BACKGROUND:As many as one in three HIV-positive people continue unprotected sexual practices after learning that they are HIV infected. This article reports the outcomes of a theory-based intervention to reduce risk of HIV transmission for people living with HIV infection. METHODS:Men (n=233) and women (n=99) living with HIV-AIDS were randomly assigned to receive either (1) a five-session group intervention focused on strategies for practicing safer sexual behavior, or (2) a five-session, contact-matched, health-maintenance support group (standard-of-care comparison). Participants were followed for 6 months post-intervention. RESULTS:The intervention to reduce risk of HIV transmission resulted in significantly less unprotected intercourse and greater condom use at follow-up. Transmission-risk behaviors with non-HIV-positive sexual partners and estimated HIV transmission rates over a 1-year horizon were also significantly lower for the behavioral risk-reduction intervention group. CONCLUSIONS:This study is among the first to demonstrate successful HIV-transmission risk reduction resulting from a behavioral intervention tailored for HIV-positive men and women.

Unwanted sexual experiences are associated with high‐risk sexual practices for HIV infection. The current study examined histories of unwanted sexual contact in childhood and adulthood in relation to HIV risk behavior in men who have sex with men. Men attending a large gay pride event in Atlanta, Georgia (N = 595) completed anonymous surveys measuring sexual history, substance use, sexual risk behavior, and symptoms of dissociation, trauma‐related anxiety, and borderline personality. Results showed that men who had been sexually coerced into unwanted sexual activity as adults were more likely to report being treated for substance abuse as well as use of crack cocaine and nitrite inhalants in the past 6 months. Sexually coerced men were also more likely to report high‐risk sexual behaviors and symptoms of dissociation, trauma‐related anxiety, and borderline personality. History of sexual victimization in childhood and revictimization in adulthood was not, however, associated with increased risk behavior over and above that seen in relation to adult unwanted sexual experiences. We conclude that sexual coercion is a significant problem among men who have sex with men, including increasing risk for HIV infection.