Corneli Amy, Pettifor Audrey, Kamanga Gift, Golin Carol, McKenna Kevin, Ou San-San, Hamela Gloria, Massa Cecelia, Martinson Francis, Tharaldson Jenae, Hilgenberg Deborah, Yu Xuesong, Chege Wairimu, Hoffman Irving
Social and Behavioral Health Sciences, FHI 360, 359 Blackwell St, Suite 200, Durham, NC, 27701, USA,
AIDS Behav. 2014 Sep;18(9):1785-800. doi: 10.1007/s10461-014-0707-1.
Acute HIV infection (AHI) is a relatively brief period of time when individuals are highly infectious and the opportunity to intervene to prevent forward transmission is extremely limited. HPTN 062 partnered with CHAVI 001 to evaluate the feasibility and acceptability of a motivational interviewing (MI)-based counseling intervention to reduce HIV-transmission risk behaviors among individuals with acute and early HIV infection in Lilongwe, Malawi. Participants were randomized to receive either (1) brief education sessions about HIV and AHI; or (2) the same brief education sessions plus an MI-based counseling intervention called Uphungu Wanga. Although Uphungu Wanga was determined to be feasible and acceptable, few major differences existed between the two arms with regard to acceptability, feasibility, and self-reported sexual behaviors. We therefore conclude that an additional MI-based counseling intervention may not be needed during the short period of AHI. Instead, we recommend that individuals with AHI receive frequent, but brief, counseling immediately after diagnosis and then transition to receiving counseling at less frequent intervals until they can initiate antiretroviral therapy. Other recommendations are provided.
急性HIV感染(AHI)是一段相对短暂的时期,在此期间个体具有高度传染性,而预防病毒进一步传播的干预机会极为有限。HPTN 062与CHAVI 001合作,评估基于动机性访谈(MI)的咨询干预措施在马拉维利隆圭减少急性和早期HIV感染者中HIV传播风险行为的可行性和可接受性。参与者被随机分为两组,一组接受(1)关于HIV和AHI的简短教育课程;另一组接受(2)相同的简短教育课程,外加一种名为Uphungu Wanga的基于MI的咨询干预。尽管Uphungu Wanga被认定为可行且可接受,但在可接受性、可行性和自我报告的性行为方面,两组之间几乎没有重大差异。因此,我们得出结论,在急性HIV感染的短时期内可能不需要额外的基于MI的咨询干预。相反,我们建议急性HIV感染者在确诊后立即接受频繁但简短的咨询,然后过渡到接受间隔时间更长的咨询,直到他们能够开始抗逆转录病毒治疗。还提供了其他建议。