In the past, HIV-prevention programs focused on preventing the virus among HIV-negative persons. The messages were straightforward: “Use a condom to reduce your chances of getting HIV or AIDS,” “Don’t share needles,” or “Get tested.”

But seldom did these prevention campaigns target HIV-positive persons, even though one HIV-positive person is involved in any new case of HIV.

Today, prevention programs are beginning to change and studies are giving more attention to people living with HIV. This new approach is called prevention with positives.

One such program in San Diego is the Supporting Positive Living and Sexual Health (SPLASH) project, a prevention project designed to reduce HIV transmission risk behaviors among persons living with HIV.

A collaboration between the University of California, San Diego’s Owen Clinic and the Division of Community Pediatrics, the SPLASH project’s main purpose “is to combine a brief provider intervention with intense counseling sessions in order to reduce the risk of HIV transmission from HIV-positive patients to their sexual partners,” according to Estela Blanco, a research assistant for the evaluation team of the project.

In addition to providing primary care, the Owen Clinic also offers services such as mental health, and drug and alcohol counseling.

SPLASH consists of two main components: brief provider interventions and one-on-one interventions.

The brief provider intervention involves a short message a doctor gives to their patient about reducing their risk of transmitting the virus to others and/or becoming re-infected with the virus.

Blanco gave two examples of a message a doctor may give to his or her patients: “Unprotected sex may expose you to other sexually transmitted diseases or other strains of HIV. If you don’t use a latex condom when you have sex, you risk infecting your partner.”

Or, “I believe it is important for you to tell the people you have sex with that you have HIV. When you don’t share this information, you may feel guilty and lose his/her trust.”

Patients receive a brief provider intervention during their routine medical visit, but eligible patients can participate in the counseling intervention when they are referred to the program by an Owen Clinic provider.

Brief provider interventions have been shown to be effective in changing behaviors of patients.

The one-on-one intervention, on the other hand, is a series of counseling sessions with a sexual-health counselor.

“The patient meets with the sexual-health counselor for up to five one-hour sessions in which transmitting risk behaviors, safe sex, disclosure of HIV status and a participant’s willingness to change behaviors are discussed,” Blanco said. “…The counseling sessions also give clients a chance to really think about previous and current health choices that may be putting them or others at risk.”

The SPLASH project goals are to reduce the risk of HIV transmission from HIV-positive patients with risk behaviors to their sexual and/or drug sharing partners; determine whether a combined biomedical and behavioral prevention program is effective for HIV primary-care clinics in urban settings with a large and diverse population; determine how a combined biomedical behavioral prevention program can be reproduced in primary-car clinics in urban settings; and contribute to the literature on prevention of HIV transmission from infected persons to their partners.

The SPLASH program can be reached at (619) 471-9520.