An audit carried out at 15 of the larger sexual health clinics in England suggests that only a limited number of gay men are offered and accept a structured behavioural intervention.
The National Institute for Health and Clinical Excellence (NICE) recommends that health professionals should offer a structured discussion on risk reduction to people who are at high risk of having a sexually transmitted infection (STI), including gay and bisexual men. These one-to-one discussions should be structured on the basis of behaviour change theories and should last at least 15 to 20 minutes.
A case-note review found that four-in-ten patients received a behavioural intervention, but frequently this was just advice. Fewer than one-in-ten received a structured intervention, as recommended. Although men who reported recent unprotected anal intercourse were more likely to be offered and to accept an intervention than other men, uptake remained low.
Interventions delivered were mostly counselling and motivational interviewing; a handful of men received cognitive behavioural therapy or peer education.
The authors recommend that the reasons why such interventions are not offered to men at higher risk of HIV infection be investigated and addressed. Moreover, practitioners need a better understanding of how acceptable such interventions are to potential participants.