA

    Carol E. Golin

Authors
  1. Carol E. Golin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jo Anne Earp
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Catherine A. Grodensky
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shilpa N. Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chirayath Suchindran
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Megha Parikh
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Seth Kalichman
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kristine Patterson
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Heidi Swygard
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. E. Byrd Quinlivan
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Kemi Amola
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Zulfiya Chariyeva
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Jennifer Groves
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carol E. Golin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Golin, C.E., Earp, J.A., Grodensky, C.A. et al. Longitudinal Effects of SafeTalk, a Motivational Interviewing-Based Program to Improve Safer Sex Practices Among People Living with HIV/AIDS. AIDS Behav 16, 1182–1191 (2012). https://doi.org/10.1007/s10461-011-0025-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-011-0025-9

Keywords

Search

Navigation