Abstract
This longitudinal study examines male veterans with a history of cocaine dependence and treatment, focusing on the relationship between levels of crack use and HIV-related knowledge, beliefs and risk behaviors. Over half the subjects were African-American and the majority were heterosexual. A survey instrument was administered at one and two years after initiating treatment. HIV serotesting was conducted at each interview which showed the rate of seropositivity to be low at both points. Knowledge about HIV transmission increased significantly over time for the sample, but no differences were significantly related to level of crack use. Few subjects report the use of condoms on a consistent basis, regardless of crack use level. However, both the number of sex partners reported and beliefs about personal susceptibility to HIV infection increased as the level of crack use increased. Our crack-using subjects had not fully internalized their risk of HIV infection or were fatalistic about their ability to change HIV-related risk behaviors. Either of these possibilities presents a significant challenge to education and prevention efforts targeted to crack users. AIDS education efforts in drug treatment programs may need to more strongly emphasize the sexual transmission routes of HIV infection and highlight the effects of cocaine use on sexual practices.
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