Abstract
BackgroundThe objective of the current study was to examine predictors and moderators of response to two HIV sexual risk interventions of different content and duration for individuals in substance abuse treatment programs.MethodsParticipants were recruited from community drug treatment programs participating in the National Institute on Drug Abuse Clinical Trials Network (CTN). Data were pooled from two parallel randomized controlled CTN studies (one with men and one with women) each examining the impact of a multi-session motivational and skills training program, in comparison to a single-session HIV education intervention, on the degree of reduction in unprotected sex from baseline to 3- and 6- month follow-ups. The findings were analyzed using a zero-inflated negative binomial (ZINB) model.ResultsSeverity of drug use (p < .01), gender (p < .001), and age (p < .001) were significant main effect predictors of number of unprotected sexual occasions (USOs) at follow-up in the non-zero portion of the ZINB model (men, younger participants, and those with greater severity of drug/alcohol abuse have more USOs). Monogamous relationship status (p < .001) and race/ethnicity (p < .001) were significant predictors of having at least one USO vs. none (monogamous individuals and African Americans were more likely to have at least one USO). Significant moderators of intervention effectiveness included recent sex under the influence of drugs/alcohol (p < .01 in non-zero portion of model), duration of abuse of primary drug (p < .05 in non-zero portion of model), and Hispanic ethnicity (p < .01 in the zero portion, p < .05 in the non-zero portion of model).ConclusionThese predictor and moderator findings point to ways in which patients may be selected for the different HIV sexual risk reduction interventions and suggest potential avenues for further development of the interventions for increasing their effectiveness within certain subgroups.
Highlights
The objective of the current study was to examine predictors and moderators of response to two HIV sexual risk interventions of different content and duration for individuals in substance abuse treatment programs
HIV risk reduction education is often provided in substance abuse treatment programs because of the documented association between substance abuse and HIV risk behaviors [1,2,3,4,5]
Survey studies of clinics participating in the National Institute on Drug Abuse Clinical Trials
Summary
The objective of the current study was to examine predictors and moderators of response to two HIV sexual risk interventions of different content and duration for individuals in substance abuse treatment programs. Network (NIDA CTN) have indicated that most provide HIV risk reduction education [6,7] These consist of single 30- to 90-minute sessions delivered in group or individual formats and are limited to providing information rather than improving motivation and teaching skills (e.g., role plays, etc.). A meta-analysis of 35 such studies concluded that, in general, there are minimal differences identified between multi-session psychosocial interventions and standard educational interventions for both drug risks (injection) and sexual risks for HIV, though both types of interventions typically result in relatively large pre-post changes in risk behaviors [8]. Some evidence for single-gender groups was found in this review
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