Short-term effects of a brief intervention to reduce alcohol use and sexual risk among homeless young adults: results from a randomized controlled trial

Abstract

Background: Homeless young adults are more likely than their never-homeless counterparts to abuse alcohol and engage in risky sexual behaviors, yet no interventions to simultaneously reduce both these behaviors among this vulnerable population have been systematically designed and evaluated. We therefore developed a brief intervention (BI) to reduce both alcohol use and sexual risk behaviors among homeless young adults. The results of a randomized trial testing the BI against an education comparison (EC) are presented.Method: Young adults (N = 61; age 17–22 years) from an urban, Northeastern crisis shelter were randomly assigned to either the two-session, individual-level BI or a time-matched, two-session, individual-level EC. Generalized linear mixed models for repeated measures determined effects of treatment condition on outcomes.Results: The BI significantly increased participant readiness to change alcohol use. However, it did not significantly decrease primary alcohol or HIV sexual risk outcomes, independently or relative to EC (all ps > 0.05). Participants in the EC reduced times engaged in unprotected sex between baseline and post-intervention to a significantly greater extent (p < 0.01) than those in the BI condition. Participants in both conditions reported satisfaction with respective interventions.Conclusions: Findings suggest that the BI was acceptable and successful in getting participants to consider changing their drinking. However, lack of change in alcohol and sexual behavior outcomes indicates the need for further research to determine how to translate readiness to change into actual behavioral change among homeless young adults.