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Changes in Sexual Behavior of HIV-Infected Older Adults Enrolled in a Clinical Trial of Standalone Group Psychotherapies Targeting Depression

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Abstract

By 2015, one-half of all HIV-positive persons in the U.S. will be 50-plus years of age, and as many as 30 % of older adults living with HIV/AIDS continue to engage in unprotected sexual intercourse. Contemporary positive prevention models often include mental health treatment as a key component of HIV prevention interventions. This secondary data analysis characterized longitudinal patterns of sexual behavior in HIV-positive older adults enrolled in a randomized controlled trial of group mental health interventions and assessed the efficacy of psychosocial treatments that targeted depression to reduce sexual risk behavior. Participants were 295 HIV-positive adults ≥50 years of age experiencing mild to severe depressive symptoms, randomized to one of three study conditions: a 12-session coping improvement group intervention, a 12-session interpersonal support group intervention, or individual therapy upon request. Approximately one-fifth of participants reported one or more occasions of unprotected anal or vaginal intercourse with HIV-negative sexual partners or persons of unknown HIV serostatus over the study period. Changes in sexual behavior did not vary by intervention condition, indicating that standalone treatments that target and reduce depression may be insufficient to reduce sexual risk behavior in depressed HIV-positive older adults.

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References

  1. Justice AC. HIV and aging: time for a new paradigm. Curr HIV/AIDS Rep. 2010;7:69–76.

    Article  PubMed  Google Scholar 

  2. Cooperman NA, Arnsten JH, Klein RS. Current sexual activity and risky sexual behavior in older men with or at risk for HIV infection. AIDS Educ Prev. 2007;19:321–33.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Golub SA, Tomassilli JC, Pantalone DW, Brennan M, Karpiak SE, Parsons JT. Prevalence and correlates of sexual behavior and risk management among HIV-positive adults over 50. Sex Transm Dis. 2010;37:615–20.

    PubMed  Google Scholar 

  4. Lovejoy TI, Heckman TG, Sikkema KJ, et al. Patterns and correlates of sexual activity and condom use behavior in persons 50-plus years of age living with HIV/AIDS. AIDS Behav. 2008;12:943–56.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Onen FN, Shacham E, Stamm KE, Overton T. Comparisons of sexual behaviors and STD prevalence among older and younger individuals with HIV infection. AIDS Care. 2010;22:711–7.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Bernstein KT, Marcus JL, Nieri G, Philip SS, Klausner JD. Rectal gonorrhea and chlamydia reinfection is associated with increased risk of HIV seroconversion. J Acquir Immune Defic Syndr. 2010;53:537–43.

    Article  PubMed  Google Scholar 

  7. Nusbaum MR, Wallace RR, Slatt LM, Kondrad EC. Sexually transmitted infections and increased risk of co-infection with human immunodeficiency virus. J Am Osteopath Assoc. 2004;104:527–35.

    PubMed  Google Scholar 

  8. Sikkema KJ, Watt MH, Drabkin AS, Meade CS, Hansen NB, Pence BW. Mental health treatment to reduce HIV transmission risk behavior: a positive prevention model. AIDS Behav. 2010;14:252–62.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Fisher JD, Smith L. Secondary prevention of HIV infection: the current state of prevention for positives. Curr Opin HIV AIDS. 2009;4:279–87.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Fisher JD, Smith LR, Lenz EM. Secondary prevention of HIV in the United States: past, current, and future perspectives. J Acquir Immune Defic Syndr. 2010;55:S106–15.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Coleman CL, Ball K. Sexual diversity and HIV risk among older heterosexual African American males who are seropositive. Appl Nurs Res. 2010;23:122–9.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Cook RL, McGinnis KA, Kraemer KL, et al. Intoxication before intercourse and risky sexual behavior in male veterans with and without HIV infection. Med Care. 2006;44:S31–6.

    Article  PubMed  Google Scholar 

  13. Cook RL, McGinnis KA, Samet JH, et al. Erectile dysfunction drug receipt, risky sexual behavior and sexually transmitted diseases in HIV-infected and HIV-uninfected men. J Gen Intern Med. 2010;25:115–21.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Illa L, Brickman A, Saint-Jean G, et al. Sexual risk behaviors in late middle age and older HIV seropositive adults. AIDS Behav. 2008;12:935–42.

    Article  PubMed  Google Scholar 

  15. Siegel K, Schrimshaw EW, Karus D. Racial disparities in sexual risk behaviors and drug use among older gay/bisexual and heterosexual men living with HIV/AIDS. J Natl Med Assoc. 2004;96:215–23.

