Original Paper

AIDS and Behavior

, Volume 11, Issue 1, pp 58-71

Supporting Positive Living and Sexual Health (SPLASH): A Clinician and Behavioral Counselor Risk-Reduction Intervention in a University-Based HIV Clinic

  • María Luisa ZúñigaAffiliated withDepartment of Family and Preventive Medicine, University of California, San Diego Email author 
  • , Heather BaldwinAffiliated withDepartment of Internal Medicine, University of California, San Diego
  • , Daniel UhlerAffiliated withDepartment of Internal Medicine, University of California, San Diego
  • , Jesse BrennanAffiliated withDepartment of Pediatrics, University of California, San Diego
  • , Alisa María OlshefskyAffiliated withDelaware Division of Public Health, Health Promotion and Disease Prevention
  • , Erin OliverAffiliated withDepartment of Family and Preventive Medicine, University of California, San Diego
  • , William Christopher MathewsAffiliated withDepartment of Internal Medicine, University of California, San Diego

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Effective HIV prevention interventions with HIV-positive persons are paramount to stemming the rate of new infections. This paper describes an HIV-clinic-based demonstration project aimed at decreasing patient HIV-transmission risk behaviors and sexually transmitted infections. Systematic, computer-assisted assessment of patient risk aided primary care providers in delivering prevention messages. Patients at greater risk were referred to an HIV Prevention Specialist for behavioral counseling. Patients completed a computerized behavioral staging assessment to self-identify risk behaviors and readiness to change behaviors and counseling messages were individually tailored based on computer assessment. Challenges to project implementation: primary care provider buy-in, patient privacy concerns during risk assessment, and low participation in behavioral counseling. Forty-six percent of persons completing a risk assessment (2,124) were at risk for HIV transmission. Of 121 patients who scheduled counseling appointments, 42% completed at least one session. Despite challenges, successful implementation of a clinic-based prevention intervention is feasible, particularly with attention to patient and provider concerns.

Keywords

HIV prevention Clinical intervention Risk assessment Risk behavior