HIV Intervention for Providers Study: A Randomized Controlled Trial of a Clinician-Delivered HIV Risk-Reduction Intervention for HIV-Positive People

Rose, Carol Dawson PhD, RN*; Courtenay-Quirk, Cari PhD†; Knight, Kelly PhD‡; Shade, Starley B PhD‡; Vittinghoff, Eric PhD§; Gomez, Cynthia PhD*; Lum, Paula J MD, MPH∥; Bacon, Oliver MD∥; Colfax, Grant MD¶

JAIDS Journal of Acquired Immune Deficiency Syndromes: 15 December 2010 - Volume 55 - Issue 5 - pp 572-581
doi: 10.1097/QAI.0b013e3181ee4c62
Clinical Science

Clinician-delivered prevention interventions offer an opportunity to integrate risk-reduction counseling as a routine part of medical care. The HIV Intervention for Providers study, a randomized controlled trial, developed and tested a medical provider HIV prevention training intervention in 4 northern California HIV care clinics. Providers were assigned to either the intervention or control condition (usual care). The intervention arm received a 4-hour training on assessing sexual risk behavior with HIV-positive patients and delivering risk-reduction-oriented prevention messages to patients who reported risk behaviors with HIV-uninfected or unknown-status partners. To compare the efficacy of the intervention versus control on transmission risk behavior, 386 patients of the randomized providers were enrolled. Over six-months of follow-up, patients whose providers were assigned the intervention reported a relative increase in provider-patient discussions of safer sex (OR = 1.49; 95% CI = 1.06 to 2.09), assessment of sexual activity (OR = 1.60; 95% CI = 1.05 to 2.45), and a significant decrease in the number of sexual partners (OR = 0.49, 95% CI = 0.26 to 0.92). These findings show that a brief intervention to train HIV providers to identify risk and provide a prevention message results in increased prevention conversations and significantly reduced the mean number of sexual partners reported by HIV-positive patients.

Received for publication September 17, 2009; accepted June 21, 2010.

From the *UCSF, Center for AIDS Prevention Studies, School of Nursing; †Centers for Disease Control and Prevention; ‡UCSF, Center for AIDS Prevention Studies; §UCSF, Epidemiology and Biostatistics; ∥UCSF, Department of Medicine, HIV/AIDS Division; and ¶San Francisco Department of Health.

This study was funded by the Centers for Disease Control and Prevention (CDC), PA 01190, cooperative agreement (CDC Grant # R18/CCR920974).

Meetings at which parts of data were presented: International AIDS Conference, 2008, Mexico City, Mexico; University of California, Davis Medical Center Infectious Disease Grand Rounds, 2007; International AIDS Conference, 2006, Toronto, Canada.

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

The clinical trials registration number is NCT00164398.

Correspondence to: Dr. Carol Dawson Rose, PhD, RN, Center for AIDS Prevention Studies, University of California - San Francisco, 50 Beale St Ste. #1300 San Francisco, CA 94105 (e-mail: Carol.Dawson-Rose@ucsf.edu).

© 2010 Lippincott Williams & Wilkins, Inc.