AIDS and Behavior

, Volume 10, Issue 2, pp 115–130 | Cite as

Behavioral Interventions for HIV-Positive and HCV-Positive Drug users

Featured Review Article

The nature, context and frequency of use of various licit and illicit non-injection drugs associated with an elevated risk of HIV infection. Beyond HIV, a high proportion of HIV-infected IDUs are co-infected with HCV (hepatitis C virus). In this review, we provide a brief review of the epidemiology of these problems, discuss behavioral interventions that can reduce ongoing high risk behaviors among HIV-seropositive IDUs and MSM-DUs, and review the literature which has evaluated their effectiveness. The majority of these interventions have focused on HIV-seronegative heterosexuals and therefore need to be considered in this larger context; however, where possible we discuss the potential impact of these interventions among HIV-seropositive persons. In addition, we briefly discuss interventions which have the potential to simultaneously reduce ongoing transmission of both HIV and HCV. Finally, given the dearth of information on the effectiveness of behavioral interventions in reducing the burden of the HIV and HCV epidemics among persons already infected with either or both viruses, we describe some newer, promising interventions and offer suggestions for future studies.


Review Injection drug use Intervention Hepatitis C virus HIV/AIDS Homosexual men 


  1. Alter, M. J., Kruszon-Moran, D., Nainan, O. V., McQuillan, G. M., Gao, F., Moyer, L. A., Kaslow, R., and Margolis, H. S. (1999). The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. New England Journal of Medicine, 341, 556562.CrossRefPubMedGoogle Scholar
  2. Altice, F. L., Mezger, J. A., Hodges, J., Bruce, R. D., Marinovich, A., Walton, M., Springer, S. A., and Friedland, G. H. (2004). Developing a directly administered antiretroviral therapy intervention for HIV-infected drug users: implications for program replication. Clinical Infectious Diseases, 38, S376–S387.CrossRefPubMedGoogle Scholar
  3. Auerbach, J. D., and Coates, T. J. (2000). HIV prevention research: accomplishments and challenges for the third decade of AIDS. American Journal of Public Health, 90, 29–32.Google Scholar
  4. Ball, A. L. (2002). Overview: Policies and interventions to stem HIV-1 epidemics associated with injecting drug use. In G. Stimson, D. C. Des Jarlais, and A. Ball (Eds.), Drug Injecting and HIV Infection: Global Dimensions and Local Responses (pp. 201–232). London: UCL Press.Google Scholar
  5. Ball, J. C., Lange, W. R., Myers, C. P., and Friedman, S. R. (1988). Reducing the risk of AIDS through methadone maintenance treatment. Journal of Health and Social Behavior, 29, 214226.PubMedCrossRefGoogle Scholar
  6. Bastos, F. I., and Strathdee, S. A. (2000). Evaluating Effectiveness of Syringe Exchange Programmes: Current Issues and Future Prospects. Social Science & Medicine, 51, 17711782.CrossRefGoogle Scholar
  7. Beckett, M., Burnam, A., Collins, R. L., Kanouse, D. E., and Beckman, R. (2003). Substance use and high-risk sex among people with HIV: a comparison across exposure groups. AIDS and Behavior, 7, 209219.CrossRefPubMedGoogle Scholar
  8. Benotsch, E. G., Kalichman, S., and Cage, M. (2002). Men who have met sex partners via the Internet: prevalence, predictors, and implications for HIV prevention. Archives of Sexual Behavior, 31, 177–183CrossRefPubMedGoogle Scholar
  9. Bluthenthal, R. N., Kral, A. H., Gee, L., Erringer, E. A., and Edlin, B. R. (2000). The effect of syringe exchange use on high-risk injection drug users: a cohort study. AIDS, 14, 605611.CrossRefPubMedGoogle Scholar
  10. Booth, R. E., Crowley, and Zhang, Y. (1996). Substance abuse treatment entry, retention, and effectiveness: out-of-treatment opiate injection drug users. Drug and Alcohol Dependence, 42, 11–20CrossRefPubMedGoogle Scholar
  11. Brooks, J. S., Nomura, C., and Cohen, P. (1989). A network of influences on adolescent drug users involvement: Neighborhood, school, peer, and family. Genetic, Social, and General Psychology Monographs, 115, 125145.Google Scholar
  12. Brooner, R., Kidorf, M., King, V., Beilenson, P., Svikis, D., and Vlahov, D. (1998). Drug abuse treatment success among needle exchange participants. Public Health Reports, 113, 12939.PubMedGoogle Scholar
  13. Bruneau, J., Lamothe, F., Franco, E., Lachance, N., Desy, M., Soto, J., and Vincelette, J. (1997). High rates of HIV infection among injection drug users participating in needle exchange programs in Montreal: results of a cohort study. American Journal of Epidemiology, 146, 9941002.PubMedGoogle Scholar
