Routine brief risk-reduction counseling with biannual STD testing reduces STD incidence among HIV-infected men who have sex with men in care.
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BACKGROUND: We evaluated whether routine biannual sexually transmitted disease (STD) testing coupled with brief risk-reduction counseling reduces STD incidence and high-risk behaviors. METHODS: The SUN study is a prospective observational HIV cohort study conducted in 4 US cities. At enrollment and every 6 months thereafter, participants completed a behavioral survey and were screened for STDs, and if diagnosed, were treated. Medical providers conducted brief risk-reduction counseling with all patients. Among men who have sex with men (MSM), we examined trends in STD incidence and rates of self-reported risk behaviors before and after exposure to the risk-reduction intervention. The "preintervention" visit was the study visit that was at least 6 months after enrollment STD screening and treatment and at which the participant was first exposed to the intervention. The "postintervention" visit was 12 months later. RESULTS: Among 216 MSM with complete STD and behavioral data, median age was 44.5 years; 77% were non-Hispanic white; 83% were on highly active antiretroviral treatment; 84% had an HIV RNA level <400 copies/mL and the median CD4 (cluster of differentiation 4) count was 511 cells/mm. Twelve months after first exposure to the risk-reduction intervention, STD incidence declined from 8.8% to 4.2% (P = 0.041). Rates of unprotected receptive or insertive anal intercourse with HIV-positive partners increased (19% to 25%, P = 0.024), but did not change with HIV-negative partners or partners of unknown HIV status (24% to 22%, P = 0.590). CONCLUSIONS: STD incidence declined significantly among HIV-infected MSM after implementing frequent, routine STD testing coupled with risk-reduction counseling. These findings support adoption of routine STD screening and risk-reduction counseling for HIV-infected MSM.
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Brief risk-reduction counseling delivered by medical providers during HIV primary care visits, coupled with routine STI screening, has been reported to reduce STI incidence among persons with HIV infection.
“Brief risk-reduction counseling delivered by medical providers during HIV primary care visits, coupled with routine STI screening, has been reported to reduce STI incidence among persons with HIV infection (8).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [8]
A review of 11 studies reported that brief prevention messages delivered by providers and health counselors are feasible and decrease subsequent STIs in STD clinic and HIV care settings.
“A review of 11 studies evaluated brief prevention messages delivered by providers and health counselors and reported them to be feasible and to decrease subsequent STIs in STD clinic settings (7) and HIV care settings (8).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [8]
Certain STIs can be asymptomatic; their diagnosis might prompt referral for partner services, might identify sexual and needle-sharing partners who can benefit from early diagnosis and treatment of HIV, and might prompt reengagement in care or HIV prevention services.
“Certain STIs can be asymptomatic; their diagnosis might prompt referral for partner services, might identify sexual and needle-sharing partners who can benefit from early diagnosis and treatment of HIV, and might prompt reengagement in care or HIV prevention services (e.g., PEP or PrEP) (8).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [8]
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Sexually Transmitted Infections Treatment Guidelines, 2021
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- Authors
- Patel, P., Bush, T., Mayer, K., Milam, J., Richardson, J., Hammer, J., Henry, K., Overton, T., Conley, L., Marks, G., & Brooks, J. T.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Brown University (US)
- University of Southern California (US)
- Infectious Disease Consultants (US)
- Hennepin County Medical Center (US)
- Washington University in St. Louis (US)
- Corresponding author
- Patel, Pragna
- Overton, Turner
- Conley, Lois
- Marks, Gary
- Brooks, John T.
- Venue
- Sexually Transmitted Diseases
- Published
- 2012-06
- Volume
- 39
- Issue
- 6
- Pages
- 470-474
- ISSN
- 0148-5717 (ISSN-L)
- PMC
- PMC6195212
- OpenAlex
- W2314281840
- Cited by
- 25
- References
- 16
- Citations by year
- 2026: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 4 · 2018: 3 · 2017: 2 · 2016: 3 · 2015: 1 · 2014: 3 · 2013: 2
- FWCI
- 1.33
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Sexually Transmitted Diseases (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- U.S. Public Health Service (200-2007-23635, 200-2002-00612, 200-2002-00613, 200-2007-23634, 200-2007-23636, 200-2007-23633, 200-2002-00610, 200-2002-00611)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- HIV-infected men who have sex with men, risk reduction counseling, STD incidence, unprotected anal intercourse, HIV care
- MeSH terms
- Adult, Counseling, HIV Seropositivity, Humans, Health Knowledge, Attitudes, Practice, Male, Mass Screening, Middle Aged, Prospective Studies, Risk-Taking, Sexual Behavior, Sexual Partners, Sexually Transmitted Diseases, Cohort Studies, Incidence, Homosexuality, Male
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