Abstract:
OBJECTIVE:Primary care may be an effective venue for delivering behavioral interventions for sexual safety among HIV-positive men who have sex with men (MSM); however, few studies show efficacy for such an approach. We tested the efficacy of the Treatment Advocacy Program (TAP), a 4-session, primary-care-based, individual counseling intervention led by HIV-positive MSM "peer advocates" in reducing unprotected sex with HIV-negative or unknown partners (HIV transmission risk). METHOD:We randomized 313 HIV-positive MSM to TAP or standard care. HIV transmission risk was assessed at baseline, 6 months, and 12 months (251 participants completed all study waves). We conducted intent-to-treat analyses using general estimating equations to test the interaction of group (TAP vs. standard care) by follow-up period. RESULTS:At study completion, TAP participants reported greater transmission risk reduction than did those receiving standard care, χ2(2, N = 249) = 6.6, p = .04. Transmission risk among TAP participants decreased from 34% at baseline to about 20% at both 6 and 12 months: Transmission risk ranged from 23% to 25% among comparison participants. CONCLUSIONS:TAP reduced transmission risk among HIV-positive MSM, although results are modest. Many participants and peer advocates commented favorably on the computer structure of the program. We feel that the key elements of TAP-computer-based and individually tailored session content, delivered by peers, in the primary care setting-warrant further exploration.
journal_name
J Consult Clin Psycholjournal_title
Journal of consulting and clinical psychologyauthors
McKirnan DJ,Tolou-Shams M,Courtenay-Quirk Cdoi
10.1037/a0020759subject
Has Abstractpub_date
2010-12-01 00:00:00pages
952-63issue
6eissn
0022-006Xissn
1939-2117pii
2010-20816-001journal_volume
78pub_type
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journal_title:Journal of consulting and clinical psychology
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