  14. Bull, S. S., Piper, P., and Rietmeijer, C. (2002). Men who have sex with men and also inject drugs-profiles of risk related to the synergy of sex and drug injection behaviors. Journal of Homosexuality, 42, 3151.CrossRefPubMedGoogle Scholar
  15. Buning, E. C., Coutinho, R. A., van Brussel, G. H., van Santen, G. W., and van Zadelhoff, A. W. (1986). Preventing AIDS in drug addicts in Amsterdam. Lancet, 1, 1435.CrossRefPubMedGoogle Scholar
  16. Carrieri, M. P., Rey, D., Loundou, A., Lepeu, G., Sobel, A., Obadia, Y., and The MANIF-2000 Study Group (2003). Evaluation of buprenorphine maintenance treatment in a French cohort of HIV-infected injecting drug users. Drug and Alcohol Dependence, 72, 1321.CrossRefPubMedGoogle Scholar
  17. Catania, J. A., Morin, S. F., Canchola, J., Pollack, L., Chang, J., and Coates, T. J. (2000). Health care policy. U.S. priorities-HIV prevention. Science, 290, 717.CrossRefPubMedGoogle Scholar
  18. Celentano, D. D., Galai, N., Sethi, A. K., Shah, N. G., Strathdee, S. A., Vlahov, D., and Gallant, J. E. (2001). Time to initiating highly active antiretroviral therapy among HIV-infected injection drug users. AIDS, 15, 170715.CrossRefPubMedGoogle Scholar
  19. Celentano, D. D., Vlahov, D., Cohn, S., Anthony, J. C., Solomon, L., and Nelson, K. E. (1991). Risk factors for shooting gallery use and cessation among intravenous drug users. American Journal of Public Health, 81, 12911295.PubMedGoogle Scholar
  20. Celentano, D. D., Vlahov, D., Cohn, S., Shadle, V. M., Obasanjo, O., and Moore, R. D. (1998). Self-reported antiretroviral therapy in injection drug users. The Journal of the American Medical Association, 280, 5446.CrossRefGoogle Scholar
  21. Centers for Disease Control and Prevention. (2004). High-Risk Sexual Behavior by HIV-Positive Men Who Have Sex with Men — 16 Sites, United States, 2000–2002. Morbidity and Mortality Weekly Report, 53, 891–894. Scholar
  22. Chiasson, M. A., Stoneburner, R. L., Hildebrandt, D. S., Ewing, W. E., Telzak, E. E., and Jaffe, H. W. (1991). Heterosexual transmission of HIV-1 associated with the use of smokeable freebase cocaine (crack). AIDS, 9, 1121–1126.CrossRefGoogle Scholar
  23. Chng, C. L., and Geliga-Vargas, J. (2000). Ethnic identity, gay identity, sexual sensation seeking and HIV risk taking among multiethnic men who have sex with men. AIDS Education and Prevention, 12, 326339.PubMedGoogle Scholar
  24. Chu, P. L., McFarland, W., Gibson, S., Weide, D., Henne, J., Miller, P., Partridge, T., and Schwarcz, S. (2003). Viagra use in a community-recruited sample of men who have sex with men, San Francisco. Journal of Acquired Immune Deficiency Syndrome, 33, 1913.CrossRefGoogle Scholar
  25. Cleary, P. D., Van Devanter, N., Steilen, M., Stuart, A., Shipton-Levy, R., McMullen, W., Rogers, T. F., Singer, E., Avorn, J., and Pindyck, J. (1995). A randomized trial of an education and support program for HIV-infected individuals. AIDS, 9, 12711278.PubMedCrossRefGoogle Scholar
  26. Conway, B., Prasad, J., Reynolds, R. et. al. (2004). Directly Observed Therapy for the Management of HIV Infected Patients in a Methadone Program. Clinical Infectious Diseases, 38, S402–S408.CrossRefPubMedGoogle Scholar
  27. Copenhaver, M., Avants, S. K., Warburton, L. A., and Margolin, A. (2003). Intervening effectively with drug abusers infected with HIV: taking into account the potential for cognitive impairment. Journal of Psychoactive Drugs, 35, 20918.PubMedGoogle Scholar
  28. Crawford, I., Hammack, P. L., McKirnan, D. J., Ostrow, D., Zamboni, B. D., Robinson, B., and Hope, B. (2003). Sexual sensation seeking, reduced concern about HIV and sexual risk behaviour among gay men in primary relationships. AIDS Care, 15, 51324.CrossRefPubMedGoogle Scholar
  29. Crofts, N., Nigro, L., Oman, K., Stevenson, E., and Sherman, J. (1997). Methadone maintenance and hepatitis C virus infection among injecting drug users. Addiction, 92, 9991005.CrossRefPubMedGoogle Scholar
  30. Cross, J. E., Saunders, C. M., and Bartelli, D. (1998). The effectiveness of educational and needle exchange programs: a meta-analysis of HIV prevention strategies for injecting drug users. Quality and Quantity, 32, 165–180.CrossRefGoogle Scholar
  31. Deren, S., Beardsley, M., Tortu, S., and Goldstein, M. F. (1998). HIV serostatus and changes in risk behaviors among drug injectors and crack users. AIDS and Behavior, 2, 171176.CrossRefGoogle Scholar
  32. Des Jarlais, D. C. (1989). AIDS prevention programs for intravenous drug users: Diversity and evolutions. International Review of Psychiatry, 1, 101108.CrossRefGoogle Scholar
