Table 2.
Main topic chosen for discussion by all study participants (N = 169 sessions)
| Topic chosen | Specific issues client raised | Number choosing topic N (%) N = 169 sessions |
|---|---|---|
| Condom use | How to use condoms | 50 (30%) |
| Overcoming barriers to condom use (e.g., keeping them nearby, buying them ahead of time, using lubrication to increase sensation) |
||
| Condoms make people feel dirty | ||
| People like to “feel” their partner | ||
| Heat of the moment | ||
| Alcohol/other drug use | Discussion of how drugs and alcohol impede safer sex practices |
27 (16%) |
| Keeping self and others safe from re-infection and STI’s (usually among concordant couples or partners of unknown status) |
Keeping self-safe from STIs | 24 (14%) |
| Keeping one’s partner safe from STI’s | ||
| Re-infection | ||
| Risk of resistance | ||
| Could make one-another sicker | ||
| Karma | ||
| Relationships | Everyone wants someone | 23 (13.5%) |
| Maintaining boundaries | Not just sex, dinner, movie | |
| Time invested in relationship | ||
| Future relationships | Love | |
| Feeling safe in relationships | Likes security of relationship | |
| Remaining monogamous | If did not have relationship would probably “be on streets” |
|
| Does not want to be alone | ||
| Communication with partner | How to say “no” | |
| Maintaining relationship | Asking for what one wants out of partner | |
| Keeping partner negative | Love for partner | 17 (10%) |
| Partner has stood by them | ||
| Do not want partner to go through what they have | ||
| Disclosure | Self-care | 8 (4.5%) |
| Alternate ways to be intimate (not here) | ||
| Disclosure of serostatus to partners | ||
| Self-esteem issues | ||
| Re-disclosure | ||
| Stigma | ||
| Ignorance | ||
| They have a right to know what they are getting into | ||
| Self-care includes | Wanting to stay on same medication | 6 (3.5%) |
| Learning to say no Taking time for self Taking meds |
If no time for self then may use AOD then will not practice safer sex |
|
| Risk assessment | Pt. did not pick topic | 6 (3.5%) |
| Alternate ways to be intimate | Pt. unable to engage in certain sexual acts because of health issues |
4 (2%) |
| Fear alternate ways will not please partner | ||
| Desire to please partner | ||
| Fear of harming partner | ||
| Worries about getting a STI | Does not want another STI | 3 (2%) |
| HIV only STI | ||
| Another STI could make HIV worse | ||
| STI’s make people look sick | ||
| Patient update | Pt. in and out of hospital, extremely ill. Not appropriate to discuss sex; fear of ruining relationship with pt. did discuss later |
1 (0.5%) |