Catherine Grodensky1, Carol Golin2, Megha A Parikh3, Rebecca Ochtera4, Carlye Kincaid5, Jennifer Groves6, Laura Widman7, Chirayath Suchindran8, Camille McGirt9, Kemi Amola10, Steven Bradley-Bull11. 1. Department of Medicine, UNC School of Medicine, University of North Carolina, CB# 7030 130 Mason Farm Rd. Chapel Hill, NC 27599-7030, USA. Electronic address: grodensk@med.unc.edu. 2. Department of Medicine, UNC School of Medicine, University of North Carolina, CB# 7030 130 Mason Farm Rd. Chapel Hill, NC 27599-7030, USA; UNC Cecil G. Sheps Center for Health Services Research, University of North Carolina, CB# 7590 725 Martin Luther King Jr. Blvd. Chapel Hill, NC 27599-7590, USA; Department of Health Behavior, UNC School of Public Health, University of North Carolina, 135 Dauer Dr, Chapel Hill, NC 27516, USA. Electronic address: carol_golin@med.unc.edu. 3. Johns Hopkins University, Bloomberg School of Global Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA. Electronic address: mparikh3@jhu.edu. 4. Spark Policy Institute, 2717 Welton St., Denver, CO 80205, USA, USA. Electronic address: Rebecca@sparkpolicy.com. 5. Silber Psychological Services, 1340 SE Maynard Rd, Suite 201, Cary, NC 27511, USA. Electronic address: carlyekincaid@gmail.com. 6. UNC Cecil G. Sheps Center for Health Services Research, University of North Carolina, CB# 7590 725 Martin Luther King Jr. Blvd. Chapel Hill, NC 27599-7590, USA. Electronic address: groves@schsr.unc.edu. 7. Department of Psychology, University of North Carolina, 235 E Cameron Ave, Chapel Hill, NC 27514, USA; NC State Department of Psychology, 640 Poe Hall, Campus Box 7650, Raleigh, NC 27695-7650, USA. Electronic address: lmwidman@ncsu.edu. 8. Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, UNC 135 Dauer Dr, Chapel Hill, NC 27516, USA. Electronic address: suchi@bios.unc.edu. 9. Department of Health Behavior, UNC School of Public Health, University of North Carolina, 135 Dauer Dr, Chapel Hill, NC 27516, USA. Electronic address: cmcgirt@live.unc.edu. 10. Department of Medicine, UNC School of Medicine, University of North Carolina, CB# 7030 130 Mason Farm Rd. Chapel Hill, NC 27599-7030, USA; Voice Therapeutic Solutions, 3712 Benson Dr, Raleigh, NC 27609, USA. Electronic address: kemi_amola@med.unc.edu. 11. Department of Medicine, UNC School of Medicine, University of North Carolina, CB# 7030 130 Mason Farm Rd. Chapel Hill, NC 27599-7030, USA. Electronic address: steve_bradley-bull@med.unc.edu.
Abstract
OBJECTIVE: Although past research has demonstrated a link between the quality of motivational interviewing (MI) counseling and client behavior change, this relationship has not been examined in the context of sexual risk behavior among people living with HIV/AIDS. We studied MI quality and unprotected anal/vaginal intercourse (UAVI) in the context of SafeTalk, an evidence-based secondary HIV prevention intervention. METHODS: We used a structured instrument (the MISC 2.0 coding system) as well as a client-reported instrument to rate intervention sessions on aspects of MI quality. Then we correlated client-reported UAVI with specific counseling behaviors and the proportion of interactions that achieved MI quality benchmarks. RESULTS/ CONCLUSION: Higher MISC-2.0 global ratings and a higher ratio of reflections to questions both significantly predicted fewer UAVI acts at 8-month follow-up. Analysis of client ratings, which was more exploratory, showed that clients who rated their sessions higher in counselor acceptance, client disclosure, and relevance reported higher numbers of UAVIs, whereas clients who selected higher ratings for perceived benefit were more likely to have fewer UAVI episodes. PRACTICE IMPLICATIONS: Further research is needed to determine the best methods of translating information about MI quality into dissemination of effective MI interventions with people living with HIV.
OBJECTIVE: Although past research has demonstrated a link between the quality of motivational interviewing (MI) counseling and client behavior change, this relationship has not been examined in the context of sexual risk behavior among people living with HIV/AIDS. We studied MI quality and unprotected anal/vaginal intercourse (UAVI) in the context of SafeTalk, an evidence-based secondary HIV prevention intervention. METHODS: We used a structured instrument (the MISC 2.0 coding system) as well as a client-reported instrument to rate intervention sessions on aspects of MI quality. Then we correlated client-reported UAVI with specific counseling behaviors and the proportion of interactions that achieved MI quality benchmarks. RESULTS/ CONCLUSION: Higher MISC-2.0 global ratings and a higher ratio of reflections to questions both significantly predicted fewer UAVI acts at 8-month follow-up. Analysis of client ratings, which was more exploratory, showed that clients who rated their sessions higher in counselor acceptance, client disclosure, and relevance reported higher numbers of UAVIs, whereas clients who selected higher ratings for perceived benefit were more likely to have fewer UAVI episodes. PRACTICE IMPLICATIONS: Further research is needed to determine the best methods of translating information about MI quality into dissemination of effective MI interventions with people living with HIV.
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