Logo image
Back
Interactive "Video Doctor" counseling reduces drug and sexual risk behaviors among HIV-positive patients in diverse outpatient settings
Journal article   Open access   Peer reviewed

Interactive "Video Doctor" counseling reduces drug and sexual risk behaviors among HIV-positive patients in diverse outpatient settings

Paul Gilbert, Daniel Ciccarone, Stuart A Gansky, David R Bangsberg, Kathleen Clanon, Stephen J McPhee, Sophia H Calderón, Alyssa Bogetz and Barbara Gerbert
PloS one, Vol.3(4), pp.e1988-e1988
04/23/2008
DOI: 10.1371/journal.pone.0001988
PMCID: PMC2292251
PMID: 18431475
url
https://doi.org/10.1371/journal.pone.0001988View
Published (Version of record) Open Access

Abstract

Reducing substance use and unprotected sex by HIV-positive persons improves individual health status while decreasing the risk of HIV transmission. Despite recommendations that health care providers screen and counsel their HIV-positive patients for ongoing behavioral risks, it is unknown how to best provide "prevention with positives" in clinical settings. Positive Choice, an interactive, patient-tailored computer program, was developed in the United States to improve clinic-based assessment and counseling for risky behaviors. We conducted a parallel groups randomized controlled trial (December 2003-September 2006) at 5 San Francisco area outpatient HIV clinics. Eligible patients (HIV-positive English-speaking adults) completed an in-depth computerized risk assessment. Participants reporting substance use or sexual risks (n = 476) were randomized in stratified blocks. The intervention group received tailored risk-reduction counseling from a "Video Doctor" via laptop computer and a printed Educational Worksheet; providers received a Cueing Sheet on reported risks. Compared with control, fewer intervention participants reported continuing illicit drug use (RR 0.81, 95% CI: 0.689, 0.957, p = 0.014 at 3 months; and RR 0.65, 95% CI: 0.540, 0.785, p<0.001 at 6 months) and unprotected sex (RR 0.88, 95% CI: 0.773, 0.993, p = 0.039 at 3 months; and RR 0.80, 95% CI: 0.686, 0.941, p = 0.007 at 6 months). Intervention participants reported fewer mean days of ongoing illicit drug use (-4.0 days vs. -1.3 days, p = 0.346, at 3 months; and -4.7 days vs. -0.7 days, p = 0.130, at 6 months) than did controls, and had fewer casual sex partners at (-2.3 vs. -1.4, p = 0.461, at 3 months; and -2.7 vs. -0.6, p = 0.042, at 6 months). The Positive Choice intervention achieved significant cessation of illicit drug use and unprotected sex at the group-level, and modest individual-level reductions in days of ongoing drug use and number of casual sex partners compared with the control group. Positive Choice, including Video Doctor counseling, is an efficacious and appropriate adjunct to risk-reduction efforts in outpatient settings, and holds promise as a public health HIV intervention. Clinicaltrials.gov NCT00447707.
 HIV Seropositivity - psychology Demography Follow-Up Studies Risk Assessment Risk Reduction Behavior HIV Seropositivity - complications Humans Male Unsafe Sex - prevention & control Substance-Related Disorders - complications Outpatients Substance-Related Disorders - prevention & control Counseling Adult Female Software Patient Education as Topic

Details

Metrics

8 Record Views
91 Times Cited - Web of Science
Logo image