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Intervention Helps Reduce Risky Sexual Behavior Among Homeless HIV-positive Adults

Science Update

An NIMH-funded program already shown to reduce risky sexual and substance abuse behavior among HIV-infected adults also appears to be effective in improving the lives of HIV-infected homeless or near-homeless adults, according to a new report. The study was published in the November 2008 issue of the American Journal of Public Health.


Mary Jane Rotheram-Borus, Ph.D., of the University of California, Los Angeles, and colleagues examined the effectiveness of the NIMH-funded Healthy Living Program among a subgroup of HIV-positive adults. The program was designed for HIV-infected adults in general who continued to engage in risky behavior after learning of their infection. It consists of three intervention modules of five sessions each, designed to help participants reduce risky sexual behavior and drug use, improve their quality of life and stick to healthy behaviors.

A previous trial with 737 HIV-infected adults found the program to be effective in reducing risky behaviors. For this study, the authors analyzed data from 270 participants who were homeless or had been homeless in the three years prior to and during the study.

Results of the Study

Compared with a control group who did not receive the Healthy Living intervention, the authors found a significant reduction of risky sexual behavior among the subgroup. Up to 34 percent fewer risky sexual acts took place, and 72 percent fewer sexual encounters occurred with partners who were HIV negative or of unknown HIV status. In addition, individuals in the subgroup experienced up to 26 percent fewer days of alcohol, marijuana and hard drug use.


In the United States, HIV infection is more commonly found among populations with significant life stressors, such as homelessness and drug use. The results of this study highlight the importance of programs designed to prevent or reduce the spread of HIV among these specific populations. It also supports the notion that intervention programs that focus on skills development and target both the physical and mental health needs of participants are more likely to succeed than programs designed only to reduce HIV transmission rates.

What’s Next?

Future research into intervention programs such as Healthy Living are needed to identify the most effective components and determine if the programs can be applied on a wider scale. Future research also can examine how, in what format, and by whom the next generation of programs can be implemented.


Rotheram-Borus MJ, Desmond K, Comulada WS, Arnold EM, Johnson M, Healthy Living Trial Group. Reducing risky sexual behavior and substance use among currently and formerly homeless adults living with HIV . American Journal of Public Health. Nov 08. 98(11).