Reducing HIV Risk from Compulsive Sexual Behavior Using Cognitive Behavioral Therapy Within a Harm Reduction Framework: A Case Example

Abstract

While medical advances in the treatment of AIDS have recently reduced morbidity and mortality to some degree, HIV infections continue to increase at an alarming rate with disproportionate rises in the rates of HIV in people of color, and more recently, among youth at risk (Centers for Disease Control and Prevention, 2000). Compulsive sexual behavior, popularly termed sexual addiction, may increase an individual's risk for HIV infection, yet this topic has received little attention in the empirical HIV prevention literature. The concept of sexual addiction has been hindered by conceptual difficulties and limited empirical data about its nature; hence, there is limited quantifiable information regarding effective treatments for this problem. Harm reduction theory is a topic receiving increasing attention in the fields of addiction treatment and HIV prevention. Harm reduction theory provides a framework for managing high-risk behaviors and has been widely applied to HIV prevention as well as problems of substance abuse and dependence. This theory may hold promise in the treatment of individuals who are at risk for HIV because of compulsive sexual behavior or addiction. A case study describes the treatment of a woman with compulsive sexual behavior that placed her at risk for HIV infection. The intervention employed cognitive behavioral therapy within the framework of a harm reduction approach.