A Behavioral Intervention Reduces HIV Transmission by Promoting Sustained Serosorting Practices Among HIV-Infected MSM

The authors sought to examine factors that explain the effect of a cognitive-behavioral intervention, the Healthy Living Project, on reduction in HIV transmission risk among HIV-positive men who have sex with men (MSM).

A total of 1,910 HIV-infected MSM were screened. Of these, 616 participants considered to be at risk of transmitting the virus were randomized to a 15-session, individually delivered cognitive-behavioral intervention (n=301) or a wait-list control (n=315).

An overall reduction in transmission risk acts was observed among MSM in both the intervention and control arms, as is consistent with previous intent-to-treat findings. Significant intervention effects were seen at five-, 10-, 15- and 20-month assessments (risk ratios=0.78, 0.62, 0.48 and 0.38, respectively). These intervention-related decreases in HIV transmission risk acts seemed in part due to sustained serosorting practices. MSM in the intervention condition reported a significantly greater proportion of sexual partners who were HIV-infected at the five- and 10-month assessments (risk ratios=1.14 and 1.18).

"The Healthy Living Project, a cognitive-behavioral intervention, is efficacious in reducing transmission risk acts among MSM. This seems to have been due in large part to the fact that MSM in the intervention condition reported sustained serosorting practices," the authors concluded.

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