Behavioral intervention reduces risk of HIV spread

NEW YORK (Reuters Health) - People living with HIV infection who participate in a psychotherapy program can significantly reduce their risk of transmitting the virus, the results of the Healthy Living Project show.

The program consists of "cognitive-behavioral" therapy, a type of counseling that focuses on the key role that thinking plays in feelings and behaviors. Proponents of this therapy believe that unwanted feelings and behaviors can be changed by alteration of the thinking patterns that lead to them.

Dr. Stephen F. Morin of the University of California, San Francisco and colleagues assigned 936 individuals with HIV infection, and at risk of transmitting the virus, to the cognitive-behavioral therapy or to no intervention.

The program consisted of fifteen 90-minute sessions, covering three modules. One module consisted of stress, coping and adjustment behaviors; the second involved teaching safer behaviors; and the third was a program of healthy behaviors.

Follow-up assessments were conducted at 5, 10, 15, 20 and 25 months. The goal was to see if the behavior intervention reduced a person's HIV transmission risk, defined as "the number of unprotected sexual risk acts with persons of HIV-negative or unknown status," the team reports in the Journal of Acquired Immune Deficiency Syndromes.

HIV transmission risk was reduced by 36 percent in the intervention group compared with the no-intervention group, at the 20-month assessment.

"Unfortunately, the treatment effect in terms of a reduction of HIV transmission risk acts was not maintained at 25 months," the investigators report.

Morin and colleagues point out that "even small behavior changes among infected individuals can have a significant effect on the epidemic." This suggests that the behavioral intervention used in this study "can be effective in reducing the number of new HIV events."

SOURCE: Journal of Acquired Immune Deficiency Syndromes, February 1, 2007.