Men were randomized to receive a behavioral intervention versus standard risk-reduction counseling. The experimental intervention, described in detail by , consisted of 19 core counseling modules delivered at one-on-one counseling sessions. This has proven equally challenging to implement in many settings. The CBT focused on using self-justifications for HIV high-risk behaviors thoughts, attitudes or beliefs that allow participant to engage in high-risk behaviors. A meta-analytic review by , synthesizing evidence and evaluating the effectiveness of four HIV individual interventions based in a variety of conceptual models, found an average 43 percent reduced odds of engaging in unprotected anal intercourse among individual intervention-group members relative to the comparison group aggregate effect size OR 0.
The CBT focused on using self-justifications for HIV high-risk behaviors thoughts, attitudes or beliefs that allow participant to engage in high-risk behaviors. Men were randomized to receive a behavioral intervention versus standard risk-reduction counseling. Inclusion criteria for the EXPLORE study were men who were HIV-uninfected, 16 years or older, had had anal sex with another man during the past year, and had not been involved in a mutually monogamous relationship in the past 2 years with a male partner who was HIV-uninfected. Participants were again asked to keep diaries of their sexual behavior for 16 weeks. Cognitive behavioral therapy CBT In another study, by , MSM with methamphetamine use were randomized to one of four interventions to address methamphetamine use and sexual risk behavior. Its focus is on reducing the risks associated with drug use, while recognizing the many users are likely to continue using. After 4 weeks, they were randomized into a control group without any intervention, an intervention group with instructions to recall a detailed description of a safe-sex slip-up without self-justifying behaviors, or a second intervention group with instructions to examine posters designed to focus on promoting evaluation of one's self-justifications. The participants were randomized; each individual either watched a video on AIDS, received individual counseling for HIV, took part in a group program on AIDS with safer sex guidelines, took part in a group program on eroticizing safer sex, or was assigned to a control condition wait-list. The experimental intervention, described in detail by , consisted of 19 core counseling modules delivered at one-on-one counseling sessions. Significant differences in unprotected sex acts in the past 3 months were observed at 3-month follow-up OR 0. A subsequent study by Gold and Rosenthal , also based on the relapse prevention model, further evaluated the effects of use of self-justification with posters versus vivid recalls of events to reduce risk of STDs. Harm reduction, human rights and public health Chris Beyrer, This principle has guided the British system of opiate addiction for over 50 years. Participants were 89 MSM who reported engaging in three or more recent episodes of oral or anal sex without a condom. Counselors delivered the intervention to individuals, and follow-up evaluation occurred at 6 and 12 months. The in-person intervention group showed significantly higher condom use, as well as higher condom use with HIV-infected partners, while participants in the delayed-intervention control reported fewer sexual partners, a decrease in drug use and emotional distress, as well as a decrease in antiretroviral therapy. Meta-analyses Individual HIV behavioral interventions with adult MSM have been shown to result in significant reductions in self-reported sexual risk behaviors ;. The intervention focused on improving physical health; coping with HIV status; maintaining drug regimens and making health-care decisions; identifying life goals; reducing distress; anticipating situations that raise anxiety, depression, fear or anger; and recognizing and controlling negative emotion with relaxation, self-instruction, and meditation. Reductions from baseline were significant across all groups. Motivational interviewing, social learning theory, social cognitive theory Employing motivational interviewing based in social cognitive theory, Picciano and colleagues evaluated the effects of a telephone-based intervention to reduce sexual risk-taking in MSM. This has proven equally challenging to implement in many settings. Episodes of UAI with other than the primary partner in the past 30 days were reduced from an average of 3 episodes to an average of less than 1 episode at month follow-up. After 4 weeks, participants were randomized to three different conditions: At baseline, only A meta-analytic review by , synthesizing evidence and evaluating the effectiveness of four HIV individual interventions based in a variety of conceptual models, found an average 43 percent reduced odds of engaging in unprotected anal intercourse among individual intervention-group members relative to the comparison group aggregate effect size OR 0.
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