    PubMed Central  PubMed  Google Scholar 

  16. Tsai AC, Mimiaga MJ, Dilley DW, et al. Does effective depression treatment alone reduce secondary HIV transmission risk? Equivocal findings from a randomized trial. AIDS Behav. 2013;17:2765–72.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Tsai AC, Karasic DH, Hammer GP, et al. Directly observed antidepressant medication treatment and HIV outcomes among homeless and marginally housed HIV-positive adults: a randomized controlled trial. Am J Public Health. 2013;103:308–15.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Heckman TG, Sikkema KJ, Hansen N, Kochman A, Heh V, Neufeld S, The AIDS and Aging Research Group. A randomized clinical trial of a coping improvement group intervention for HIV-infected older adults. J Behav Med. 2011;34:102–11.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Beck AT, Steer RA, Brown GK. Manual for the beck depression inventory-II. San Antonio: The Psychological Corporation; 2003.

    Google Scholar 

  20. Teng EL, Chui HC. The modified mini-mental status (3MS) examination. J Clin Psychiatry. 1987;48:314–8.

    CAS  PubMed  Google Scholar 

  21. Heckman TG, Barcikowski R, Ogles B, et al. A telephone-delivered coping improvement group intervention for middle-aged and older adults living with HIV/AIDS. Ann Behav Med. 2006;32:27–38.

    Article  PubMed  Google Scholar 

  22. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.

    Google Scholar 

  23. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1983;17:37–49.

    Article  CAS  Google Scholar 

  24. O’Cleirigh C, Newcomb ME, Mayer KH, Skeer M, Traeger L, Safren SA. Moderate levels of depression predict sexual transmission risk in HIV-infected MSM: a longitudinal analysis of data from six sites involved in a “prevention for positives” study. AIDS Behav. 2013;17:1764–9.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Heckman TG, Heckman BD, Anderson T, et al. Supportive-expressive and coping group teletherapies for HIV-infected older adults: a randomized clinical trial. AIDS Behav. 2013;17:3034–44.

    Article  PubMed  Google Scholar 

  26. Safren SA, O’Cleirigh CM, Skeer M, Elsessser SA, Mayer KH. Project enhance: a randomized controlled trial of an individualized HIV prevention intervention for HIV-infected men who have sex with men conducted in a primary care setting. Health Psychol. 2013;32:171–9.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Crepaz N, Marks G. Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review. Health Psychol. 2001;20:291–9.

    Article  CAS  PubMed  Google Scholar 

  28. Vallabhaneni S, McConnell JJ, Loeb L, et al. Changes in seroadaptive practices from before to after diagnosis of recent HIV infection among men who have sex with men. PLoS One. 2013;8:e55397. doi:10.1371/journal.pone.0055397.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  29. Lovejoy TI. Telephone-delivered motivational interviewing targeting sexual risk behavior reduces depression, anxiety, and stress in HIV-positive older adults. Ann Behav Med. 2012;44:416–21.

    Article  PubMed  Google Scholar 

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Acknowledgments

This research was support by Grant R01-MH067568 from the National Institute of Mental Health, the National Institute of Nursing Research, and the National Institute on Aging. We extend our appreciation to all study participants and to the AIDS service organizations that collaborated on this study: Columbus AIDS Task Force, AIDS Volunteers of Cincinnati, and Callen-Lorde Community Health Center in NYC.

Conflict of interest

No author reports a conflict of interest, financial or otherwise.

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Authors and Affiliations

  1. Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA

    Travis I. Lovejoy

  2. Mental Health and Clinical Neurosciences Division, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Road, Portland, OR, 97239, USA

    Travis I. Lovejoy

  3. College of Public Health, University of Georgia, Athens, GA, USA

    Timothy G. Heckman & Nathan B. Hansen

  4. Department of Psychology & Neuroscience, Duke University, Durham, NC, USA

    Kathleen J. Sikkema

  5. Clinician in Private Practice, New York, NY, USA

    Arlene Kochman

Authors
  1. Travis I. Lovejoy
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  2. Timothy G. Heckman
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  3. Kathleen J. Sikkema
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  4. Nathan B. Hansen
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  5. Arlene Kochman
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Correspondence to Travis I. Lovejoy.

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Lovejoy, T.I., Heckman, T.G., Sikkema, K.J. et al. Changes in Sexual Behavior of HIV-Infected Older Adults Enrolled in a Clinical Trial of Standalone Group Psychotherapies Targeting Depression. AIDS Behav 19, 1–8 (2015). https://doi.org/10.1007/s10461-014-0746-7

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  • DOI: https://doi.org/10.1007/s10461-014-0746-7

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