Abstract
Background. There is a strong association between crack/cocaine use and increased sexual risk behavior, but little research on the efficacy of HIV education for decreasing such behavior in crack/cocaine-addicted individuals in substance abuse treatment. Method. Datasets from two cocaine dependence trials including either one or three HIV education sessions, respectively, were analyzed for changes over time in the proportion of participants practicing safe sex. A pooled dataset from two earlier trials not offering HIV education was also analyzed. Results. We included 83 participants from the 1-session trial and 65 participants from the 3-session trial. Both sets of participants evidenced a significant increase in the proportion of participants having safe sex with casual partners. Participants in the 3-session HIV education study also evidenced a significant increase in the proportion of participants having safe sex with regular partners. In the trials without HIV education, no change in safe sex practices was found, and change in condom use was observed only among female participants. Conclusions. These findings are consistent with recommendations that HIV education/counseling should be provided to individuals in substance abuse treatment. A randomized controlled trial to confirm these results may be warranted. This trial is registered with NCT00033033, NCT00086255, NCT00015106, and NCT00015132.
Highlights
47,800 Americans contract HIV annually, with sexual contact accounting for about 87% of transmissions [1]
Since evaluating the efficacy of HIVeducation in reducing sexual risk behavior (SRB) was a secondary goal of the studies, the resources for systematic clinical monitoring and supervision of these sessions were not available; this is a methodological weakness of the study design, this lack of standardized monitoring/supervision is consistent with the manner in which HIV education will be provided in most substance treatment programs
This paper presents the findings from two separate clinical trials using a before and after design in which cocaine dependent individuals were provided with substance abuse treatment and HIV education
Summary
47,800 Americans contract HIV annually, with sexual contact accounting for about 87% of transmissions [1]. We present data from two cocaine-dependence clinical trials in which HIV education was provided in ISRN Addiction addition to cognitive behavioral therapy (CBT) for cocaine dependence. In these before and after evaluations of the efficacy of HIV education and substance abuse treatment for increasing safe sex, we selected measures with the greatest public health significance: total abstinence or consistent condom use [13]. There is a strong association between crack/cocaine use and increased sexual risk behavior, but little research on the efficacy of HIV education for decreasing such behavior in crack/cocaine-addicted individuals in substance abuse treatment. This trial is registered with NCT00033033, NCT00086255, NCT00015106, and NCT00015132
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