ABSTRACT
Little is known about the amount of Motivational Interviewing (MI) needed to reduce risky sexual behavior among People Living with HIV/AIDS (PLWHA) or the roles self-efficacy and motivation to practice safer sex play. Among 183 PLWHA who received safer sex MI and were surveyed every 4 months over a 12 month period, we used hierarchical negative binomial regression models to examine the association between amount of counseling time and sexual risk behavior. We performed mediation analysis to evaluate whether changes in self-efficacy and motivation explained this association. This study found that as MI time and number of provided sessions increased, participants' sexual risk behavior decreased. The effect of MI time and number of sessions on sexual behavior was mediated by self-efficacy but not by motivation to practice safer sex.
Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , HIV Seropositivity/epidemiology , Motivational Interviewing , Self Efficacy , Sexual Behavior/statistics & numerical data , Substance-Related Disorders/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/psychology , Adult , Female , HIV Seropositivity/psychology , Health Promotion , Humans , Male , Meta-Analysis as Topic , Motivational Interviewing/methods , North Carolina/epidemiology , Program Evaluation , Randomized Controlled Trials as Topic , Risk-Taking , Sexual Behavior/psychology , Social SupportABSTRACT
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.
Subject(s)
Acquired Immunodeficiency Syndrome/psychology , Directive Counseling/methods , Sexual Behavior/psychology , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/transmission , Adult , Female , Focus Groups , Health Knowledge, Attitudes, Practice , Humans , Longitudinal Studies , Male , Motivation , North Carolina , Program Evaluation , Sexual Partners , Surveys and Questionnaires , Treatment OutcomeABSTRACT
OBJECTIVE: This study examined the impact of motivational interviewing (MI) counseling time on self-efficacy to practice safer sex for people living with HIV/AIDS (PLWHA). METHODS: In 4 month intervals we followed a cohort of 490 PLWHA for 12 months. We conducted hierarchical linear regression models to examine changes in safer sex self-efficacy when participants received zero, low to moderate (5-131 min) and high (132-320 min) doses of MI time. We conducted a similar analysis using number of counseling sessions as the predictor variable. RESULTS: Participants with low to moderate doses of MI counseling had 0.26 higher self-efficacy scores than participants with zero MI time (p=0.01). Also, they had 0.26 lower self-efficacy scores than participants with high amounts of MI time (p=0.04). Participants with high doses of MI had a 0.5 higher self-efficacy score than participants with zero amount of MI time (p<0.0001). Participants who received 3-4 counseling sessions had 0.41 greater self-efficacy scores than participants who did not receive any sessions (p<0.0001) but did not differ from participants receiving 1-2 sessions. CONCLUSION: MI time is a key to enhancing safer sex self-efficacy among PLWHA. PRACTICE IMPLICATIONS: Safer sex self-efficacy improves the more MI counseling time and sessions PLWHA receive.
