A Randomized-Controlled Trial of Computer-based Prevention Counseling for HIV-Positive Persons (HPTN 065)

Laura A McKinstry, Allison Zerbe, Brett Hanscom, Jennifer Farrior, Ann E Kurth, Jill Stanton, Maoji Li, Rick Elion, Jason Leider, Bernard Branson, Wafaa M El-Sadr, Laura A McKinstry, Allison Zerbe, Brett Hanscom, Jennifer Farrior, Ann E Kurth, Jill Stanton, Maoji Li, Rick Elion, Jason Leider, Bernard Branson, Wafaa M El-Sadr

Abstract

Objective: Decreasing the risk of HIV transmission from HIV-positive individuals is an important public health priority. We evaluated the effectiveness of a computer-based sexual risk reduction counseling intervention (CARE+) among HIV-positive persons enrolled in care.

Methods: HIV-positive eligible participants (N=1075) were enrolled from 11 care sites in the Bronx, NY and Washington, DC and randomized 1:1 to either a tablet-based self-administered CARE+ intervention or standard of care (SOC). The primary outcome was the proportion of participants reporting any unprotected vaginal/anal sex at last sex, among all partners, HIV-negative or HIV-unknown-status partners and for primary and non-primary partners.

Results: At baseline, 7% of participants in both arms reported unprotected sex with an HIV-negative or HIV-unknown-status partner, while 13% in the CARE+ arm and 17% in the SOC arm reported unprotected sex with any partner. Most participants (88%) were on antiretroviral therapy (ART) at baseline. There was no significant difference in changes over time in unprotected vaginal/anal sex between the CARE+ and SOC arms for any partners (p=0.67) or either HIV-negative or HIV-unknown-status partners (p=0.40). At the Month 12 visit, most participants (85%) either strongly agreed or agreed that computer counseling would be a good addition to in-person counseling by a provider.

Conclusion: The CARE+ intervention was not effective at reducing sexual risk behaviors among HIV-positive patients in care, most of whom were on ART. Further research may be warranted around the utility of computer-based counseling for HIV prevention.

Keywords: Computer-delivered counseling; HIV prevention; Prevention for positives; Technology-based intervention.

Conflict of interest statement

Conflicts of Interest HPTN 065 is sponsored by NIAID and NIMH (Cooperative Agreements #UM1 AI068619; #UM1 AI068617) and the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, US Centers for Disease Control and Prevention. The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Consort diagram.
Figure 2
Figure 2
Proportion of participants reporting unprotected sex with any partner at last sex.
Figure 3
Figure 3
Proportion of participants reporting unprotected sex with any HIV−/unknown HIV status partner at last sex.

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Source: PubMed

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