  33. Des Jarlais, D. C., Hagan, H., Friedman, S. R., Friedmann, P., Goldberg, D., Frischer, M., Green, S., Tunving, K., Ljungberg, B., Wodak, A., et al. (1995). Maintaining low HIV seroprevalence in populations of injecting drug users. The Journal of the American Medical Association, 274, 12261231.CrossRefGoogle Scholar
  34. Des Jarlais, D. C., Marmor, M., Friedmann, P., Titus, S., Aviles, E., Deren, S., Torian, L., Glebatis, D., Murrill, C., Monterroso, E., and Friedman, S. R. (2000). HIV incidence among injection drug users in New York City, 1992–1997: evidence for a declining epidemic. American Journal of Public Health, 90, 352359.PubMedGoogle Scholar
  35. Des Jarlais, D. C., Perlis, T., Arasteh, K., Hagan, H., Milliken, J., Braine, N., Yancovitz, S., Mildvan, D., Perlman, D. C., Maslow, C., and Friedman, S. R. (2004). Informed altruism” and “partner restriction” in the reduction of HIV infection in injecting drug users entering detoxification treatment in New York City, 1990–2001. Journal of Acquired Immune Deficiency Syndromes, 35, 158166.PubMedCrossRefGoogle Scholar
  36. Diamond, C., Thiede, H., Perdue, T., Secura, G. M., Valleroy, L., Mackellar, D., Corey, L. and Seattle Young Men's Survey Team. (2003). Viral hepatitis among young men who have sex with men: prevalence of infection, risk behaviors, and vaccination. Sexually Transmitted Diseases, 30, 42532.CrossRefPubMedGoogle Scholar
  37. DiScenza, S., Nies, M., and Jordan, C. (1996). Effectiveness of counseling in the health promotion of HIV-positive clients in the community. Public Health Nursing, 13, 209216.PubMedCrossRefGoogle Scholar
  38. Dolezal, C., Carballo-Dieguez, A., Nieves-Rosa, L., and Diaz, F. (2000). Substance use and sexual risk behavior: understanding their association among four ethnic groups of Latino men who have sex with men. Journal of Substance Abuse, 11, 32336.CrossRefPubMedGoogle Scholar
  39. Drucker, E., Lurie, P., Wodak, A., and Alcabes, P. (1998). Measuring harm reduction: the effects of needle and syringe exchange programs and methadone maintenance on the ecology of HIV. AIDS, 12, S217–S230.CrossRefPubMedGoogle Scholar
  40. Edlin, B. R., Irwin, K. L., Faruque, S., McCoy, C. B., Word, C., Serrano, Y., Inciardi, J. A., Bowser, B. P., Schilling, R. F., and Holmberg, S. D. (1994). Intersecting epidemics—crack cocaine use and HIV infection among inner-city young adults. New England Journal of Medicine, 331, 1422–1427.CrossRefPubMedGoogle Scholar
  41. Elliot, D. S., Huizinga, D., and Ageton, S. S. (1985). Explaining delinquency and drug use. Beverly Hills, CA: Sage.Google Scholar
  42. Fisher, J. D., and Fisher, W. A. (1992). Changing AIDS risk behavior. Psychological Bulletin, 111, 455474.CrossRefPubMedGoogle Scholar
  43. Fisher, J. D., and Misovich, S. J. (1990). Social influence and AIDS-preventive behaviors. In J. Edwards, R. Tindale, L. Heath, and E. Posavac (Eds.), Applying social influence processes in preventing social problems (pp. 39–70). New York: Plenum Press.Google Scholar
  44. Friedman, S. R., Des Jarlais, D. C., Sotheran, J. L., Garber, J., Cohen, H., and Smith, D. (1987). AIDS and self- organization among intravenous drug users. The International Journal of the Addictions, 23, 201219.Google Scholar
  45. Friedman, S. R., Jose, B., Neaigus, A., Goldstein, M., Curtis, R., Ildefonso, G., Mota, P., and Des Jarlais, D. C. (1994). Consistent condom use in relationships between seropositive injecting drug users and sex partners who do not inject drugs. AIDS, 8, 35761.PubMedCrossRefGoogle Scholar
  46. Galvan, F. H., Burnam, M. A., and Bing, E. G. (2003). Co-occurring psychiatric symptoms and drug dependence or heavy drinking among HIV-positive people. Journal of Psychoactive Drugs, 35, 15360.PubMedGoogle Scholar
  47. Garfein, R. S., Doherty, M. C., Monterroso, E. R., Thomas, D. L., Nelson, K. E., and Vlahov, D. (1998). Prevalence and incidence of hepatitis C virus infection among young adults injection drug users. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 8, S11–S19.Google Scholar
  48. Garfein, R. S., Vlahov, D., Galai, N., Doherty, M. C., and Nelson, K. E. (1996). Viral infections in short-term injection drug users; the prevalence of the hepatitis C, hepatitis B, human immunodeficiency virus, and human T-lymphotropic virus. American Journal of Public Health, 86, 655661.PubMedCrossRefGoogle Scholar
  49. Gerberding, J. (1995). Management of occupational exposure to blood borne viruses. New England Journal of Medicine, 332, 444451.CrossRefPubMedGoogle Scholar
