PEPSE for SURE.sav

Background

In western countries, men who
have sex with men (MSM) are most affected by HIV and increasingly likely to
engage in risky sexual behaviour. MSM who experience a potential sexual
exposure to HIV (PEPSE) and receive a preventative regimen of anti-HIV
treatment are at particularly high risk of acquiring HIV and could potentially
benefit from targeted risk reduction behavioural interventions such as
motivational interviewing (MI).

Purpose

The aim of this trial was to examine
the impact of augmented MI (MI plus information provision and behavioural
skills building), over and above routine care, on reducing risky sexual
behaviour in MSM prescribed PEPSE. Secondary aims of the research were to examine whether the intervention
reduced sexually transmitted infections (STI) and further requests for PEP.

Methods

A parallel-group pragmatic randomised controlled trial was conducted
with 175 MSM recruited from five sexual health (SH) clinics in the south east
of England. The intervention was two fixed-duration sessions of telephone administered
augmented MI. A manual guided the selection of individualised persuasive
communication strategies based on underlying change mechanisms specified by the
Information, Motivation and Behavioural Skills (IMB) model. Primary outcomes
were the number of receptive and
active anal intercourse (AI) partners, the use of condoms every time during
receptive and active AI and the use of condoms sometimes during receptive and
active AI.

Results

There were no significant impacts
on sexual risk behaviour or any of the psychological measures, and no discernible
reduction in requests for repeat PEP or rates of STIs within a year.

Conclusion

Our behavioural
intervention of augmented MI did not affect risky sexual behaviour, rates of
further PEP and STIs, and psychological factors, in MSM prescribed PEPSE.