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Implementation and Operational Research: Computer-Assisted Intervention for Safer Sex in HIV-Positive Men Having Sex With Men: Findings of a European Randomized Multi-Center Trial. | LitMetric
Departments of *Public Health; †Clinical Sciences, Institute of Tropical Medicine, ITM's HIV AIDS Center (IHAC), Antwerp, Belgium; ‡Department of Infectious Diseases, Ludwig-Maximilian University, University Hospital Munich, Munich, Germany; §Faculty of Education, Sociology, and Health Services, University of Zielona Gora, Zielona Gora, Poland; ‖Institute of Tropical Medicine and Hygiene, Lisbon, Portugal; ¶Central North West London NHS Trust, London, United Kingdom; #Department of Medicine, Center for Infectious Diseases and Travel Medicine and IFB Center for Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg, Germany; **AIDES, Mission Innovation Recherche Expérimentation (MIRE), Paris, France; ††National Reference Centre for HIV/AIDS Prevention, Slovak Medical University, Bratislava, Slovak Republic; ‡‡Faculty of Psychology and Educational Sciences, Open University, Heerlen, the Netherlands; and §§Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium.
Published: March 2016
AI Article Synopsis
Article Abstract
Objective: Men who have sex with men (MSM) are the key population most affected by HIV in Europe. We performed the first European multicenter, simple-randomized parallel-group study to test the effectiveness of a theory-guided computer-assisted intervention to improve safer sex among HIV-positive men who have sex with men.
Methods: Between February, 2011 and February, 2013, 112 participants were enrolled in 8 different European HIV-care settings. Intervention participants received 3 individual counseling sessions facilitated by trained service providers using computer-assisted tools. The control-group received sexual health advice delivered as part of regular HIV care. Outcome behavior (self-reported condom use at last intercourse; combined HIV transmission risk score), its influencing factors, and mediating variables were assessed at baseline, and at 3 and 6 months follow-up. Mixed effects models were used to compare primary outcomes (condom use at last intercourse, HIV transmission risk score), and mediation analysis to explore intervention effects.
Results: Condom use at last intercourse increased more among intervention than control participants at 3 months follow-up (odds ratio of 3.83; P = 0.03), but not significantly at 6 months follow-up. Intervention participants reported a lower transmission risk at 3 months follow-up than controls (odds ratio compared with baseline of 11.53 and 1.28, respectively; P = 0.008), but this effect became nonsignificant at 6 months. Intervention effects were mediated by the proximal variables, self-efficacy to negotiate condom use and condom attitudes.
Conclusions: This intervention showed short-term effectiveness. The intervention should be replicated in other settings, eventually investigating if booster-counseling sessions would yield a longer lasting effect.
