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Interactive Voice Response Self-Monitoring to Assess Risk Behaviors in Rural Substance Users Living with HIV/AIDS

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Community-dwelling HIV/AIDS patients in rural Alabama self-monitored (SM) daily HIV risk behaviors using an Interactive Voice Response (IVR) system, which may enhance reporting, reduce monitored behaviors, and extend the reach of care. Sexually active substance users (35 men, 19 women) engaged in IVR SM of sex, substance use, and surrounding contexts for 4–10 weeks. Baseline predictors of IVR utilization were assessed, and longitudinal IVR SM effects on risk behaviors were examined. Frequent (n = 22), infrequent (n = 22), and non-caller (n = 10) groups were analyzed. Non-callers had shorter durations of HIV medical care and lower safer sex self-efficacy and tended to be older heterosexuals. Among callers, frequent callers had lost less social support. Longitudinal logistic regression models indicated reductions in risky sex and drug use with IVR SM over time. IVR systems appear to have utility for risk assessment and reduction for rural populations living with HIV disease.

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  1. Southern AIDS Coalition. Southern States Manifesto: update 2008—HIV and sexually transmitted diseases in the south. (2008). Accessed 18 Jan 2011.

  2. Centers for Disease Control and Prevention National Centers for HIV/AIDS, Viral Hepatitis, STD, and TB prevention. 2006 Disease profile. (2008). Accessed 18 Jan 2011.

  3. Centers for Disease Control and Prevention. Cases of HIV infection and AIDS in rural and urban areas of the United States in 2006. HIV/AIDS surveillance supplemental report 2008; vol. 13(2). (2008). Accessed 18 Jan 2011.

  4. Reif S, Whetton K, Ostermann J, Raper J. Characteristics of HIV-infected adults in the Deep South and their utilization of mental health services: a rural versus urban comparison. AIDS Care. 2006;18S:S10–7.

    Article  Google Scholar 

  5. Latkin CA, Forman V, Knowlton A, Sherman S. Norms, social networks, and HIV-related risk behaviors among urban disadvantaged drug users. Soc Sci Med. 2003;56(3):465–76.

    Article  PubMed  Google Scholar 

  6. Abu-Hasaballah K, James A, Aseltine RH Jr. Lessons and pitfalls of interactive voice response in medical research. Contemp Clin Trials. 2007;28(5):592–602.

    Article  Google Scholar 

  7. Schroder KEE, Johnson CJ. Interactive voice response technology to measure HIV-related behavior. Curr HIV/AIDS Rep. 2009;6(4):210–6.

    Article  PubMed  Google Scholar 

  8. Tucker JA, Grimley DM. Public health tools for practicing psychologists. Advances in psychotherapy—evidence-based practice, vol. 20. Cambridge, MA: Hogrefe & Huber; 2011.

  9. Leigh BC, Stall R. Substance use and risky sexual behavior for exposure to HIV. Issues in methodology, interpretation, and prevention. Am Psychol. 1993;48(10):1035–45.

    Article  PubMed  CAS  Google Scholar 

  10. Horvath KJ, Beadnell B, Brown AM. A daily web diary of the sexual experiences of men who have sex with men: comparisons with a retrospective recall survey. AIDS Behav. 2007;11:537–48.

    Article  PubMed  Google Scholar 

  11. Mahoney DF, Tarlow BJ, Jones RN. Effects of an automated telephone support system on caregiver burden and anxiety: findings from the REACH TLC study. Gerontologist. 2003;43(4):556–67.

    Article  PubMed  Google Scholar 

  12. Sobell LC, Sobell MB. Timeline Followback: a technique for assessing self-reported alcohol consumption. In: Litten R, Allen J, editors. Measuring alcohol consumption. Totowa, NJ: Humana Press; 1992.

    Google Scholar 

  13. Carey MP, Carey KB, Maisto SA, Gordon CM, Weinhardt LS. Assessing sexual risk behavior with the Timeline Followback (TLFB) approach: continued development and psychometric evaluation with psychiatric outpatients. Int J STD AIDS. 2001;12:365–75.

    Article  PubMed  CAS  Google Scholar 

  14. Tucker JA, Foushee HR, Black BC, Roth DL. Agreement between prospective IVR self-monitoring and structured retrospective reports of drinking and contextual variables during natural resolution attempts. J Stud Alcohol Drugs. 2007;68(4):538–42.

    PubMed  Google Scholar 

  15. Simpson, CA, Xie L, Blum ER, Tucker JA. Agreement between prospective Interactive Voice Response Self-Monitoring and structured recall reports of risk behaviors in rural substance users living with HIV/AIDS. Psychol Addict Behav. (in press).

  16. Vuchinich RE, Simpson CA. Hyperbolic temporal discounting in social drinkers and problem drinkers. Exp Clin Psychopharmacol. 1998;6:292–305.

    Article  PubMed  CAS  Google Scholar 

  17. Strathman A, Gleicher F, Boninger DS, Edwards CS. The consideration of future consequences: weighing immediate and distant outcomes of behavior. J Pers Soc Psychol. 1994;66:742–52.

    Article  Google Scholar 

  18. Zimbardo PG, Boyd JN. Putting time in perspective: a valid, reliable individual-differences metric. J Pers Soc Psychol. 1999;77:1271–88.

    Article  Google Scholar 

  19. Norbeck JS, Lindsey AM, Carrieri L. Further development of the Norbeck social support questionnaire: normative data and validity testing. Nurs Res. 1983;32(1):4–9.

    Article  PubMed  CAS  Google Scholar 

  20. Semple SJ, Patterson TL, Grant I. The sexual negotiation behavior of HIV positive gay and bisexual men. J Consult Clin Psychol. 2000;68:934–7.

    Article  PubMed  CAS  Google Scholar 

  21. Searles JS, Perrine MW, Mundt JC, Helzer JE. Self-report of drinking using touch-tone telephone: extending the limits of reliable daily contact. J Stud Alcohol. 1995;56(4):375–82.

    PubMed  CAS  Google Scholar 

  22. Helzer JE, Badger JG, Rose JL, Mongeon JA, Searles JS. Decline in alcohol consumption during two years of reporting. J Stud Alcohol. 2002;63(5):551–8.

    PubMed  Google Scholar 

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This research was supported in part by National Institute on Drug Abuse grant no. 5 R21 DA21524 to Jalie A. Tucker. The authors thank Dr. Barbara Hanna, Medical Director, and the staff of the Health Services Center, Hobson City, AL for their support of project data collection, and Katharine E. Stewart for consultation on HIV-related assessment. Portions of the research were presented at the August 2008 meeting of the American Psychological Association, Boston, MA and the April 2010 meeting of the Society of Behavioral Medicine, Seattle, WA. Send correspondence to Jalie A. Tucker, Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, 227 RPHB, Birmingham, AL 35294 (email:

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Tucker, J.A., Blum, E.R., Xie, L. et al. Interactive Voice Response Self-Monitoring to Assess Risk Behaviors in Rural Substance Users Living with HIV/AIDS. AIDS Behav 16, 432–440 (2012).

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