Annals of Behavioral Medicine

, Volume 34, Issue 3, pp 263–274

Efficacy of a behavioral intervention for increasing safer sex behaviors in HIV-negative, heterosexual methamphetamine users: Results from the fast-lane study

  • Brent T. Mausbach
  • Shirley J. Semple
  • Jim Zians
  • Thomas L. Patterson
  • Steffanie A. Strathdee
Article

Abstract

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.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. (1).
    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.PubMedCrossRefGoogle Scholar
  2. (2).
    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.CrossRefGoogle Scholar
  3. (3).
    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.PubMedCrossRefGoogle Scholar
  4. (4).
    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.PubMedCrossRefGoogle Scholar
  5. (5).
    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.CrossRefGoogle Scholar
  6. (6).
    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.PubMedGoogle Scholar
  7. (7).
    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.Google Scholar
  8. (8).
    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.PubMedCrossRefGoogle Scholar
  9. (9).
    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.PubMedCrossRefGoogle Scholar
  10. (10).
    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.PubMedCrossRefGoogle Scholar
  11. (11).
    Jemmott LS, Jemmott JB III: Increasing condom-use intentions among sexually active black adolescent women.Nursing Research. 1992,41:273–279.PubMedGoogle Scholar
  12. (12).
    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.PubMedCrossRefGoogle Scholar
  13. (13).
    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.Google Scholar
  14. (14).
    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.PubMedCrossRefGoogle Scholar
  15. (15).
    Miller WR, Rollnick S:Motivational Interviewing: Preparing People to Change Addictive Behavior. New York: Guilford, 1991.Google Scholar
  16. (16).
    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.PubMedCrossRefGoogle Scholar
  17. (17).
    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.Google Scholar
  18. (18).
    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.PubMedCrossRefGoogle Scholar
  19. (19).
    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.PubMedCrossRefGoogle Scholar
  20. (20).
    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.PubMedCrossRefGoogle Scholar
  21. (21).
    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.CrossRefGoogle Scholar
  22. (22).
    Hawkins DA: Oral sex and HIV transmission.Sexually Transmitted Infections. 2001,77:307–308.PubMedCrossRefGoogle Scholar
  23. (23).
    Gilbart VL, Evans BG, Dougan S: HIV transmission among men who have sex with men through oral sex.Sexually Transmitted Infections. 2004,80:324.PubMedCrossRefGoogle Scholar
  24. (24).
    Dolan JP:Negotiate Like the Pros. New York: Perigee, 1992.Google Scholar
  25. (25).
    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.Google Scholar
  26. (26).
    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.Google Scholar
  27. (27).
    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.CrossRefGoogle Scholar
  28. (28).
    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.PubMedCrossRefGoogle Scholar
  29. (29).
    Holmbeck GN: Post-hoc probing of significant moderational and mediational effects in studies of pediatric populations.Journal of Pediatric Psychology. 2002,27:87–96.PubMedCrossRefGoogle Scholar
  30. (30).
    MacKinnon DP, Dwyer JH: Estimating mediated effects in prevention studies.Evaluation Review. 1993,17:144–158.CrossRefGoogle Scholar
  31. (31).
    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.Google Scholar
  32. (32).
    Bandura A:Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall, 1986.Google Scholar
  33. (33).
    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.PubMedCrossRefGoogle Scholar
  34. (34).
    Maglione M, Chao B, Anglin MD: Methamphetamine abuse in California: Correlates of injection use.AIDS and Behavior. 1998,2:257–261.CrossRefGoogle Scholar
  35. (35).
    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.PubMedCrossRefGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2007

Authors and Affiliations

  • Brent T. Mausbach
    • 1
    • 2
  • Shirley J. Semple
    • 1
  • Jim Zians
    • 1
  • Thomas L. Patterson
    • 1
  • Steffanie A. Strathdee
    • 3
  1. 1.Department of Psychiatry (0680)University of California, San DiegoLa Jolla
  2. 2.Veterans Affairs Center for Excellence on Stress and Mental HealthUSA
  3. 3.Department of Family and Preventive MedicineUniversity of CaliforniaSan Diego

Personalised recommendations