180673 HIV Prevention among People Living with HIV: The Effect of Motivational Interviewing on on Safer Sex Self-efficacy

Monday, October 27, 2008

Zulfiya Chariyeva, MPH , School of Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC
Carol E. Golin, MD, MPH , Cecil G. Sheps Center for Health Services and Research, Chapel Hill, NC
Catherine A. Grodensky, MPH , Cecil G. Sheps Center for Health Services and Research, Chapel Hill, NC
Jo Anne Earp, ScD , Health Behavior and Health Education, University of North Carolina at Chapel Hill School of Public Health, Chapel Hill, NC
D. Leann Long, MS , Dept. of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
Jennifer S. Groves, MBA , Cecil G. Sheps Center for Health Services and Research, Chapel Hill, NC
Chirayath M. Suchindran, PhD , Dept. of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
Shilpa N. Patel, MPH , Department of Behavioral Sciences and Health Education, Emory University, Rollins School of Public Health, Atlanta, GA
Kathy Ramsey, BA, RHIA , UNC Chapel Hill School of Medicine, Chapel Hill, NC
Background: At least one-third of people living with HIV/AIDS (PLWH) continue to engage in risky sexual practices. Motivational interviewing (MI), a client-centered counseling style shown to promote other healthy behaviors, is one approach to HIV prevention for this group. However, we know little about the effect of length and number of MI sessions on changes in safer sex self-efficacy or on reduction in number of unprotected sex acts.

Methods: Using a 16 item, 10-point self-efficacy scale (Cronbach alpha 0.91) from Audio Computer-Assisted Self Interviews (ACASI) for SafeTalk, a randomized controlled trial of a MI-based “prevention with positives” intervention for young, sexually active PLWHs, we surveyed 77 participants at baseline, 4 and 8 months. Using hierarchical linear modeling, we analyzed the relationship between changes in self-efficacy and (1) the number of MI sessions and amount of counseling time; and (2) the number of unprotected sex acts of our sample for the last three months. The sample's mean age was 43.5 years, 79% were African American, and 36% women.

Results: Controlling for demographic variables, a ten minute increase in counseling time was associated with a 7.03 points increase in self-efficacy (p<0.019). Every additional counseling session was associated with a 3.01 point increase in self-efficacy (p<0.015). A one unit increase on the self-efficacy scale (mean=135.4) was associated with a 0.07 units decrease in number of unprotected sex acts (p<.03).

Conclusions: The amount of motivational interviewing counseling time provided seems to be an important factor for enhancing self-efficacy to practice safer sex among PLWH.

Learning Objectives:
Describe the effect of amount of MI counseling time and number of MI counseling sessions on changes in self-efficacy of people living with HIV/AIDS (PLWH) Understand the relationship between safer sex self-efficacy and unprotected sex among PLWH Recognize the potential of MI-based interventions in HIV prevention efforts Familiarize the audience with the SafeTalk HIV-prevention program

Keywords: Self-Efficacy, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I've conducted the analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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