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Intervention may not reduce risky behaviors among those with HIV
Behavioral intervention did not lead to a significant reduction of risky behaviors in HIV-infected heavy drinkers, according to recently published data.
Jeffrey H. Samet, MD, MA, MPH, of the Boston University School of Medicine and Boston Medical Center, and colleagues conducted a single blind randomized control trial among 700 participants recruited from Russian HIV and addiction clinical sites. Seven hundred HIV-positive heavy drinkers were randomly assigned to a behavioral intervention group (n=350) or a control group (n=350). Interventions stressed disclosure of HIV serostatus and condom use through two individual sessions and three small group sessions, whereas the control group was provided similar sessions focused on stress reduction, social support and good nutrition.
Jeffrey H. Samet
The mean age of the participants was 30 years, and 59% were male. Sixty percent reported injected drug use in the past year, 21.7% reported sharing needles and 15.4% tested positive for any sexually transmitted infection.
Assessments were conducted after 6 and 12 months, with 81% of participants having at least one follow-up. Full and partial interventions were delivered to 51% and 81% of participants within the intervention group, respectively, whereas control interventions were delivered to 54% and 76% of the control group.
Upon testing at the 12-month follow-up, STIs occurred in 8.1% of the intervention group and 12% of the control group (adjusted OR=0.63; 95% CI, 0.34-1.18).
Participants in both the intervention and control groups reported a 59.9% and 60.1% reduction, respectively, in unprotected sex (adjusted OR=0.91; 95% CI, 0.69-1.2), as well as an 18.3% and 15.4% reduction in needle sharing (adjusted OR=1.13; 95% CI, 0.74-1.73).
“Addressing prevention of HIV transmission from HIV-infected Russian drinkers, a group at particularly high risk for disease transmission, requires creative approaches and aggressive uptake of antiretroviral therapy,” Samet said in a press release. “This study shows that we need to explore other options to help stem the growing epidemic as behavioral interventions alone may not be sufficient.”
Disclosure: The researchers report no relevant financial disclosures.