  50. Gordon, C. M., Stall, R., and Cheever, L. W. (2004). Prevention interventions with persons living with HIV/AIDS: Challenges, Progress, and Research Priorities. Journal of acquired immune deficiency syndromes, 37, S53–S57.PubMedCrossRefGoogle Scholar
  51. Greenblatt, J. C., and Gfoerer, J. C. (1996). Methamphetamine abuse in the United States. Analysis of Substance Abuse and Treatment Need Issues. Rockville, MD: Substance Abuse and Mental Health Services Administration.Google Scholar
  52. Hagan, H., and Des Jarlais, D. C. (2000). HIV and HCV infection among injecting drug users. The Mount Sinai Journal of Medicine, 67, 4238.Google Scholar
  53. Hagan, H., DesJarlais, D. C., Friedman, S. R., Purchase, D., and Alter, M. J. (1995). Reduced risk of Hepatitis B and Hepatitis C among injection drug users in the Tacoma Syringe Exchange Program. American Journal of Public Health, 1531–1537.Google Scholar
  54. Hahn, J. A., Vranizan, K. M., and Moss, A. R. (1997). Who uses needle exchange? A study of injection drug users in treatment in San Francisco, 1989–1990. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 15, 15764.PubMedGoogle Scholar
  55. Halkitis, P. N., Parsons, J. T., and Wilton, L. (2003). Barebacking among gay and bisexual men in New York City: explanations for the emergence of intentional unsafe behavior. Archives of Sexual Behavior, 32, 3517.CrossRefPubMedGoogle Scholar
  56. Heimer, R. (1998). Can syringe exchange serve as a conduit to substance abuse treatment? Journal of Substance Abuse Treatment, 15, 18391.CrossRefPubMedGoogle Scholar
  57. Heimer, R., Khoshnood, K., Bigg, D., Guydish, J., and Jungue, B. (1998). Syringe use and reuse: effects of syringe exchange programs in four cities. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 18, S37.PubMedGoogle Scholar
  58. Holmberg, S. D. (1996). The estimated prevalence and incidence of HIV in 96 large US metropolitan areas. American Journal of Public Health, 86, 643654.Google Scholar
  59. Hubbard, R. L., Marsden, M. E., Cavanaugh, E., Rachal, J. V., and Ginzburg, H. M. (1988). Role of drug-abuse treatment in limiting the spread of AIDS. Reviews of Infectious Diseases, 10, 37784.PubMedGoogle Scholar
  60. Janssen, R. S., Holtgrave, D. R., Valdiserri, R. O., Shepherd, M., Gayle, H. D., and De Cock, K. M.(2001). The Serostatus Approach to Fighting the HIV Epidemic: prevention strategies for infected individuals. American Journal of Public Health, 91, 10191024.PubMedGoogle Scholar
  61. Johnson, R. E., Chutuape, M. A., Strain, E. C., Walsh, S. L., Stitzer, M. L., and Bigelow, G. E. (2000). A comparison of levomethadyl acetate, buprenorphine, and methadone for opioid dependence. New England Journal of Medicine, 343, 12901297.CrossRefPubMedGoogle Scholar
  62. Johnson, W. D., Hedges, L. V., Ramirez, G., Semaan, S., Norman, L. R., Sogolow, E., Sweat, M. D., and Diaz, R. M. (2002). HIV prevention research for men who have sex with men: A systematic review and meta-analysis. Journal of Acquired Immune Deficiency Syndromes, 30, S118–S129.PubMedGoogle Scholar
  63. Kalichman, S. C., Heckman, T., and Kelly, J. A. (1996). Sensation seeking as an explanation for the association between substance use and HIV-related risky sexual behavior. Archives of Sexual Behavior, 25, 14154.PubMedCrossRefGoogle Scholar
  64. Kalichman, S. C., Kelly, J. A., and Rompa, D. (1997). Continued high-risk sex among HIV seropositive gay and bisexual men seeking HIV prevention services. Health Psychology, 16, 369373.CrossRefPubMedGoogle Scholar
  65. Kalichman, S. C., Rompa, D., Cage, M., DiFonzo, K., Simpson, D., Austin, J., Luke, W., Buckles, J., Kyomugisha, F., Benotsch, E., Pinkerton, S., and Graham, J. (2001). Effectiveness of an intervention to reduce HIV transmission risks in HIV-positive people. American Journal of Preventive Medicine, 21, 8492.CrossRefPubMedGoogle Scholar
  66. Kalichman, S. C., Weinhardt, L., DiFonzo, K., Austin, J., and Luke, W. (2002). Sensation seeking and alcohol use as markers of sexual transmission risk behavior in HIV-positive men. Annals of Behavioral Medicine, 24, 22935.CrossRefPubMedGoogle Scholar
  67. Kim, A. A., Kent, C., McFarland, W., and Klausner, J. D. (2001). Cruising on the Internet highway. Journal of Acquired Immune Deficiency Syndrome, 28, 8993.Google Scholar
  68. Kosten, T., Oliveto, A., Feingold, A., Poling, J., Sevarino, K., McCance-Katz, E., Stine, S., Gonzalez, G., and Gonsai, K. (2003). Desipramine and contingency management for cocaine and opiate dependence in buprenorphine maintained patients. Drug and Alcohol Dependence, 70, 315–325CrossRefPubMedGoogle Scholar
