Sustained Sexual Behavior Change After Acute HIV Diagnosis in Malawi

Sex Transm Dis. 2018 Nov;45(11):741-746. doi: 10.1097/OLQ.0000000000000873.


Background: Identification of acute HIV infection (AHI) allows for important opportunities for HIV prevention through behavior change and biomedical intervention. Here, we evaluate changes in sexual risk behaviors among persons with AHI enrolled in a combined behavioral and biomedical intervention designed to reduce onward transmission of HIV.

Methods: Participants were randomized to standard HIV counseling, a multisession behavioral intervention, or a multisession behavioral intervention plus antiretrovirals. Sexual behaviors were assessed periodically over 1 year.

Results: Four weeks after diagnosis, the predicted probability of reporting multiple sexual partners decreased from 24% to 9%, and the probability of reporting unprotected sex decreased from 71% to 27%. These declines in sexual risk behaviors were sustained over follow-up irrespective of study arm.

Conclusions: Diagnosis of AHI alone may be sufficient to achieve immediate and sustained behavior change during this highly infectious period.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Acute Disease
  • Adult
  • Behavior Therapy
  • Counseling*
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / prevention & control*
  • Humans
  • Malawi / epidemiology
  • Male
  • Mass Screening
  • Risk Reduction Behavior
  • Risk-Taking*
  • Safe Sex / statistics & numerical data
  • Sexual Behavior / psychology*
  • Sexual Behavior / statistics & numerical data*
  • Sexual Partners / psychology
  • Unsafe Sex / psychology
  • Unsafe Sex / statistics & numerical data
  • Young Adult