Effects of a short individually tailored counselling session for HIV prevention in gay and bisexual men receiving Hepatitis B vaccination

John Bf De Wit,Harm J Hospers,Onno De Zwart,Jan H Richardus,Mireille Eg Wolfers

doi:10.1186/1471-2458-9-255

Abstract

BackgroundThere is currently a trend towards unsafe unprotected anal intercourse (UAI) among men who have sex with men. We evaluated a short individual counselling session on reducing UAI among gay and bisexual men.MethodsA quasi-experimental design was used to evaluate the counselling session. This session was conducted during consulting hours at four municipal health clinics during a Hepatitis B vaccination campaign. These clinics offered free vaccination to high-risk groups, such as gay and bisexual men.All gay and bisexual men attending health clinics in four cities in the Netherlands were asked to participate. Each participant in the intervention group received a fifteen-minute individual counselling based on the Theory of Planned Behaviour and Motivational Interviewing. Changes in UAI were measured over a 5-months period, using self-administered questionnaires. UAI was measured separately for receptive and insertive intercourse in steady and casual partners. These measures were combined in an index-score (range 0–8).ResultsWhile UAI in the counselling group remained stable, it increased in the controls by 66% from 0.41 to 0.68. The results show that the intervention had a protective effect on sexual behaviour with steady partners. Intervention effects were strongest within steady relationships, especially for men whose steady-relationship status changed during the study. The intervention was well accepted among the target group.ConclusionThe fifteen-minute individually tailored counselling session was not only well accepted but also had a protective effect on risk behaviour after a follow-up of six months.

Highlights

There is currently a trend towards unsafe unprotected anal intercourse (UAI) among men who have sex with men
Life expectancy of people living with HIV in high income countries has improved dramatically since the introduction of effective antiretroviral therapy (ART), and research among men who have sex with men (MSM) in the Netherlands has shown that a decreased perception of HIV/AIDS threat prospectively predicts an increase in UAI, but is related to STI incidence [18,19]
Participants During the inclusion period, 428 MSM were eligible for enrolment at the experimental site; 363 MSM were eligible at the control sites

Summary

Introduction

There is currently a trend towards unsafe unprotected anal intercourse (UAI) among men who have sex with men. In the Netherlands, as in many industrialized counties, men who have sex with men (MSM) are at highest risk for HIV infection. Among MSM, unprotected anal intercourse (UAI) is the major route of HIV transmission and the use of condoms is related to the relational status men have with their sexual partner. Studies have shown that UAI among MSM is more likely with steady partners than with casual partners, while new HIV infections are more likely to occur within steady relationships than in casual contacts [1113]. Life expectancy of people living with HIV in high income countries has improved dramatically since the introduction of effective antiretroviral therapy (ART), and research among MSM in the Netherlands has shown that a decreased perception of HIV/AIDS threat prospectively predicts an increase in UAI, but is related to STI incidence [18,19]

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