  69. Kral, A. H., Bluthenthal, R. N., Lorvick, J., Gee, L., Bacchetti, P., and Edlin, B. R. (2001). Sexual transmission of HIV-1 among injection drug users in San Francisco, USA: risk-factor analysis. Lancet, 357, 13971401.CrossRefPubMedGoogle Scholar
  70. Langendam, M. W., van Brussel, G. H., Coutinho, R. A., and van Ameijden, E. J. (1999). Methadone maintenance treatment modalities in relation to incidence of HIV: results of the Amsterdam cohort study. AIDS, 13, 17111716.CrossRefPubMedGoogle Scholar
  71. Latkin, C. A., Forman, V., Knowlton, A., Hoover, D., Hatcher, M., and Celentano, D. D. (2001). Injection Drug Users' Disclosure of HIV Seropositive Status to Network Members. AIDS and Behavior, 5, 297–305.CrossRefGoogle Scholar
  72. Latkin, C. A., Forman-Hoffman, V. L., D'Souza, G., and Knowlton, A. R. (2004). Associations between medical service use and HIV risk among HIV-positive drug users in Baltimore, MD. AIDS Care, 16, 901908.CrossRefPubMedGoogle Scholar
  73. Latkin, C. A., Sherman, S. G., and Knowlton, A. (2003). HIV prevention among drug users: Outcome of a network-oriented peer outreach intervention. Health Psychology, 22, 332339.CrossRefPubMedGoogle Scholar
  74. Lau, J. T., Kim, J. H., Lau, M., and Tsui, H. Y. (2003). Prevalence and risk behaviors of Chinese men who seek same-sex partners via the internet in Hong Kong. AIDS Education and Prevention, 15, 51628.CrossRefPubMedGoogle Scholar
  75. Leigh, B. C. (2002). Alcohol and condom use: a meta-analysis of event-level studies. Sexually Transmitted Diseases, 29, 47682.CrossRefPubMedGoogle Scholar
  76. Loughlin, A., and Strathdee, S. A. (In Press). Hepatitis C infection among drug users enrolled in methadone maintenance program. The International Journal on Drug Policy.Google Scholar
  77. Lucas, G. M., Cheever, L. W., Chaisson, R. E., and Moore, R. D. (2001). Detrimental effects of continued illicit drug use on the treatment of HIV-1 infection. Journal of Acquired Immune Deficiency Syndromes, 27, 251259.PubMedGoogle Scholar
  78. Lucas, G. M., Weidle, P. J., Hader, S., Moore, R. D. (2004). Directly administered antiretroviral therapy in an urban methadone maintenance clinic: a nonrandomized comparative study. Clinical Infectious Diseases, 38, S409–S413.CrossRefPubMedGoogle Scholar
  79. Lurie, P., Gorsky, R., Jones, T. S., and Shomphe, L. (1998). An economic analysis of needle exchange and pharmacy-based programs to increase sterile syringe availability for injection drug users. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 18, S126–S132.PubMedGoogle Scholar
  80. Macalino, G. E., Mitty, J. A., Bazerman, L. B., Singh, K., McKenzie, M., and Flanigan, T. (2004). Modified directly observed therapy for the treatment of HIV-seropositive substance users: lessons learned from a pilot study. Clinical Infectious Diseases, 38, S393–S397.CrossRefPubMedGoogle Scholar
  81. MacGowan, R. J., Brackbill, R. M., Rugg, D. L., Swanson, N. M., Weinstein, B., Couchon, A., Scibak, J., Molde, S., McLaughlin, P., Barker, T., and Voigt, R. (1997). Sex, drugs and HIV counseling and testing: a prospective study of behavior-change among methadone-maintenance clients in New England. AIDS, 11, 22935.CrossRefPubMedGoogle Scholar
  82. Marmor, M., Friedman-Kien, A. E., Laubenstein, L., Byrum, R. D., William, D. C., D'Onofrio, S., and Dubin, N. (1982). Risk factors for Kaposi's sarcoma in homosexual men. Lancet, 15, 10837.CrossRefGoogle Scholar
  83. Mattison, A. M., Ross, M. W., Wolfson, T., Franklin, D., and the HIV Neurobehavioral Research Center Group (2001). Circuit party attendance, club drug use, and unsafe sex in gay men. Journal of Substance Abuse, 13, 11926.CrossRefPubMedGoogle Scholar
  84. McCance-Katz, E. F., Rainey, P. M., Friedland, G., and Jatlow, P. (2003). The protease inhibitor lopinavir-ritonavir may produce opiate withdrawal in methadone-maintained patients. Clinical Infectious Diseases, 37, 47682.CrossRefPubMedGoogle Scholar
  85. McCance-Katz, E. F., Rainey, P. M., Jatlow, P., and Friedland, G. (1998). Methadone effects on zidovudine disposition (AIDS Clinical Trials Group 262). Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 18, 43543.PubMedGoogle Scholar
  86. McCusker, J., Stoddard, A. M., Hindin, R. N., Garfield, F. B., and Frost, R. (1996). Changes in HIV risk behavior following alternative residential programs of drug abuse treatment and AIDS education. Annals of Epidemiology, 6, 119–125.CrossRefPubMedGoogle Scholar
  87. McMahon, R. C., Malow, R. M., Jennings, T. E., and Gomez, C. J. (2001). Effects of a cognitive-behavioral HIV prevention intervention among HIV negative male substance abusers in VA residential treatment. AIDS Education and Prevention, 13, 91107.CrossRefPubMedGoogle Scholar
