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The Treatment Advocacy Program: A randomized controlled trial of a peer-led safer sex intervention for HIV-infected Men who have Sex with Men

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Title: The Treatment Advocacy Program: A randomized controlled trial of a peer-led safer sex intervention for HIV-infected Men who have Sex with Men
Author(s): McKirnan, David; Tolou-Shams, Marina; Courtenay-Quirk, Cari
Subject(s): HIV prevention HIV-infected men
Abstract: Objectives: Primary care may be an effective venue for delivering behavioral interventions for sexual safety among HIV-positive men who have sex with men (MSM); however, few studies show efficacy for such an approach. We tested the efficacy of the Treatment Advocacy Program (TAP), a four-session, primary care-based, individual counseling intervention led by HIV-positive, MSM “peer advocates” in reducing unprotected sex with HIV-negative or unknown partners (HIV transmission risk). Methods: We randomized 313 HIV-positive MSM to TAP or standard care. HIV transmission risk was assessed at baseline, 6, and 12 months (n=251 completed all study waves). We conducted intent to treat analyses using general estimating equations to test the interaction of group (TAP versus standard care) by follow-up period. Results: At study completion, TAP participants reported greater transmission risk reduction than did those receiving standard care (X2 [2, 249]= 6.6, p=.04). Transmission risk among TAP participants decreased from 34% at baseline to about 20% at both 6- and 12-months: transmission risk ranged from 23% to 25% among comparison participants. Conclusions: TAP reduced transmission risk among HIV-positive MSM, although results were modest. Many participants and peer advocates commented favorably on the computer structure of the program. We feel that the key elements of TAP – computer-based and individually tailored session content, delivered by peers, in the primary care setting – warrant further exploration.
Issue Date: 2010-12
Publisher: American Psychological Association
Citation Info: McKirnan, D. J., Tolou-Shams, M., & Courtenay-Quirk, C. 2010. The Treatment Advocacy Program: A Randomized Controlled Trial of a Peer-Led Safer Sex Intervention for HIV-Infected Men Who Have Sex With Men. Journal of Consulting and Clinical Psychology, 78(6): 952-963. DOI: 10.1037/a0020759
Type: Article
Description: Post print version of article may differ from published version. The definitive version is available through American Psychological Association at DOI: 10.1037/a0020759
ISSN: 0022-006X
Sponsor: This research was funded by CDC PA# 01190.
Date Available in INDIGO: 2011-05-07

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