Authors: L Brooks¹, C Metcalf², R Francis³, J Douglas¹, S Padilla⁴, B Dillon², H Cross⁵

¹Denver Department of Public Health; ²Centers for Disease Control & Prevention; ³NOVA Research Company; ⁴California State University, Long Beach; ⁵New Jersey Department of Health & Senior Services

Background: HIV prevention counseling reduces risk of acquiring STDs. It is difficult to determine which behavioral changes are most influenced by prevention counseling, and which would occur after an STD examination without prevention counseling.

Objective: To determine the effect of HIV prevention counseling on STD clinic clients’ intended risk-reduction behavior.

Methods: Patients attending 3 STD clinics for an STD examination were enrolled in a randomized trial comparing 2 HIV testing and counseling interventions (rapid and standard HIV testing). Participants were offered 2 counseling sessions either in one clinic visit, or in 2 visits about one week apart. Counseling focused on risk behavior and developing a risk-reduction plan. Participants completed self-administered questionnaires before and after counseling. This included a set of questions on intention to use specific behaviors to reduce risk of STDs.

Results: Prior to counseling, most of the 2,108 respondents were already practicing, or wanted to start practicing, most risk-reduction behaviors applicable to their situation. Comparing responses before and after counseling, the goals most impacted by counseling include: have fewer partners (67% vs. 73%); talk to partners about risk (86% vs. 91%); break-up with a risky partner (62% vs. 67%); and get to know potential partners better before having sex (59% vs. 63%). Of the suggested risk-reduction goals, the least favored initial goal was sexual abstinence (29%). Following counseling a total of 32% chose abstinence as a risk-reduction goal. All these changes were statistically significant (p<0.01).

Conclusions: Prevention counseling influenced risk-reduction goals in multiple ways, and had a beneficial effect on intention to practice less risky behavior.

Implications for Programs/Policy: Prevention counseling is useful in helping clients to consider additional ways of reducing risky sexual behavior.

Implications for Research: Further research is needed to determine how to sustain the benefits of prevention counseling, by ensuring that intentions are carried-out.

Learning Objectives: Participants will be able to describe types of changes in risk-reduction goals that may occur following HIV prevention counseling, as well as the likely magnitude of increases in intention to adopt different types of risk-reduction behavior.

Contact information: Lesley Brooks / Phone no. 303-436-4103 / lbrooks@dhha.org