P19.02
Background: In the iPrEx Open Label Extension (OLE) study counselors integrated Next Step Counseling (NSC-developed by iPrEx to promote adherence) with sexual health promotion counseling to produce Integrated Next Step Counseling (iNSC). This approach combines sexual health promotion and PrEP-adherence counseling into a single discussion. We evaluated iNSC session records from US iPrEx OLE study sites (Boston, Chicago, San Francisco) to identify main themes of discussions relevant to sexual-health promotion practices and PrEP adherence.
Methods: iNSC entails a brief discussion between counselors and participants based on demonstrated health behavior models and motivational communication strategies. The approach includes a two-part discussion that explores contextual facilitators, barriers and individualized needs for enhancing sexual health promotion (part 1) and repeats this kind of discussion specific to PrEP adherence (part 2). Counselors documented facilitators, barriers, and needs on a record form at the end of each iNSC session.
Results: iNSC was administered to 287 participants (regardless whether on or off PrEP) between June, 2011 and September, 2013 producing a total of 2492 sessions for review with 1576 sessions also including PrEP-adherence for 223 on-PrEP participants. The most reported facilitator of safer sex practices included ‘personal commitment (motivation) to staying HIV-negative' (49%). ‘Getting caught up in the moment’ (21%) was the most common identified barrier. For iNSC adherence discussions, matching dose taking with a routine daily event (86%) was the most common facilitator; disruption in routine the most common challenge (37%). Challenges and needs were not identified for 42% and 49% of sessions, respectively.
Conclusions: The iNSC discussions identified factors participants found relevant in promoting their sexual-health practices and PrEP adherence. Future explorations into other factors that are influential to the promotion of sexual-health practices and PrEP adherence are needed.
