UCLA AIDS Institute scientists have found that HIV-positive teens and young adults demonstrated significantly higher rates of condom use � especially with uninfected partners � following one-on-one behavioral interventions. Reported in the October issue of the Journal of Acquired Immune Deficiency Syndromes, the UCLA findings suggest a new model for preventing the spread of HIV among youth.
“Our findings built upon the successful results of a small-group HIV intervention that was double the length of this one-on-one program,� said Mary Jane Rotheram-Borus, a professor at the UCLA Neuropsychiatric Institute and an associate director of the UCLA AIDS Institute. “We wanted to know if we could still help HIV-positive young people make positive behavioral changes if we shortened and changed the program format.�
The UCLA team offered 175 HIV-positive young people in Los Angeles, San Francisco and New York City a choice of receiving the intervention in person or by telephone. Participants included teens, young men and women, methamphetamine users, and intravenous drug users. Ages ranged from 16 to 29, with an average age of 23. Only persons who had used drugs at least five times in the past three months were eligible for enrollment.
Each intervention addressed preventing HIV transmission and improving health outcomes. The program focused on helping young people to set goals, become and remain motivated to change, and plan and role-play how to cope with high-risk situations in the future.
“Our findings showed that we can deliver HIV-prevention programs in alternative formats while preserving their effectiveness,� Rotheram-Borus said.
Results of the program delivered one-on-one compared well to the longer program delivered in small groups. Teens and young adults attending the individual intervention had a significantly higher rate of protected sex than their counterparts in a control group.
“We were surprised to discover that methamphetamine and IV-drug users were just as likely to have protected sex,� Rotheram-Borus said. “We concluded that pre-screening HIV?infected individuals is key to selecting those most responsive to intervention.�
The researchers also demonstrated that repeated assessments of infected individuals can provide a cost-effective step toward reducing high-risk sex and the spread of HIV infection.
“Providing regular medical care and case management services to young people with HIV offers important opportunities for delivering interventions in accessible settings,� Rotheram-Borus said. “We need to figure out ways to make these interventions even more effective.�
Young people represent nearly half of all HIV infections in the world. In the United States, about 110,000 young adults under 23 are infected, making up 18 percent of the nation’s total cases. Young adults who do not change their sexual behavior or drug use may infect others and become infected with new viral strains.
The National Institute on Drug Abuse supported the UCLA study, which was co-authored by Martha Lee, Marguerita Lightfoot, Dallas Swendeman, Robert E. Weiss and W. Scott Comulada.
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