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A Randomized-Controlled Trial of Computer-based Prevention Counseling for HIV-Positive Persons (HPTN 065).

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The CARE+ computer-based intervention did not reduce sexual risk behaviors in HIV-positive individuals. Most participants were on antiretroviral therapy, and further research is needed on computer-based counseling for HIV prevention.

Keywords:
Computer-delivered counselingHIV preventionPrevention for positivesTechnology-based intervention

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Behavioral Science

Background:

  • Reducing HIV transmission from HIV-positive individuals is a key public health goal.
  • Computer-based interventions are being explored to support sexual risk reduction counseling.

Purpose of the Study:

  • To evaluate the effectiveness of a computer-based sexual risk reduction counseling intervention (CARE+) among HIV-positive individuals receiving care.
  • To determine if CARE+ reduces unprotected sex among HIV-positive patients.

Main Methods:

  • 1075 HIV-positive participants were randomized to either the CARE+ intervention or standard of care (SOC).
  • The primary outcome measured was unprotected vaginal/anal sex with any partner, or partners of HIV-negative or unknown status.
  • Participants were enrolled from 11 care sites in New York and Washington D.C.

Main Results:

  • No significant difference in unprotected sex was observed between the CARE+ and SOC groups at 12 months.
  • At baseline, 7% reported unprotected sex with HIV-negative/unknown partners, and 13-17% with any partner.
  • Most participants (88%) were on antiretroviral therapy (ART) at baseline.

Conclusions:

  • The CARE+ intervention was not effective in reducing sexual risk behaviors among HIV-positive patients on ART.
  • Further research is suggested to explore the potential of computer-based counseling for HIV prevention.
  • Most participants found computer counseling a valuable addition to in-person care.