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. 2015 May 1;29(5):288–298. doi: 10.1089/apc.2014.0240

Table 1.

Characteristics of Included Studies: The PICO Elements

Study Setting(s) and study period Sample characteristics Intervention design Intervention description Sexual outcomes
Cornman 200823 One urban HIV clinic; KwaZulu-Natal, South Africa
Study period: 10/2004–01/2005
HIV-infected; receiving HIV clinical care No precondition of sexual activity (and condomless sex), past 3 months (n=152) ≥18 years old, mean age 34 years (range 18–58 years); 43% male; 95% African/5% other; 93% reported heterosexual HIV acquisition; 66% on ARTa
Participation rate 98%, overall retention 85%
RCTb (2 arms)
Intervention: Behavioral intervention; sexual risk topic
Level: Individual
Provision: HIV counselors, face-to-face, using Motivational Interviewing techniques
Intensity-duration: 15 min session at each clinic visit (appr. 3 months apart) until study end
Follow-up (post intervention): none
Data collection: baseline and month 6
Aim: Reduce number of condomless sexual events; evaluate the feasibility and fidelity of the intervention adapted from the Options Project27
Theoretical basis: Information-Motivation-Behavioral Skills Model
Intervention group (n=103): brief patient-centered discussion (the Options for Health sexual risk reduction intervention)27 in addition to standard HIV counseling
Comparison group (n=49): standard care (HIV counseling)
Number of condomless sexual acts during last 3 months (all and HIV-/?):
↓ mean no. of sex acts with all partners from baseline in intervention arm (stat.sign.);↑in control arm (marginally stat.sign.)
Same direction changes in condomless sexual risk acts with HIV-/? partners (marginally stat.sign)
↑total no. of sex acts (both w and w/o condom) in both arms from baseline (stat.sign)
Gilbert 200824 Five outpatient HIV clinics; San Francisco Bay Area, US
Study period: 12/2003–09/2006
HIV-infected (≥3 mo); receiving HIV care No precondition of sexual activity, and only had to report at least 1 of 3 risk behaviors (alcohol, drugs, sex): for sexual risk behavior past 3 months (n=476)≥18 years old, mean age 44.1 years (SD 9.09)c; 51% male; 29% white/ 50% black/African-American/ 13% Hispanic/Latino/ 8% other; 51% reported MSM/Wd/ 16% IDUe related HIV acquisition; data on ART not provided
Participation rate 96% (of those 52% eligible according to risk behavior), overall retention 83%
RCT (2 arms, 2:1)
Intervention: Behavioral intervention; multitopic
Level: Individual
Provision: Interactive computer program, using Motivational Interviewing approach
Intensity-duration: Average 24 min session prior to regularly scheduled medical appointment with booster at 3 months; post-session doctor-patient discussion (based on computer-suggested risk counseling statements) during medical appointment; behavioral assignment (take-away)
Follow-up (post intervention): 3 months
Data collection: baseline and months 3, 6
Aim: Reduce illicit drug-use, risky alcohol consumption and condomless anal-vaginal (UVA) sexual acts
Theoretical basis: N/A
Intervention group (n=243): Positive Choice intervention with computer-based risk assessment preceding tailored “Video Doctor” risk reduction counseling session; printout of behavioral assignment and referrals to substance use and harm-reduction services
Comparison group (n=233): Computer-based risk assessment, followed by standard care, risk counseling at providers' discretion
Sexual risk, measured by:
(1) 100% (consistently) /<100% (inconsistently) using condom during last 3 months with main and/or casual partner(s):
↓UVA (stat.sign)g
↑Condom use, all partners: trend in both arms, no difference between arms
(2) No. of sexual partners:
↓No. of casual partners (stat.sign)
Kurth 201325 HIV clinic and community setting; Seattle, WA, US
Study period: 03/2006–07/2007
HIV-infected, on ART
No precondition of sexual activity, past ? months
(n=240)≥18 years old; mean age 45 (SD 10.37)c years; 91% male; 46% white/25% black or African American/7% Hispanic/Latino, 22% other; 62% MSM; 11% current IDU
Participation rate 80%, overall retention 87%
RCT (2 arms)
Intervention: Behavioral intervention; multitopic
Level: Individual
Provision: Computerized, personal, using motivational interviewing and social cognitive techniques
Intensity-duration: 4 sessions with 3-month intervals; during 9 months
Follow-up: 9 months
Data collection: at baseline and months 3, 6, 9
