***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In a r and omized trial of a behavioral intervention among substance-using men who have sex with men , aim ed at reducing sexual risk behavior , Mansergh and colleagues fail to find evidence of a reduction in risk from the intervention Numerous herpesvirus infections are associated with clinical ly relevant outcomes as well as an accelerated HIV replication rate and subsequent disease progression .  Stress management interventions mayimprovemarkersofcellularimmunecontroloverlatent herpesvirus infections and these changes appear to be mediated by perceptions of increased social support availability . We examined the effects ofagroup-based cognitive behavioral stress management ( CBSM ) intervention on distress , dysphoria , perceived socialsupport , and herpesvirus immunoglobulin G ( IgG ) antibody titers during the 6to 12 months following the intervention . Of those who were initially r and omized , 49 HIV-infected men were followed during the 6-to 12-month period after r and omization to either a 10-week CBSM intervention ( n=31 ) or amodified wait-list control condition ( n = 18 ) . Measures of distress , dysphoria , social support , and blood sample s for herpesvirus Ig Gtiters were taken at baseline , immediately following CBSM and at-6-to 12-month follow-up . Men in CBSM displayed maintenance of previously observed intervention effects on dysphoria , reliable alliance support , and herpesvirus IgG antibody titers ( i.e. , Epstein-Barr virus capsid antigen ; EBV-VCA ) . Intervention-related changes in EBV-VCA were unrelated to changes in lymphocyte subsets ( i.e. , CD4 + , CD8 + , and CD4+:CD8 + ) or changes in measures of dysphoria and social support during the investigation period . Data indicate that HIV-infected men participating in a CBS Mintervention maintain better psychosocial status and immunologic control of latent EBV infection up to 1 year after its conclusion BACKGROUND Effective interventions are needed to prevent acquisition of HIV infection in men who have sex with men . To date , no behavioural interventions specifically for this risk group have been tested with HIV infection as the primary outcome . METHODS This multisite two-group r and omised controlled phase IIb trial tested the efficacy of a behavioural intervention in preventing HIV infection among 4295 men who have sex with men . The experimental intervention consisted of ten one-on-one counselling sessions followed by maintenance sessions every 3 months . The st and ard condition was twice-yearly Project RESPECT individual counselling . Twice-yearly follow-up visits included testing for HIV antibody and assessment of behavioural outcomes . FINDINGS The rate of acquisition of HIV infection was 18.2 % ( 95 % CI -4.7 to 36.0 ) lower in the intervention group than the st and ard group . Adjustment for baseline covariates attenuated the intervention effect to 15.7 % ( -8.4 to 34.4 ) . The effect was more favourable in the first 12 - 18 months of follow-up . The occurrence of unprotected receptive anal intercourse with HIV-positive and unknown-status partners was 20.5 % ( 10.9 to 29.0 ) lower in the intervention than in the st and ard group . INTERPRETATION The results from the primary analyses allow us to rule out that the experimental intervention is associated with a 35 % lower rate of HIV acquisition than in the st and ard group . The overall estimate of a difference of 18.2 % , more favourable estimates of effect in the first 12 - 18 months , and similar effects on risk behaviours suggest that prevention of HIV infection among men who have sex with men by a behavioural intervention is feasible . Further work should be done to develop more effective interventions Background : Brief and low-burden HIV risk reduction counseling interventions are needed for population s at greatest risk for HIV infection . Purpose : This r and omized controlled trial tested a brief theory-based counseling intervention delivered entirely over the telephone for men who engage in unprotected intercourse with men . Methods : Participants received either risk reduction counseling that included information , motivational enhancement and behavior skills building , or brief HIV education counseling . A total of 319 participants completed follow-up assessment s over a 10-month period . Descriptive and r and om effects mixed models are used to evaluate findings . Results : Results demonstrate that a brief telephone intervention can reach and engage high-risk men in risk reduction counseling . Nearly one third of participants identified as men of color ; the median age was 33 years . Participants in both counseling conditions increased their motivation and behavioral skills to practice safer sex and reduced their number of