Efficacy of a behavioral intervention for increasing safer sex behaviors in HIV-negative, heterosexual methamphetamine users: Results from the fast-lane study
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Background: The risk of acquiring HIV is particularly high among persons who use methamphetamine, which is often associated with unprotected sex and high numbers of sexual partners.Purpose: This study examined the efficacy of a behavioral intervention emphasizing motivational interviewing and social cognitive theory for increasing safer sex behaviors in the context of ongoing methamphetamine use in a sample of HIV-negative, heterosexual methamphetamine users.Methods: Four hundred fifty-one participants from San Diego, California, were randomly assigned to receive one of three treatment conditions: (a) a safer sex behavioral intervention (Fast-Lane [FL]), (b) the FL intervention with boosters (FL+B), or (c) a time-equivalent diet-and-exercise attention-control (D&E) condition. Random effects regression analyses were used to evaluate change in safer sex behaviors over an 18-month period.Results: Compared to those in the D&E condition, participants in the FL+B condition (p=.019) and FL condition (p=.020) significantly increased their engagement in protected sex acts over the active intervention phase. Also, compared to the D&E condition, those in the FL condition demonstrated a significant decrease in unprotected sex (p=.005) and an increase in percent protected sex (p=.001) during the active intervention. Finally, relative to D&E participants, FL participants demonstrated significant improvements in self-efficacy for negotiating safer sex (p=.011), and change in self-efficacy mediated the efficacy of the FL condition for increasing safer sex behaviors (p=.033).Conclusions: These results suggest that our behavioral intervention was successful in terms of reducing high-risk sexual behaviors in the context of ongoing methamphetamine use among HIV-negative heterosexuals. Reductions in high-risk sexual behavior were likely because of the impact of the intervention on participants’ self-efficacy for negotiating safer sex.
- Essien EJ, Meshack AF, Peters RJ, Ogungbade GO, Osemene NI: Strategies to prevent HIV transmission among heterosexual African-American men.BMC Public Health. 2005,5:3. CrossRef
- Fernández MI, Bowen GS, Varga LM, et al.: High rates of club drug use and risky sexual practices among Hispanic men who have sex with men in Miami, Florida.Substance Use & Misuse. 2005,40:1347–1362. CrossRef
- Halkitis PN, Parsons JT, Stirratt MJ: A double epidemic: Crystal methamphetamine drug use in relation to HIV transmission among gay men.Journal of Homosexuality. 2001,41:17–35. CrossRef
- Purcell DW, Parsons JT, Halkitis PN, Mizuno Y, Woods WJ: Substance use and sexual transmission risk behavior of HIV-positive men who have sex with men.Journal of Substance Abuse. 2001,13:185–200. CrossRef
- Clatts MC, Goldsamt LA, Yi H: Club drug use among young men who have sex with men in NYC: A preliminary epidemiological profile.Substance Use & Misuse. 2005,40:1317–1330. CrossRef
- Molitor F, Truax SR, Ruiz JD, Sun RK: Association of methamphetamine use during sex with risky sexual behaviors and HIV infection among non-injection drug users.The Western Journal of Medicine. 1998,168:93–97.
- Bandura A: Social cognitive theory and exercise of control over HIV infection. In DiClemente R, Peterson J (eds),Preventing AIDS: Theories and Methods of Behavioral Interventions. New York: Plenum, 1994, 25–59.
- Hobfoll SE, Jackson AP, Lavin J, Britton PJ, Shepherd JB: Reducing inner-city women’s aids risk activities: A study of single, pregnant women.Health Psychology. 1994,13:397–403. CrossRef
- Kelly JA, Murphy DA, Washington CD, et al.: The effects of HIV/AIDS intervention groups for high-risk women in urban clinics.American Journal of Public Health. 1994,84:1918–1922. CrossRef
- Kalichman SC: The other side of the healthy relationships intervention: Mental health outcomes and correlates of sexual risk behavior change.AIDS Education and Prevention. 2005,17(Suppl. A):66–75. CrossRef
- Jemmott LS, Jemmott JB III: Increasing condom-use intentions among sexually active black adolescent women.Nursing Research. 1992,41:273–279.
- DiClemente RJ, Wingood GM, Harrington KF, et al.: Efficacy of an HIV prevention intervention for African American adolescent girls: A randomized controlled trial.Journal of the American Medical Association. 2004,292:171–179. CrossRef
- Prochaska J, DiClemente C: Stages of change in the modification of problem behaviors. In Heresen M, Eisler RM, Miller PM (eds),Progress in Behavior Modification. Sycamore, IL: Sycamore, 1992, 184–214.
