Background: Acute HIV infection (AHI) as an important driver of secondary transmission. AHI describes the 3-to-4-week period following viral transmission when an individual remains HIV seronegative despite having a detectable viral load. Subsequently, the virus enters a stage of rapid multiplication, resulting in extremely high viral loads and high rates of infectiousness. We implemented HPTN 062, a pilot study on the feasibility and acceptability of a positive prevention-based motivational interviewing intervention, to reduce forward transmission of HIV among individuals with acute and early HIV infection in Lilongwe, Malawi.
Methods: Participants were followed for 24 weeks after diagnosis with AHI and were randomly assigned 1:1 to receive either brief education about HIV and AHI or the brief education plus the MI counseling intervention. All participants, regardless of study arm, received brief education at each visit. Participants in the MI-intervention arm received four additional counseling sessions within the first two weeks after diagnosis of AHI and one booster session eight weeks after diagnosis. In this presentation, we describe these participants'' understanding of AHI and perceptions of infectiousness during the period of AHI, and how these perceptions influenced their decisions to practice safer sexual behaviors at week eight.
Results: A total of 26 men and women completed the quantitative assessment (14 in the MI-intervention arm and 12 in the brief education arm). All 26 answered questions about their understanding of AHI during the SSIs, with slightly fewer answering questions about perceived infectiousness and changes in sexual behavior (13 in the MI-intervention arm and 11 in the brief education arm). While most participants in both the MI-intervention and brief education arms understood key aspects of AHI, those in the MI-intervention arm gave substantailly more detailed descriptions of their understanding. However, nearly all participants, regardless of study arm, understood that they are highly infectious and would be very likely to transmit HIV if they had unprotected sex during AHI.
Conclusions: Our findings suggest that messages about AHI delivered during the period of AHI are likely beneficial for ensuring that those with AHI understand their level of infectiousness and its association with forward transmission and/or HIV reinfection.