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Sustained Sexual Behavior Change after Acute HIV Diagnosis in Malawi


Rucinski, Katherine B.; Rutstein, Sarah E.; Powers, Kimberly A.; Pasquale, Dana K.; Dennis, Ann M.; Phiri, Sam; Hosseinipour, Mina C.; Kamanga, Gift; Nsona, Dominic; & Massa, Cecilia, et al. (2018). Sustained Sexual Behavior Change after Acute HIV Diagnosis in Malawi. Sexually Transmitted Diseases, 45(11), 741-746. PMCID: PMC6179914


BACKGROUND: Identification of acute HIV infection (AHI) allows 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 multi-session behavioral intervention, or a multi-session behavioral intervention plus antiretrovirals. Sexual behaviors were assessed periodically over one 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 from 71% to 27%. These declines in sexual risk behaviors were sustained over follow-up irrespective of study arm.
CONCLUSIONS: AHI diagnosis alone may be sufficient to achieve immediate and sustained behavior change during this highly infectious period.


Reference Type

Journal Article

Year Published


Journal Title

Sexually Transmitted Diseases


Rucinski, Katherine B.
Rutstein, Sarah E.
Powers, Kimberly A.
Pasquale, Dana K.
Dennis, Ann M.
Phiri, Sam
Hosseinipour, Mina C.
Kamanga, Gift
Nsona, Dominic
Massa, Cecilia
Hoffman, Irving F.
Miller, William C.
Pettifor, Audrey E.