- Semple SJ, Patterson TL, Grant I: Determinants of condom use stage of change among heterosexually-identified methamphetamine users.AIDS and Behavior. 2004,8:391–400. CrossRef
- Miller WR, Rollnick S:Motivational Interviewing: Preparing People to Change Addictive Behavior. New York: Guilford, 1991.
- Burke BL, Arkowitz H, Menchola M: The efficacy of motivational interviewing: A meta-analysis of controlled clinical trials.Journal of Consulting and Clinical Psychology. 2003,71:843–861. CrossRef
- DiClemente C, Peterson JL: Changing HIV/AIDS risk behaviors: The role of behavioral interventions. In DiClemente C, Peterson JL (eds),Preventing AIDS: Theories and Methods of Behavioral Interventions. New York: Plenum, 1994, 1–4.
- Mausbach BT, Semple SJ, Strathdee SA, Zians JK, Patterson TL: Effectiveness of a behavioral intervention for increasing safer sex behaviors in HIV-positive MSM methamphetamine users: Results from the EDGE study.Drug and Alcohol Dependence. 2007,87:249–257. CrossRef
- Fogarty L, Heiliq C, Armstrong K, et al.: Long-term effectiveness of a peer-based intervention to promote condom and contraceptive use among HIV-positive and at-risk women.Public Health Reports. 2001,116:103–119. CrossRef
- Wingood GM, DiClemente C, Mikhail I, et al.: A randomized controlled trial to reduce HIV transmission risk behaviors and sexually transmitted diseases among women living with HIV: The WiLLOW program.Journal of Acquired Immune Deficiency Syndromes. 2004,37:S58-S67. CrossRef
- The NIMH Multisite HIV Prevention Trial: Reducing HIV sexual risk behavior. The National Institute of Mental Health (NIMH) multisite HIV prevention trial group.Science. 1998,280:1889–1894. CrossRef
- Hawkins DA: Oral sex and HIV transmission.Sexually Transmitted Infections. 2001,77:307–308. CrossRef
- Gilbart VL, Evans BG, Dougan S: HIV transmission among men who have sex with men through oral sex.Sexually Transmitted Infections. 2004,80:324. CrossRef
- Dolan JP:Negotiate Like the Pros. New York: Perigee, 1992.
- Rhodes F, Malotte CK: HIV risk interventions for active drug users: Experience and prospects. In Oskamp S, Thompson S (eds),Understanding and Preventing HIV Risk Behavior: Safer Sex and Drug Use. Thousand Oaks, CA: Sage, 1996, 207–235.
- Zapka JG, Stoddard AM, McCusker J: Social network, support and influence: Relationships with drug use and protective aids behavior.AIDS Education & Prevention. 1993,5:352–366.
- Baron RM, Kenny DA: The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.Journal of Personality & Social Psychology. 1986,51:1173–1182. CrossRef
- Holmbeck GN: Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: Examples from the child-clinical and pediatric psychology literatures.Journal of Consulting and Clinical Psychology. 1997,65:599–610. CrossRef
- Holmbeck GN: Post-hoc probing of significant moderational and mediational effects in studies of pediatric populations.Journal of Pediatric Psychology. 2002,27:87–96. CrossRef
- MacKinnon DP, Dwyer JH: Estimating mediated effects in prevention studies.Evaluation Review. 1993,17:144–158. CrossRef
- Sobel ME: Asymptotic confidence intervals for indirect effects in structural equations models. In Leinhart S (ed),Sociological Methodology. San Francisco: Jossey-Bass, 1982, 290–312.
- Bandura A:Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall, 1986.
- Carroll KM, Rounsaville BJ, Keller DS: Relapse prevention strategies for the treatment of cocaine abuse.American Journal of Drug and Alcohol Abuse. 1991,17:249–265. CrossRef
- Maglione M, Chao B, Anglin MD: Methamphetamine abuse in California: Correlates of injection use.AIDS and Behavior. 1998,2:257–261. CrossRef
- Dilley JW, Woods WJ, Loeb L, et al.: Brief cognitive counseling with HIV testing to reduce sexual risk among men who have sex with men: Results from a randomized controlled trial using paraprofessional counselors.Journal of Acquired Immune Deficiency Syndromes. 2007,44:569–577. CrossRef
- Efficacy of a behavioral intervention for increasing safer sex behaviors in HIV-negative, heterosexual methamphetamine users: Results from the fast-lane study
Annals of Behavioral Medicine
Volume 34, Issue 3 , pp 263-274
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- 1. Department of Psychiatry (0680), University of California, San Diego, 9500 Gilman Drive, 92093-0680, La Jolla, CA
- 2. Veterans Affairs Center for Excellence on Stress and Mental Health, USA
- 3. Department of Family and Preventive Medicine, University of California, San Diego