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Telephone-Administered Motivational Interviewing to Reduce Risky Sexual Behavior in HIV-Infected Rural Persons: A Pilot Randomized Clinical Trial

Cosio, David PHD*; Heckman, Timothy G. PHD; Anderson, Timothy PHD*; Heckman, Bernadette D. PHD*; Garske, John PHD*; McCarthy, John PHD

Sexually Transmitted Diseases: March 2010 - Volume 37 - Issue 3 - p 140-146
doi: 10.1097/OLQ.0b013e3181c18975
Original Study

Background: Although several studies have characterized patterns and predictors of continued risky sexual behavior in HIV-infected rural persons, far less research has evaluated interventions to reduce risky sex in this group. This pilot randomized clinical trial compared 2 brief telephone-administered interventions designed to reduce continued risky sexual behaviors in HIV-infected rural persons.

Methods: Participants were 79 HIV-infected rural persons who reported 1 or more occasions of unprotected anal, vaginal, or oral sex in the past 2 months. Participants were recruited through AIDS service organizations in rural areas of 27 states and assigned randomly to either a 2-session, motivational interviewing plus skills-building intervention (i.e., integrated intervention; n = 48) or a 2-session, skills-building only comparison intervention (n = 31). Participants completed self-report measures of sexual behaviors and factors related to risky sex at preintervention and 2-month follow-up.

Results: Before enrolling into the intervention, 37% of participants had 2 or more sexual partners in the past 2 months, 29% had sex with 1 or more partners without knowing their partners' HIV serostatus, and almost one-third of participants located sex partners in high-risk environments (e.g., public parks, roadside rest areas). A 2 × 2 repeated measures multivariate analyses of variance found that integrated intervention participants reported greater increases in risk-reduction motivation and greater increases in condom-protected vaginal and oral intercourse occasions at follow-up compared to skills-building only participants.

Conclusions: Brief telephone-administered interventions that integrate motivational interviewing with skills-building show potential to reduce risky sexual behaviors in HIV-infected rural persons. Additional and large-scale evaluations of this intervention approach appear warranted.

A pilot randomized clinical trial involving 79 HIV-infected rural persons found that a 2-session telephone-administered intervention that combined motivational interviewing with skills-building techniques produced greater reductions in risky sexual behaviors than a skills-building only comparison intervention.

From the *Department of Psychology, †Department of Geriatric Medicine/Gerontology, College of Osteopathic Medicine, and ‡Department of Hearing, Speech, and Language Sciences, Ohio University, Athens, OH

Correspondence: Timothy G. Heckman, PhD, Department of Geriatric Medicine/Gerontology, 346 Grosvenor Hall, Ohio University College of Osteopathic Medicine, Athens, OH 45701. E-mail:

Received for publication December 22, 2008, and accepted September 2, 2009.

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