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APHA Scientific Session and Event Listing

Shilpa N. Patel, MPH¹, Carol E. Golin, MD, MPH², Tsui-Shan Lu, MS³, Hsiao Tien, PhD³, Zulfia Chariyeva, MPH⁴, Melanie Thompson, MD⁵, Mark Thrun, MD⁶, Tracey Wilson, PhD⁷, April Timmons, BS⁷, Andrew Yale⁶, Jacquel Clemons, MPH⁵, Evelyn Byrd Quinlivan, MD¹, and Julie Wright, PharmD⁸. (1) School of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Road, CB 7030, Chapel Hill, NC 27599, 919.843.1832, shilpa_patel@med.unc.edu, (2) Cecil G. Sheps Center for Health Services and Research, 725 Airport Road CB7590, Chapel Hill, NC 27599, (3) Biostatistics, University of North Carolina, Chapel Hill, McGavran-Greenberg Hall CB# 7420, Chapel Hill, NC 27599, (4) School of Public Health, University of North Carolina, Chapel Hill, Rosenau Hall CB 7400, Chapel Hill, NC 27599, (5) AIDS Research Consortium of Atlanta, 131 Ponce de Leon Avenue, Suite 130, Atlanta, GA 30308, (6) Denver Health and Hospital Authority, 605 Bannock Street, MC2600; Rm 274, Denver, CO 80204, (7) Preventive Medicine and Community Health, SUNY Downstate Medical Center, Box 1240, 450 Clarkson Avenue, Brooklyn, NY, NY 11203, (8) Truman Medical Center, University of Missouri at Kansas City, 2411 Holmes Street, Kansas City, MO 64108

Background: Despite advances in the treatment of HIV infection, the US sees 40,000 new cases of HIV annually. National guidelines recommend that HIV care practitioners routinely provide secondary prevention in clinical settings.

Methods: We developed, implemented and evaluated a medical provider-delivered secondary prevention program at 7 HIV clinics. Using a 12 item, 7-point self-efficacy scale, we surveyed patients at baseline and 6 months after program implementation regarding their level of confidence to: 1) talk to sexual partners about safer sex; 2) convince sexual partners to use a condom; 3) tell sex partners they have HIV; and 4) refuse to share needles with partners. We stratified analyses by gender, sexual partner type, age group, and ethnicity. A positive percent change in score means a higher score at 6 months.

Results: Of the 1050 HIV positive patients surveyed, mean age was 41 years, 61% were African- American, 31% women, 67% men (45% MSM, and 22% MSW). Overall change in the self-efficacy score from baseline was significant for the following: 1) safer sex: 9%; p<.00001; 2) partner condom use: 9%; p<.0001; 3) disclosing HIV status: 12%; p<.0001; and 4) not sharing needles: 16%; p<.0001. Self-efficacy to disclose increased 18% for women (p<.0006) and 15% for African Americans (p<.0001).

Conclusions: Increases were noted between baseline and 6 months for all four self-efficacy items. Although we cannot stratify yet by dose of provider intervention received, 12 month follow-up and dose collection are underway and may strengthen our conclusions.

Learning Objectives:

• Describe trends in self-efficacy among people living with HIV before and after implementation of a national prevention with positives initiative.
• Recognize the differences in the self-efficacy to engage in preventive behaviors across various subpopulations.
• Understand the successes and limitations to such a prevention with positives evaluation based on our results.

Presenting author's disclosure statement:

Any relevant financial relationships? No