Self-assessment may lower HIV patients' risk-taking

By Amy Norton

NEW YORK (Reuters Health) - Self-assessments may offer the push some HIV patients need to make lifestyle changes for the better, a new study suggests.

A vital part of HIV care is encouraging HIV-positive people to stop behaviors that raise the risk of transmitting the virus, such as unprotected sex and drug use. Typically, this means relatively time-intensive and expensive counseling.

However, the new study found that simply asking patients some questions as they wait for a routine doctor appointment may be effective.

Among the 365 HIV patients studied, those who completed more of these self-assessments over time were more likely to increase their condom use, according to findings published in the journal AIDS Care.

The strategy is considered self-assessment because the patients answered questions about their sexual behavior and attitudes anonymously via computer. Researchers believe that this acts as something of an eye-opener.

To answer the questions, people have to reflect on their behavior, and perhaps see it in a new, "objective" way, explained lead study author Dr. Marguerita Lightfoot, a research psychologist at the University of California Los Angeles.

"I think that's a big reason that this intervention is powerful," she told Reuters Health.

Another likely reason, Lightfoot added, is the use of computers frees people from the worry of being judged. "People are much more truthful and let down their guard when talking to a computer," she said.

The findings are based on groups of HIV-positive patients seen at various community health clinics and HMOs. Before their medical appointments, the patients were taken to a private room to answer questions on a laptop computer.

Overall, patients who completed four or more self-assessments had the biggest increases in abstinence, from 47 percent to 61 percent.

They also had the greatest improvement in condom use. At the start of the study, 73 percent said they used a condom when their partner was HIV-negative or when they didn't know the partner's HIV status; that increased to 85 percent.

Since this is the first study of such an intervention, Lightfoot said, more research is still needed.

But she added that, "practically speaking," self-assessments require only some laptop computers and would be relatively inexpensive and simple for clinics to implement.

SOURCE: AIDS Care, July 2007.