Journal
ADDICTIVE BEHAVIORS
Volume 31, Issue 5, Pages 868-879Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.addbeh.2005.07.009
Keywords
human immunodeficiency virus; sexual risk taking; drug abuse; cognitive behavior therapy; contingency management; methadone maintenance
Categories
Funding
- Intramural NIH HHS Funding Source: Medline
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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 / 8 1) 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. (c) 2005 Elsevier Ltd. All rights reserved.
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