  88. Meandzija, B., O'Connor, P. G., Fitzgerald, B., Rounsaville, B. J., and Kosten, T. R. (1994). HIV infection and cocaine use in methadone maintained and untreated intravenous drug users. Drug and Alcohol Dependence, 36, 10913.CrossRefPubMedGoogle Scholar
  89. Metsch, L. R., McCoy, C. B., Lai, S., and Miles, C. (1998). Continuing risk behaviors among HIV-seropositive chronic drug users in Miami, Florida. AIDS and Behavior, 2, 161169.CrossRefGoogle Scholar
  90. Metsch, L. R., Pereyra, M., and Brewer, T. H. (2001). Use of HIV health care in HIV-seropositive crack cocaine smokers and other active drug users. Journal of Substance Abuse, 13, 15567.CrossRefPubMedGoogle Scholar
  91. Metzger, D. S., and Navaline, H. (2003). Human immunodeficiency virus prevention and the potential of drug abuse treatment. Clinical Infectious Diseases, 37, S451–S456.CrossRefPubMedGoogle Scholar
  92. Metzger, D. S., Woody, G. E., McLellan, A. T., O'Brien, C. P., Druley, P., Navaline, H., DePhilippis, D., Stolley, P., Abrutyn, E. (1993). Human immunodeficiency virus seroconversion among in- and out-of-treatment intravenous drug users: an 18-month prospective follow-up. Journal of Acquired Immune Deficiency Syndromes, 6, 1049–1056.PubMedGoogle Scholar
  93. National Commission on AIDS. (1991). The twin epidemics of substance abuse and HIV. Washington, DC: National Commission on AIDS.Google Scholar
  94. National Consensus Development Panel on Effective Medical Treatment of Opiate Addiction. (1998). Effective medical treatment of opiate addiction. Journal of the American Medical Association, 280, 19361943.CrossRefGoogle Scholar
  95. NIH Consensus Statement. (1997). Interventions to prevent HIV risk behaviors. 15, 1–41Google Scholar
  96. Normand, J., Vlahov, D., and Moses, L. E. (1995). Preventing HIV transmission: the role of sterile needles and bleach. Washington, DC: National Academy Press.Google Scholar
  97. Office of the Surgeon General. (2000). Evidence-based findings on the efficacy of syringe exchange programs: an analysis from the Assistant Secretary for Health and Surgeon General of the scientific research completed since April 1998. Washington, DC: Office of the Surgeon General. Scholar
  98. Ompad, D. C., Fuller, C. M., Vlahov, D., Thomas, D., and Strathdee, S. A. (2002). Lack of behavior change after disclosure of hepatitis C virus infection among young injection drug users in Baltimore, Maryland. Clinical Infectious Diseases, 35, 783788.CrossRefPubMedGoogle Scholar
  99. Ostrow, D. E., Fox, K. J., Chmiel, J. S., Silvestre, A., Visscher, B. R., Vanable, P. A., Jacobson, L. P., and Strathdee, S. A. (2002). Attitudes towards highly active antiretroviral therapy are associated with sexual risk taking among HIV-infected and uninfected homosexual men. AIDS, 16, 775780.CrossRefPubMedGoogle Scholar
  100. Palepu, A., Tyndall, M. W., Li, K., Yip, B., O'Shaughnessy, M. V., Schechter, M. T., Montaner, J. S., and Hogg, R. S. (2003). Alcohol Use and Incarceration Adversely Affect HIV-1 RNA Suppression Among Injection Drug Users Starting Antiretroviral Therapy. Journal of Urban Health, 80, 66775.PubMedGoogle Scholar
  101. Parsons, J. T., and Halkitis, P. N. (2002). Sexual and drug-using practices of HIV-positive men who frequent public and commercial sex environments. AIDS Care, 14, 81526.CrossRefPubMedGoogle Scholar
  102. Parsons, J. T., Huszti, H. C., Crudder, S. O., Rich, L., and Mendoza, J. (2000). Maintenance of safer sexual behaviours: Evaluation of a theory-based intervention for HIV seropositive men with hemophilia and their female partners. Hemophilia, 6, 181197.CrossRefGoogle Scholar
  103. Patterson, T. L., and Semple, S. J. (2002). Reducing the Sexual Risk Behaviors of HIV-positive Individuals: Outcome of a Randomized Controlled Trial. Annals of Behavioral Medicine, 25.Google Scholar
  104. Prendergast, M. L., Urada, D., and Podus, D. J. (2001). Meta-analysis of HIV risk-reduction interventions within drug abuse treatment programs. Journal of Consulting and Clinical Psychology, 69, 389405.CrossRefPubMedGoogle Scholar
  105. Purcell, D. W., Metsch, L. R., Latka, M., Santibanez, S., and Gomez, C. A., Eldred, L., and Latkin, C. A. (2004). Interventions for seropositive injectors - Research and evaluation - An integrated behavioral intervention with HIV-positive injection drug users to address medical care, adherence, and risk reduction. Journal of Acquired Immune Deficiency Syndromes, 37, S110–S118.PubMedCrossRefGoogle Scholar
