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APHA Scientific Session and Event Listing

Recorded presentation

Sarit A. Golub, PhD, MPH¹, Lisa Rosenthal¹, Daniel E. Cohen, MD², and Kenneth Mayer, MD³. (1) Department of Psychology, Queens College, City University of New York, 65-30 Kissena Boulevard, Flushing, NY 11367, 718-997-3244, sarit.golub@qc.cuny.edu, (2) Research Department, Fenway Community Health, 7 Haviland Street, Boston, MA 02115, (3) Fenway Community Health and Brown University/Miriam Hospital, 7 Haviland Street, Boston, MA 02115

Background: Non-occupational post-exposure prophylaxis (NPEP) refers to the initiation of combination antiretroviral therapy within 72 hours of a high-risk sexual exposure to HIV. The 28-day NPEP treatment period is a period of high stress in which individuals are asked to adhere to a treatment regimen and refrain from risky behavior. This study was designed to examine psychological and situational factors related to high-risk behavior during NPEP. Methods: Data were collected on 104 individuals presenting to a community health clinic seeking NPEP treatment. Participants completed measures at three time points: before initiating NPEP, during NPEP treatment, and four weeks following the completion of the NPEP regimen. Data were collected through structured interviews conducted by the medical provider administering NPEP treatment. Participants were asked about pessimism/fatalism about HIV infection, attitudes toward safer sex, loss of loved ones to HIV, activism and engagement with the HIV care system, negative affect, and high-risk sexual behavior and substance use. Results: During the 28-day NPEP treatment period, 37% of participants reported engaging in high-risk sexual behavior. Hierarchical regression analyses indicated that controlling for baseline sexual risk-taking, HIV activism predicted high-risk sexual behavior (R2 = .23, p < .01), as well as alcohol or drug use immediately prior to sex (R2 = .08, p <.05) during the 28-day NPEP period. Conclusions: Consistent with a cognitive escape model, individuals most active in the HIV care system may experience greater vulnerability to high-risk behavior in response to situational and/or emotional cues and should not be ignored in risk-reduction interventions.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Articulate psychosocial and environmental factors that might increase or decrease an individual’s vulnerability to engaging in high-risk behavior during NPEP treatment;
• Discuss a cognitive escape model as a potential explanation of situational, behavioral, and emotional vulnerability to high-risk behavior during NPEP treatment; and
• Apply findings to the development of assessments and interventions designed to support individuals receiving nPEP.

Keywords: HIV Risk Behavior, Prevention

Awards: Excellence in Abstract Submission among New Investigators--Award Winner - Recipient

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation