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Examining the Efficacy of HIV Risk-Reduction Counseling on the Sexual Risk Behaviors of a National Sample of Drug Abuse Treatment Clients: Analysis of Subgroups

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Abstract

HIV counseling with testing has been part of HIV prevention in the U.S. since the 1980s. Despite the long-standing history of HIV testing with prevention counseling, the CDC released HIV testing recommendations for health care settings contesting benefits of prevention counseling with testing in reducing sexual risk behaviors among HIV-negatives in 2006. Efficacy of brief HIV risk-reduction counseling (RRC) in decreasing sexual risk among subgroups of substance use treatment clients was examined using multi-site RCT data. Interaction tests between RRC and subgroups were performed; multivariable regression evaluated the relationship between RRC (with rapid testing) and sex risk. Subgroups were defined by demographics, risk type and level, attitudes/perceptions, and behavioral history. There was an effect (p < .0028) of counseling on number of sex partners among some subgroups. Certain subgroups may benefit from HIV RRC; this should be examined in studies with larger sample sizes, designed to assess the specific subgroup(s).

Resumen

Consejería con pruebas de VIH han sido parte de la prevención de VIH en los EE.UU. desde los 1980s. A pesar de una larga historia de pruebas de VIH con consejería sobre prevención, en el 2006 el CDC publicó una serie de recomendaciones para los centros de atención de salud disputando los beneficios de la consejería sobre prevención con pruebas para la reducción de comportamientos sexuales de riesgo entre personas VIH-negativas. Se examinó la eficacia de la consejería breve sobre reducción de riesgo (RRC, por sus siglas en inglés) de VIH en la disminución del riesgo sexual entre subgrupos de pacientes en tratamiento de uso de sustancias utilizando datos de un ensayo clínico multi-centro. Se realizaron pruebas de interacción entre RCC y los subgrupos; una regresión multivariada donde se evaluó la relación entre RCC (con pruebas rápida) y riesgo sexual. Los subgrupos fueron definidos por las características sociodemográficas, tipo y nivel de riesgo, actitudes/percepciones e historial de comportamiento. Se encontró que la consejería tuvo efecto (p < .0028) en el número de parejas sexuales entre algunos subgrupos. Ciertos subgrupos podrían beneficiarse de RRC de VIH; esto debe ser examinado en estudios con muestras más grandes, diseñados para evaluar subgrupos específicos.

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Acknowledgments

Funding for this study was provided by the National Drug Abuse Treatment Clinical Trials Network under the following cooperative agreements, awards, and contracts: U10DA013720, U10DA13720-09S, U10DA020036, U10DA15815, U10DA13034, U10DA013038, U10DA013732, U10DA13036, U10DA13727, U10DA015833, HHSN271200522081C, and HHSN271200522071C. Lisa R. Metsch, Ph.D. and Grant N. Colfax, M.D. were the Lead Investigators of the parent trial. Lauren Gooden, Lisa R. Metsch, Margaret R. Pereyra, C. Kevin Malotte, Louise F. Haynes, Antoine Douaihy, Jacky Chally and Daniel J. Feaster reported that their respective institutions received grant funds from the study sponsor in support of this study.

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Authors and Affiliations

  1. Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA

    Lauren Gooden, Lisa R. Metsch & Margaret R. Pereyra

  2. Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA

    Lauren Gooden, Lisa R. Metsch, Margaret R. Pereyra & Daniel J. Feaster

  3. Department of Health Science, California State University, Long Beach, CA, USA

    C. Kevin Malotte

  4. Department of Psychiatry and Behavioral Science, Medical University of South Carolina, Charleston, SC, USA

    Louise F. Haynes

  5. University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Antoine Douaihy

  6. Johns Hopkins University, Baltimore, MD, USA

    Jack Chally

  7. EMMES Corporation, Inc., Rockville, MD, USA

    Jack Chally

  8. National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA

    Raul N. Mandler

  9. Department of Sociomedical Sciences, Mailman School of Public Health, Miami Research Center, Columbia University, 1120 NW 14th Street, Room 1030, Miami, FL, 33136, USA

    Lauren Gooden & Margaret R. Pereyra

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Correspondence to Lauren Gooden.

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Conflict of interest

LG, LRM, MRP, CKM, LFH, AD, JC and DJF reported that their respective institutions received grant funds from the study sponsor in support of this study. LG, LRM, AD, and JC reported that their respective institutions received support for travel related to this study. LG and JC reported that they and their respective institutions received funding from other grants from the study sponsor. No other disclosures were reported.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Western Institutional Review Board (WIRB) reviewed and approved all procedures related to the parent trial.

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Informed consent was obtained from all individual participants included in the study.

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Gooden, L., Metsch, L.R., Pereyra, M.R. et al. Examining the Efficacy of HIV Risk-Reduction Counseling on the Sexual Risk Behaviors of a National Sample of Drug Abuse Treatment Clients: Analysis of Subgroups. AIDS Behav 20, 1893–1906 (2016). https://doi.org/10.1007/s10461-016-1300-6

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