  106. Rhodes, T., and Hartnoll, R. (1996). AIDS, Drugs, and Prevention: Perspectives on Individual and Community Action. London: Routledge.Google Scholar
  107. Rippeth, J. D., Heaton, R. K., Carey, C. L., Marcotte, T. D., Moore, D. J., Gonzalez, R., Wolfson, T., Grant, I., and the HNRC group. (2004). Methamphetamine dependence increases risk of neuropsychological impairment in HIV infected persons. Journal of the International Neuropsychological Society, 10, 114.CrossRefPubMedGoogle Scholar
  108. Robles, R. R., Marrero, C. A., Reyes, J. C., Colon, H. M., Matos, T. D., Finlinson, H. A., Munoz, A., Melendez, M., and Sahai, H. (1998). Risk behaviors, HIV seropositivity, and tuberculosis infection in injecting drug users who operate shooting galleries in Puerto Rico. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 17, 47783.PubMedGoogle Scholar
  109. Ross, M. W., Mattison, A. M., and Franklin, D. R. (2003). Club drugs and sex on drugs are associated with different motivations for gay circuit party attendance in men. Substance Use & Misuse, 38, 117383.CrossRefGoogle Scholar
  110. Schechter, M. T., Strathdee, S. A., Cornelisse, P. G., Currie, S., Patrick, D. M., Rekart, M. L., and O'Shaughnessy, M. V. (1999). Do needle exchange programmes increase the spread of HIV among injection drug users?: An investigation of the Vancouver outbreak. AIDS, 13, F45–F51CrossRefPubMedGoogle Scholar
  111. Semaan, S., Des Jarlais, D. C., Sogolow, E., Johnson, W. D., Hedges, L. V., Ramirez, G., Flores, S. A., Norman, L., Sweat, M. D., and Needle, R. (2002). A meta-analysis of the effect of HIV prevention interventions on the sex behaviors of drug users in the United States. Journal of Acquired Immune Deficiency Syndromes, 30, S73–S93.CrossRefPubMedGoogle Scholar
  112. Semple, S. J., Patterson, T. L., and Grant, I. (2003). Binge Use of Methamphetamine Among HIV-positive Men Who Have Sex With Men: Pilot Data And HIV Prevention Implications. AIDS Education and Prevention, 15, 133–147CrossRefPubMedGoogle Scholar
  113. Shah, N., Celentano, D. D., Vlahov, D., Stambolis, V., Johnson, L., Nelson, K. E., and Strathdee, S. A. (2000). Correlates of enrollment in methadone maintenance programs differ by HIV-serostatus. AIDS, 14, 203543.CrossRefPubMedGoogle Scholar
  114. Stimson, G. V., and Choopanya, K. (1998). Global Perspectives on Drug Injecting. In G. V. Stimson, D. C. Des Jarlais, A. Ball (Eds.), Drug Injecting and HIV Infection: Global Dimensions and Local Responses (Social Aspects of AIDS) (pp.1–21). London: UCL Press.Google Scholar
  115. Strathdee, S. A., Celentano, D. D., Shah, N., Lyles, C., Macalino, G., Nelson, K., and Vlahov, D. (1999). Needle Exchange Attendance and Health Care Utilization Promote Entry into Detoxification. Journal of Urban Health, 76, 448460.CrossRefPubMedGoogle Scholar
  116. Strathdee, S. A., Galai, N., Safaiean, M., Celentano, D. D., Vlahov, D., Johnson, L., and Nelson, K. E. (2001). Sex differences in risk factors for HIV seroconversion among injection drug users: a 10-year perspective. Archives of Internal Medicine, 161, 12818.CrossRefPubMedGoogle Scholar
  117. Strathdee, S. A., Palepu, A., Cornelisse, P. G. A., Yip, B., O'Shaughnessy, M. V., Montaner, J. S. T., Schechter, M. T., and Hogg, R. S. (1998). Barriers to utilization of antiretroviral therapies among HIV-infected injection drug users in a universal health care setting. Journal of American Medical Association, 280, 547549.CrossRefGoogle Scholar
  118. Strathdee, S. A., Patrick, D. M., Archibald, C. P., Ofner, M., Cornelisse, P. G. A., Rekart, M. L., Schechter, M. T., and O'Shaughnessy, M. V. (1997). Social determinants predict needle sharing behaviour among injection drug users in Vancouver, Canada. Addiction, 92, 13391347.CrossRefPubMedGoogle Scholar
  119. Strauss, S. M., Des Jarlais, D. C., Astone, J., and Vassilev, Z. P. (2003). On-site HIV testing in residential drug treatment units: results of a nationwide survey. Public Health Reports, 118, 3743.PubMedGoogle Scholar
  120. Sylvestre, D. L. (2002). Treating hepatitis C in methadone maintenance patients: an interim analysis. Drug and Alcohol Dependence, 67, 117–123.CrossRefPubMedGoogle Scholar
  121. Sylvestre, D. L., Loftis, J. M., Hauser, P., Genser, S., Cesari, H., Borek, N., Kresina, T. F., Seeff, L., and Francis, H. (2004). Co-occurring Hepatitis C, substance use, and psychiatric illness: treatment issues and developing integrated models of care. Journal of Urban Health, 81, 71934.PubMedGoogle Scholar
