The primary objective of this study is to evaluate the efficacy of a brief intervention designed to reduce high risk sexual practices of HIV+ individuals. This study was designed to enroll 400 HIV+ individuals over a five-year period, and was approved for 3 years. During the first 2-1/2 years, we have enrolled 200 subjects. Two additional years of funding will allow us to recruit and followup 200 more subjects so that sufficient data are available to test the efficacy of our intervention (N=400; 100/grp). Preliminary analyses indicate that our brief comprehensive intervention with boosters is effective in reducing high risk sexual practices of HIV+ individuals. Our intervention--TRIPLE """"""""S"""""""" (SHARE SAFER SEX)-- utilizes a randomized, pretest, multiple posttest, control group design. Our four group design addresses the question of how intensive (time and content) an intervention is necessary to achieve behavioral change. Four hundred sexually active HIV+ men and women are being randomly assigned to one of four conditions: (1) a brief (90 minute) one session targeted intervention focused on problem areas identified in three intervention domains (i.e., condom use, negotiation, disclosure); (2) a brief (90 minute) one session comprehensive intervention that covers all three intervention domains; 3) the same brief comprehensive intervention plus two monthly 90-minute booster sessions to reinforce behavior change; and (4) an attention-control condition (three 90-minute sessions) which addresses diet and exercise as related to HIV. Followup assessments are conducted at 4-, 8-, and 12-months post-intervention. The design of our intervention is guided by the principles of social cognitive theory. Skill-building exercises, demonstrations, role playing, rehearsal, and positive reinforcement are the main techniques used to enhance knowledge, self-efficacy, and positive outcome expectancies in the process of attaining desired behavioral change. A variety of behavioral outcomes are being examined (e.g., unprotected anal, vaginal, oral sex; partner types; number of HIV-partners). Moreover, subgroup differences in the effectiveness of the intervention based on gender, ethnicity, and key psychosocial factors (e.g., alcohol/drug use, stage of change) are being explored.
