Receipt of HIV/STD prevention counseling by HIV-infected adults receiving medical care in the United States.

OBJECTIVE: Guidelines recommend risk-reduction counseling by HIV providers to all HIV-infected persons. Among HIV-infected adults receiving medical care in the United States, we estimated prevalence of exposure to three types of HIV/sexually transmitted disease (STD) risk-reduction interventions and described the characteristics of persons who received these interventions.
DESIGN: Data were from the Medical Monitoring Project (MMP), a supplemental HIV surveillance system designed to produce nationally representative estimates of behavioral and clinical characteristics of HIV-infected adults receiving medical care in the United States.
METHODS: Descriptive analyses were conducted to estimate the exposure to each type of HIV/STD risk-reduction intervention. Bivariate and multivariable analyses were conducted to assess associations between the selected correlates with each exposure variable.
RESULTS: About 44% of participants reported a one-on-one conversation with a healthcare provider about HIV/STD prevention, 30% with a prevention program worker, 16% reported participation in a small group risk-reduction intervention, and 52% reported receiving at least one of the three interventions in the past 12 months. Minority race/ethnicity, low income, and risky sexual behavior consistently predicted greater intervention exposure. However, 39% of persons who reported risky sex did not receive any HIV/STD risk-reduction interventions.
CONCLUSIONS: HIV-infected persons in care with fewer resources or those who engaged in risk behaviors were more likely to receive HIV/STD risk-reduction interventions. However, less than half of HIV-infected persons in care received HIV/STD prevention counseling from their provider, an intervention that has been shown to be effective and is supported by guidelines.