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Effect of Continuing Care for Cocaine Dependence on HIV Sex-Risk Behaviors

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Abstract

Evaluate the effect of continuing care interventions for cocaine use with HIV risk-reduction components on HIV sex-risk. Explore whether cocaine use at treatment initiation interacts with the type of continuing care intervention to affect HIV sex-risk. Cocaine dependent participants (N = 321) were randomized to: (1) Treatment as usual (TAU): intensive outpatient treatment, (2) TAU and telephone monitoring and counseling (TMC), and (3) TAU and TMC plus incentives for participation in telephone contacts (TMC+). Participants in TMC and TMC+ received a brief HIV intervention, with booster sessions as needed. Generalized estimating equations analysis compared TAU, TMC and TMC+ at 6, 12, 18, 24 months post-baseline on the following outcomes: overall HIV sex-risk, number of sexual partners, condom usage, exchange of drugs for sex, exchange of sex for drugs, exchange of money for sex, exchange of sex for money, and crack house visits. Overall sex-risk decreased for all treatment conditions at follow-up, with no treatment main effects. For people with no cocaine use at baseline, TAU experienced greater sex-risk reductions than TMC (p < .01) and TMC+ (p < .001). The three treatment conditions are effective in reducing HIV sex-risk. TMC with HIV risk-reduction components is unnecessary for cocaine-dependent clients who stop using cocaine early in treatment.

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Acknowledgments

We thank the management, clinical staffs and patients at NorthEast Treatment Centers and Presbyterian Hospital for collaborating on this research project.

Funding

This study was funded by National Institute on Drug Abuse Grants F31 DA038429, R01 DA020623, K02 DA000361, and K24 DA029062. Additional support was provided by the Center of Excellence in Substance Abuse Treatment and Education of the Department of Veterans Affairs.

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Authors and Affiliations

  1. School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA

    Alexandra S. Wimberly

  2. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Megan Ivey & James R. McKay

  3. Biomedical Graduate Studies, University of Pennsylvania, Philadelphia, PA, USA

    Lior Rennert

  4. Department of Behavioral Health, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA

    James R. McKay

Authors
  1. Alexandra S. Wimberly
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  2. Megan Ivey
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  3. Lior Rennert
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  4. James R. McKay
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Correspondence to Alexandra S. Wimberly.

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Conflict of Interest

Alexandra S. Wimberly declares that she has no conflict of interest. Megan Ivey declares that she has no conflict of interest. Lior Rennert declares that he has no conflict of interest. James R. McKay declares that he has no conflict of interest.

Ethical Approval

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. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

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

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Wimberly, A.S., Ivey, M., Rennert, L. et al. Effect of Continuing Care for Cocaine Dependence on HIV Sex-Risk Behaviors. AIDS Behav 21, 1082–1090 (2017). https://doi.org/10.1007/s10461-016-1434-6

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  • DOI: https://doi.org/10.1007/s10461-016-1434-6

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