sex partners and frequencies of engaging in unprotected anal sex over the study observation period . However , there were few differences between intervention conditions . Conclusions : The effects of repeated measurement reactivity and brief interpersonal consciousness raising may account for the lack of differences between counseling conditions and the decrease in risk for all participants over time BACKGROUND As many as one in three HIV-positive people continue unprotected sexual practice s 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 r and omly 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 ( st and ard-of-care comparison ) . Participants were followed for 6 months post-intervention . RESULTS The intervention to reduce risk of HIV transmission result ed 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 result ing from a behavioral intervention tailored for HIV-positive men and women At the time of this writing , no r and omized controlled trial ( RCT ) of an intervention to reduce unsafe sex among Latino gay and bisexual men ( LGBM ) had been published . We report the results of an RCT conducted in New York City in which 180 LGBM were assigned either to an intervention developed specifically for this population or to a wait-list control group . The intervention was based on empowerment theory and used factors identified in prior research as determinants of unsafe sex . By eligibility criteria , all men had engaged in unprotected anal intercourse ( UAI )  within two months of the baseline assessment . At first ( two months ) and second ( six months later ) follow-up assessment s , approximately half of the men in the experimental group reported no UAI . Yet , a similar proportion of the control group also reported no UAI . Baseline data indicate that although the men had been the subject of social oppression and sexual prejudice ( homophobia ) , they did not feel disempowered , externally controlled or fatalistic , and they reported self-efficacy and intentionality to enact safer sex . Lessons learned are discussed , as well as notes of caution for future research employing a similar conceptual framework Objective : To test the efficacy of brief , safer-sex counseling by medical providers of HIV-positive patients during medical visits . Setting : Six HIV clinics in California . Design : Clinics were r and omized to intervention arms evaluated with cohorts of r and omly selected patients measured before and after the intervention . Participants : Five-hundred and eighty-five HIV-positive persons , sexually active prior to enrollment . Interventions : Prevention counseling from medical providers supplemented with written information . Two clinics used a gain-framed approach ( positive consequences of safer-sex ) , two used a loss-frame approach ( negative consequences of unsafe sex ) , and two were attention-control clinics ( medication adherence ) . Interventions were given to all patients who attended the clinics . Outcome measure : Self-reported unprotected anal or vaginal intercourse ( UAV ) . Results : Among participants who had two or more sex partners at baseline , UAV was reduced 38 % ( P < 0.001 ) among those who received the loss-frame intervention . UAV at follow-up was significantly lower in the loss-frame arm [ odds ratio ( OR ) , 0.42 ; 95 % confidence interval ( CI ) , 0.19–0.91 ; P = 0.03 ] compared with the control arm . Using generalized estimating equations ( GEE ) to adjust for clustering did not change the conclusions ( OR , 0.34 ; 95 % CI , 0.24–0.49 ; P = 0.0001 ) . Similar results were obtained in participants with casual partners at baseline . No effects were seen in participants with only one partner or only a main partner at baseline . No significant changes were seen in the gain-frame arm . Conclusions : Brief provider counseling emphasizing the negative consequences of unsafe sex can reduce HIV transmission behaviors in HIV-positive patients presenting with risky behavioral profiles Objectives : To evaluate the effects of an enhanced peer-led intervention on transmission risk behavior and serostatus disclosure of HIV-seropositive gay and bisexual men . Design : A r and omized intervention trial . Methods : HIV-seropositive gay and bisexual men were recruited from New York City and San Francisco and were r and omly assigned to either a st and ard or an enhanced intervention . The st and ard intervention consisted of one session that provided safer sex information . The enhanced intervention consisted of six sessions and included safer sex information , interactive learning activities , and discussion groups that were facilitated by HIV-seropositive peers . Participants completed audio computer-assisted self interview ( A-CASI ) assessment s at baseline and 3 and 6-month follow-ups . Optional testing for sexually transmitted infections was offered at baseline and the 6-month follow-up . Results : A total of 811 participants met the inclusion criteria for outcome analyses . Of these , 85 and 90 % were retained for the 3 and 6-month follow-ups , respectively . Compared with the st and ard intervention , fewer men assigned to the enhanced intervention reported unprotected receptive anal intercourse with a negative or unknown-serostatus partner at 3 months ( 21 versus 26 % , P < 0.05 ) . However , there were no other significant differences in transmission risk or serostatus disclosure at 3 or 6 months . Conclusion : The enhanced intervention was associated with only a limited reduction in transmission risk at 3 months relative to the st and ard intervention . The characteristics of the intervention that may have reduced its efficacy are identified and directions for future research are suggested There is an increasing interest in developing interventions for HIV and STD prevention that can be delivered on the Internet . However , we know little about what it takes to identify , recruit and retain participants in interventions so that we can test their efficacy and effectiveness . Objectives for this investigation were to evaluate rates of recruitment and retention in an Internet-based r and omized controlled trial ( RCT ) to increase sexually transmitted disease ( STD ) prevention among men who have sex with men ( MSM ) . The Smart Sex Quest study was a RCT conducted online .  Eligible participants were MSM , at least 18 years old and US residents . After completing a baseline risk assessment , participants were exposed to tailored or control messages and asked to return to the site at three months for a follow-up interview . From January 2002 through June 2003 , 3,625 persons logged on as potential study participants ; of these , 563 were not eligible , while 1,286 left the site without filling out a baseline survey . Complete baseline data were available for 1,776 participants , all of whom were eligible to complete a follow-up . Complete follow-up data were available for 270 ( 15.2 % ) participants . While the Internet is a valuable tool for conducting research , conducting this longitudinal research online was severely affected by a loss to follow-up , and analyzing outcome data was hampered by significant differences between those who did and did not complete the study . Alternate ways to recruit for and evaluate online trials must be considered To the extent that men who have sex with men ( MSM ) use the Internet , it serves as a promising medium for behavioral intervention . The present study sought to investigate the efficacy of a web-based skills training and motivational intervention in a r and omized trial ( N = 112 ) conducted completely online . After a detailed assessment , MSM were r and omly assigned to an online intervention or a control website . The experimental intervention consisted of risk assessment and feedback , motivational exercises , skills training , and education while the control intervention focused on relaxation skills . Follow-up data were collected 3 months later and analyzed with repeated- measures MANOVA . Although both groups evidence d across-the-board reductions in unprotected sex , perhaps due to the detailed assessment , the experimental group showed greater reductions with the riskiest partners , those of positive or unknown serostatus . Thus , this study gives preliminary evidence that a brief web-based intervention offering cognitive behavioral skills training and motivational enhancement can effectively reduce sexual risk in MSM Behavior change can curtail the spread of acquired immune deficiency syndrome ( AIDS ) . In this study , 104 gay men with a history of frequent AIDS high-risk behavior completed self-report , self-monitoring , and behavioral measures related to AIDS risk . The sample was r and omly divided into experimental and waiting-list control groups . The experimental intervention provided AIDS risk education , cognitive-behavioral self-management training , sexual assertion training , and attention to the development of steady and self-affirming social supports . Experimental group participants greatly reduced their frequency of high-risk sexual practice s and increased behavioral skills for refusing sexual coercions , AIDS risk knowledge , and adoption of " safer sex " practice s. Change was maintained at the 8-month follow-up Summary H 
    Output:
    
Non-EBIs had multiple method ological limitations ; the most common was not finding a significant positive effect .
Compared to EBIs , non-EBIs were less likely to use peer intervention deliverers , include sexual communication in their interventions , and intervene at the community level .