Reductions in transmission risk behaviors in HIV-positive clients receiving prevention case management services: findings from a community demonstration project.

Prevention case management (PCM) for HIV-infected persons is an HIV risk reduction intervention designed to assist clients who are aware of their HIV infection and who continue to engage in risk transmission behaviors. PCM combines individual risk reduction counseling with case management to address the psychosocial factors affecting HIV transmission. More than 350 HIV-positive clients participated in PCM in Wisconsin between 2000 and 2003, and 109 completed both baseline and follow-up risk assessments. The percentage of clients reporting risk transmission behaviors, specifically unprotected vaginal intercourse, insertive anal intercourse, or needle sharing with partners of negative or unknown HIV status, declined from 41.3% at baseline to 29.4% at follow-up (p = 0.04). Furthermore, clients showed progression (p < or =.05) through stages of change using Prochaska and DiClemente's transtheoretical model on seven domains related to HIV transmission risk, including personalizing risk of HIV transmission and sexual risk behavior.

[1]  S. Rutledge.  Single-Session Motivational Enhancement Counseling to Support Change Toward Reduction of HIV Transmission by HIV Positive Persons , 2007, Archives of sexual behavior.

[2]  J. Buehler,et al.  Ethics, practice, and research in public health. , 2004, American journal of public health.

[3]  J. Kelly,et al.  Drug Use and Sexual Risk Behaviours among Female Russian IDUs Who Exchange Sex for Money or Drugs , 2004 .

[4]  K. Mayer.  Recommendations for incorporating human immunodeficiency virus (HIV) prevention into the medical care of persons living with HIV. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[5]  Phalguni Gupta,et al.  Adherence to Antiretroviral Therapy and Persistence of HIV RNA in Semen , 2003, Journal of acquired immune deficiency syndromes.

[6]  J. Dilley,et al.  Continuing increases in sexual risk behavior and sexually transmitted diseases among men who have sex with men: San Francisco, Calif, 1999-2001, USA. , 2002, American journal of public health.

[7]  A. O'Leary,et al.  Predictors of sexual behavior patterns over one year among persons at high risk for HIV. , 2002, Archives of sexual behavior.

[8]  David R. Holtgrave,et al.  The Serostatus Approach to Fighting the HIV Epidemic: prevention strategies for infected individuals. , 2001, American journal of public health.

[9]  K. McGeary,et al.  USING THE DRUG ABUSE SCREENING TEST (DAST-10) TO ANALYZE HEALTH SERVICES UTILIZATION AND COST FOR SUBSTANCE USERS IN A COMMUNITY-BASED SETTING , 2001, Substance use & misuse.

[10]  L. Kunches,et al.  Nonoccupational postexposure prophylaxis: evolving clinical practice. , 2000, AIDS clinical care.

[11]  R. Wolitski,et al.  HIV prevention case management: current practice and future directions. , 1998, Health & social work.

[12]  D. Katzenstein,et al.  Human immunodeficiency virus type 1 RNA shedding in the female genital tract. , 1998, The Journal of infectious diseases.

[13]  J. Gordon,et al.  Relapse prevention as an interventive model for HIV risk reduction in gay and bisexual men. , 1998, AIDS education and prevention : official publication of the International Society for AIDS Education.

[14]  J. Kelly.  Changing HIV Risk Behavior: Practical Strategies , 1995 .

[15]  J O Prochaska,et al.  Stages of change in the modification of problem behaviors. , 1992, Progress in behavior modification.

[16]  Michael R. Kauth,et al.  Reliability of retrospective assessments of sexual HIV risk behavior: a comparison of biweekly, three-month, and twelve-month self-reports. , 1991, AIDS education and prevention : official publication of the International Society for AIDS Education.