Table 1.
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 |
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.