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Fisher Receives Major Grant
for Clinic-Based HIV Prevention
September 20, 1999
ew HIV drug "cocktails" may have the ability to change HIV from a fatal illness to a chronic disease. But as advances are made in the treatment of HIV, the question remains of how to help HIV-positive individuals maintain healthy lifestyles.
This summer, Jeffrey Fisher, a professor of psychology, began a major research program to teach clinicians who care for HIV-positive patients how to support their patients' efforts to practice safer sex.
Fisher's research is funded by a new $3.5 million grant from the National Institute of Mental Health. Co-investigators on the project include William A. Fisher of the University of Western Ontario and Gerald Friedland of Yale University. Jack Ross of Hartford Hospital also is a collaborator on this project.
Jeffrey Fisher's work is known around the world. In addition to his theory-based research on HIV prevention, "People Like Us" - a video Fisher designed with his brother, William Fisher, to motivate young adults to practice safer sex - has received international awards and is widely used in AIDS education programs.
Although it is estimated that between 600,000 and 800,000 Americans are infected with HIV, very little research has been done on HIV-risk behavior within the HIV-positive population, says Fisher, and very few studies have examined how best to support HIV-positive individuals in their efforts to practice safer sex. Common sense suggests that it would be very difficult for anyone to engage only in safer sexual behavior for extended periods of time, he says.
In addition, anecdotal information suggests that the medical advances that are responsible for prolonging life for HIV-positive individuals may create the false impression that HIV has been cured and that practicing safe sexual behavior is regarded as less important now than it used to be.
Fisher and his colleagues will work with HIV care clinicians to help them develop counseling skills that can support their patients' practice of safer behaviors. The clinicians are central to this counseling intervention, he says, because they tend to develop close, ongoing relationships with people who are HIV-positive, while providing medical treatment for extended periods of time.
This clinic-based intervention is grounded in the Information, Motivation, Behavioral Skills (IMB) model, developed at UConn, which examines the knowledge, attitudes and skills that contribute to safer sexual behavior.
As part of the intervention, HIV-positive participants will be asked about their recent sexual or drug-using practices. This information will be collected through a computer program that can assess the data and generate a summary or "prevention prescription" that the provider can use as a basis for a counseling session. Dialogue between the provider and the patient will be the first step toward the goal of maintaining safer sexual practices over time.
A comparison group of HIV-positive individuals will have more typical interactions with their clinicians, and the research team will compare the outcomes of the two groups of HIV-positive patients.
Those in the comparison group will be offered the experimental counseling program after its effectiveness has been clearly demonstrated.
Fisher believes that this IMB model-based counseling program will prove to be an efficient and effective method for supporting safer practices among HIV-positive individuals.
In previous studies using this model, he and his colleagues have successfully encouraged the practice of safer sexual behavior among university students and in large samples of urban minority high school students.
Fisher joined the University of Connecticut faculty in 1975. The recent grant brings his total grant awards for theory-based research on HIV prevention to approximately $8 million since 1989.
In addition to being a member of the social psychology faculty, Fisher is director of the Center for HIV Prevention and Intervention in the Department of Psychology.