The findings, which appear in the May 21st issue of AIDS, are based on a study of 585 sexually active subjects who attended clinics emphasizing either of these risk reduction approaches or to control clinics that only stressed adherence to antiretroviral therapy.

With the positive consequence approach, the subjects were told "safer sex protects you from other STDs and from other strains of HIV." By comparison, subjects in the negative consequence group were told "unsafe sex may expose you to other STDs and other strains of HIV." Moreover, the counseling sessions, which lasted 3 to 5 minutes, either emphasized engaging in safer sex or avoiding unsafe sex.

Among subjects with at least two sex partners at baseline, the negative consequence approach reduced the incidence of self-reported unprotected anal or vaginal intercourse by 38% (p < 0.001). In contrast, the positive consequence approach produced no change in UAV.

Compared with the control group, the negative consequence group was 58% less likely to report unprotected intercourse at follow-up, lead author Dr. Jean L. Richardson, from the University of Southern California at Los Angeles, and colleagues state. The negative consequence approach had no effect on subjects with only partner or one main partner at baseline.

"Additional research is needed to find ways to counsel those with one partner and, among those who are not currently sexually active, to maintain abstinence or safer sexual behavior in the future," the authors conclude.