TY - JOUR
T1 - Changes in HIV risk behaviors among patients receiving combined pharmacological and behavioral interventions for heroin and cocaine dependence
AU - Schroeder, Jennifer R.
AU - Epstein, David H.
AU - Umbricht, Annie
AU - Preston, Kenzie L.
N1 - Funding Information:
This research was supported by the Intramural Research Program of the National Institutes of Health, National Institute on Drug Abuse.
PY - 2006/5
Y1 - 2006/5
N2 - Cocaine use is associated with injecting and sexual HIV risk behaviors. This study was a randomized controlled trial of behavioral interventions for cocaine dependence and HIV risk behaviors among dually (cocaine and heroin) dependent outpatients. Methadone maintenance was augmented with cognitive-behavioral therapy (CBT), contingency management (CM), both (CBT + CM), or neither. The study sample (n = 81) was 52% female, 70% African American, and 37.9 ± 7.0 years old. Proportions reporting HIV risk behaviors at intake were: 96.3% (78 / 81) injection drug use, 56.8% (46 / 81) sharing needles, 30.9% (25 / 81) unprotected sex, 28.4% (23 / 81) trading sex for money or drugs. Proportions who no longer reported behaviors at study exit were: 51.3% (40 / 78) injection drug use, 91.3% (42 / 46) sharing needles, 88% (22 / 25) unprotected sex, 91.3% (21 / 23) trading sex for money or drugs. Participants receiving CBT + CM were more likely to report cessation of unprotected sex relative to control (OR = 5.44, 95% CI 1.14-26.0, p = 0.034) but this effect was no longer significant after adjusting for drug-negative urines. These results suggest broad beneficial effects of methadone maintenance augmented with behavioral interventions for reducing HIV risk behaviors.
AB - Cocaine use is associated with injecting and sexual HIV risk behaviors. This study was a randomized controlled trial of behavioral interventions for cocaine dependence and HIV risk behaviors among dually (cocaine and heroin) dependent outpatients. Methadone maintenance was augmented with cognitive-behavioral therapy (CBT), contingency management (CM), both (CBT + CM), or neither. The study sample (n = 81) was 52% female, 70% African American, and 37.9 ± 7.0 years old. Proportions reporting HIV risk behaviors at intake were: 96.3% (78 / 81) injection drug use, 56.8% (46 / 81) sharing needles, 30.9% (25 / 81) unprotected sex, 28.4% (23 / 81) trading sex for money or drugs. Proportions who no longer reported behaviors at study exit were: 51.3% (40 / 78) injection drug use, 91.3% (42 / 46) sharing needles, 88% (22 / 25) unprotected sex, 91.3% (21 / 23) trading sex for money or drugs. Participants receiving CBT + CM were more likely to report cessation of unprotected sex relative to control (OR = 5.44, 95% CI 1.14-26.0, p = 0.034) but this effect was no longer significant after adjusting for drug-negative urines. These results suggest broad beneficial effects of methadone maintenance augmented with behavioral interventions for reducing HIV risk behaviors.
KW - Cognitive behavior therapy
KW - Contingency management
KW - Drug abuse
KW - Human immunodeficiency virus
KW - Methadone maintenance
KW - Sexual risk taking
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U2 - 10.1016/j.addbeh.2005.07.009
DO - 10.1016/j.addbeh.2005.07.009
M3 - Article
C2 - 16085366
AN - SCOPUS:33646151879
SN - 0306-4603
VL - 31
SP - 868
EP - 879
JO - Addictive Behaviors
JF - Addictive Behaviors
IS - 5
ER -