  122. Thomas, D. L., Astemborski, J., Rai, R. M., Anania, F. A., Schaeffer, M., Galai, N., Nolt, K., Nelson, K. E., Strathdee, S. A., Johnson, L., Laeyendecker, O., Boitnott, J., Wilson, L. E., and Vlahov, D. (2000). The natural history of Hepatitis C virus infection: host, viral, and environmental factors. Journal of American Medical Association, 284, 450–456.CrossRefGoogle Scholar
  123. Tun, W., Celentano, D. D., Vlahov, D., and Strathdee, S. A. (2003). Attitudes toward HIV treatments influence unsafe sexual and injection practices among injecting drug users. AIDS, 17, 19531962.CrossRefPubMedGoogle Scholar
  124. Tyndall, M. W., Currie, S., Spittal, P., Li, K., Wood, E., O'Shaughnessy, M. V., and Schechter, M. T. (2003). Intensive injection cocaine use as the primary risk factor in the Vancouver HIV-1 epidemic. AIDS, 17, 88793.CrossRefPubMedGoogle Scholar
  125. U.S. General Accounting Office. (1993). Needle exchange programs: research suggests promise as an AIDS prevention strategy. Washington, DC: US Government Printing Office. (Publication no. GAO/HRD 93-60).Google Scholar
  126. Valleroy, L. A., MacKellar, D. A., Karon, J. M., Rosen, D. H., McFarland, W., Shehan, D. A., Stoyanoff, S. R., LaLota, M., Celentano, D. D., Koblin, B. A., Thiede, H., Katz, M. H., Torian, L. V., and Janssen, R. S. (2000). HIV prevalence and associated risks in young men who have sex with men. Young Men's Survey Study Group. Journal of American Medical Association, 284, 198204.CrossRefGoogle Scholar
  127. van Ameijden, E. J., and Coutinho, R. A. (2001). Large decline in injecting drug use in Amsterdam, 1986–1998: explanatory mechanisms and determinants of injecting transitions. Journal of Epidemiology and Community Health, 55, 356–363CrossRefPubMedGoogle Scholar
  128. van Beek, I., Dwyer, R., Dore, G. J., Luo, K., and Kaldor, J. M. (1998). Infection with HIV and hepatitis C virus among injecting drug users in a prevention setting: retrospective cohort study. British Medical Journal, 317, 433437.PubMedGoogle Scholar
  129. van Empelen, P., Kok, G., van Kesteren, N. M., van den Borne, B., Bos, A. E., and Schaalma, H. P. (2003). Effective methods to change sex-risk among drug users: a review of psychosocial interventions. Social Science & Medicine, 57, 1593608.CrossRefGoogle Scholar
  130. Vastag, B. (2001). Ecstasy experts want realistic messages. Journal of the American Medical Association, 286, 777.CrossRefPubMedGoogle Scholar
  131. Vertefeuille, J., Marx, M. A., Tun, W., Huettner, S., Strathdee, S. A., and Vlahov, D. (2000). Decline in Self-Reported High Risk Injection-Related Behaviors Among HIV Seropositive Participants in the Baltimore Needle Exchange Program. AIDS and Behavior, 4, 381388.CrossRefGoogle Scholar
  132. Vlahov, D., Junge, B., Brookmeyer, R., Cohn, S., Riley, E., Armenian, H., and Beilenson, P. (1997). Reductions in high-risk drug use behaviors among participants in the Baltimore needle exchange program. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 16, 400406.Google Scholar
  133. Warner, B. D., and Leukefeld, C. G. (2001). Assessing the differential impact of an HIV prevention intervention: who's putting the message into practice? AIDS Education and Prevention, 13, 479–94.CrossRefPubMedGoogle Scholar
  134. Weinhardt, L. S., Otto-Salaj, L. L., Brondino, M. J., Norberg, M. M., and Kalichman, S. C. (2002). Sex-related alcohol expectancies predict sexual risk behavior among severely and persistently mentally ill adults. Psychology of Addictive Behaviors, 16, 647.CrossRefPubMedGoogle Scholar
  135. Wolitski, R. J., Gomez, C. A., and Parsons, J. T. (2005a). Effects of a peer-led behavioral intervention to reduce HIV transmission and promote serostatus disclosure among HIV-seropositive gay and bisexual men. AIDS, 19, Suppl 1, S99–109.Google Scholar
  136. Wolitski, R. J., Parsons, J. T., Gomez, C. A. Purcell, D. W., Hoff, C. C., and Halkitis, P. N. (2005b). Prevention with gay and bisexual men living with HIV: rationale and methods of the Seropositive Urban Men's Intervention Trial (SUMIT). AIDS, 19 Suppl 1, S1–11.Google Scholar
  137. Woody, G. E., Donnell, D., Seage, G. R., Metzger, D., Marmor, M., Koblin, B. A., Buchbinder, S., Gross, M., Stone, B., and Judson, F. N. (1999). Non-injection substance use correlates with risky sex among men having sex with men: data from HIVNET. Drug & Alcohol Dependence, 53, 197205.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  1. 1.Division of International Health and Cross Cultural Medicine, Department of Family and Preventive MedicineUniversity of CaliforniaSan DiegoUSA
  2. 2.Department of PsychiatryUniversity of CaliforniaSan DiegoUSA

Personalised recommendations