Aim: Reduce HIV transmission risk and support ART adherence
Theoretical basis: Information-Motivation-Behavioral Skills Model, Transtheoretical Model of Change
Intervention group (n=120): computerized CARE+f (audio-narrated assessment, tailored feedback, skill-building videos, health plan, and print-out) plus standard care
Comparison group (n=120): computerized risk assessment plus standard care
Transmission risk composite outcome, incl. no condom use or condom use with problems/errors (past 3 months) and ART adherence (30 days):
↓odds of transm.risks 0.55 lower at mo 9 compared to baseline in intervention group (stat.sign), while↑in control group;↓odds of transm.risks at mo 9 reduced in intervention group compared to control group (stat.sign)
Safren 201326 HIV clinic in Boston, MA, US
Study period: 04/2004–07/2008
recruitment 04/2004–08/2007
HIV-infected MSM; receiving HIV care reporting at least one sexual transmission risk act, past 6 months (n=201) ≥18 years old, mean age 40.7 (SD 7.8) years; white 74.6%/11.9% black/African American/8.5% latino/Hispanic/5.0% other; IDU % measured, not reported; 56.7% currently on ART
Participation rate not reported (non-eligible and refusing reported together), overall retention 86%
RCT (2 arms)
Intervention: Behavioral intervention; multitopic
Level: Individual
Provision: Medical social worker, Motivational Interviewing approach
Intensity-duration: Intervention module of 5 (50–90 min) sessions (1 intake+4 “interventions”) over appr. 3 months, followed by 4 boosters at mo 3, 6, 9, 12.
Follow-up (post intervention): none (considering the boosters)
Data collection: baseline and months 3, 6, 9, 12
Aim: Reduce sexual transmission risk behavior
Theoretical basis: Information-Motivation-Behavioral Skills Model; influenced by / adapted from Project EXPLORE28
Intervention group (n=100): 7 topics, same-format, but individualized delivery – mandatory ‘Having sex’ and others: ‘Party drugs’, ‘Managing stress’, ‘Triggers’, ‘Cultures, communities and you’, ‘Disclosure’, ‘Getting the relationships you want’.
Comparison group (n=101): standard care
Transmission risk, measured by no. of condomless sexual risk acts during last 3 months with HIV-/? partner(s):
- number of acts,
- no risk acts or at least 1 risk act (dichotomized)
↓in transmission risk in whole study population, but no sign. differences between study groups in transmission risk over time for either outcomes
The Healthy Living Project Team 20073 HIV clinics and other community settings; 4 US cities (Los Angeles, CA; Milwaukee, WI; New York, NY; San Francisco, CA); Study period: 04/2000–02/2004
recruitment 04/2000–01/2002
HIV-infected (women, MSM, IDUs; at later stage also heterosexual men) considered at risk of sexually transmitting HIV; eligible only if reported at least 1 condomless sex act in past 3 months: with any HIV-/? partner OR HIV+ partner other than main
(n=936)≥18 years old, mean age 39.8 years (range 19–67 years); 79% male (of whom 72% MSM); 32% white/45% African-American/15% Hispanic/8% other; 12% IDU/ 70% non-IDU; 69% on ART
Participation rate 87%, overall retention 83%
RCT (2 arms)
Intervention: Behavioral intervention; multitopic
Level: Individual
Provision: Facilitators (social workers, therapists, community-based service providers) face-to-face, using cognitive-behavioral techniques
Intensity-duration: 15 sessions (90 min each); during 12 months
Follow-up (post intervention): appr 13 months
Data collection: baseline and months 5, 10, 15, 20, 25
Aim: Reduce number of sexual risk acts; execute effective coping responses; enchance access and and adherence to medical services
Theoretical basis: Social Action Theory
Intervention group (n=467): 3 modules (safer behaviors; stress, coping and adjustment; health behaviors)
Comparison group (n=469): No active psychosocial intervention (on waitlist)
Transmission risk, measured by no. of condomless sexual risk acts during last 3 months with HIV-/? partner(s):
↓mean no. of sex risk acts with HIV-/? partners (stat.sign);
↓no. of sex risk acts with HIV-/? partners from baseline; observed in both arms, no difference between arms
a

ART, antiretroviral therapy; bRCT, randomized controlled trial; ctotal sample mean age (SD) calculated by review authors based on means (SDs) of different study arms; dMSM/W, men having sex with men/women; eIDU, injection drug use; fCARE+, Computer Assessment & Rx Education for HIV-positive people.