The Impact of a Brief Motivational Intervention on Unprotected Sex and Sex While High Among Drug-Positive Emergency Department Patients Who Receive STI/HIV VC/T and Drug Treatment Referral as Standard of Care
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This randomized, controlled trial, conducted among out-of-treatment heroin/cocaine users at an emergency department visit, tests the impact on sexual risk of adding brief motivational intervention (B-MI) to point-of-service testing, counseling and drug treatment referral. 1,030 enrollees aged 18–54 received either voluntary counseling/testing (VC/T) with drug treatment referral, or VC/T, referral, and B-MI, delivered by an outreach worker. We measured number and proportion of non-protected sex acts (last 30 days) at 6 and 12 months (n = 802). At baseline, 70% of past-30-days sex acts were non-protected; 35% of sex acts occurred while high; 64% of sexual acts involved main, 24% casual and 12% transactional sex partners; 1.7% tested positive for an STI, and 8.8% for HIV. At six or 12 month follow-up, 20 enrollees tested positive for Chlamydia and/or Gonorrhea, and 6 enrollees HIV sero-converted. Self-reported high-risk behaviors declined in both groups with no significant between-group differences in behaviors or STI/HIV incidence.
KeywordsHIV Emergency department Brief motivational intervention Sexual behavior risk
Supriya Mehta, PhD was instrumental in the development of this proposal, but left Boston University for employment elsewhere shortly after the study began. We thank the patients for their participation in this study. The study was supported by a grant from the National Institute of Drug Abuse, NIH; RO1 DA017061. We acknowledge the dedicated contributions of Study Coordinators Ann Valentine, MPH, Desire Ashong, MPH, and Whitney Holmer, MD, Follow-up Coordinator Belinda Gilmere, and Research Assistants Michael Aguiar, Manuel Andrade, William Atherton, Jephthe Barthe, Ruben Codero, Jasmine Cromwell, Michelson Dorime, Helen Fassil, Darius Franklin, Richard Frazier, Suzanne Garverich, Robin Goffigan, Gregory Hastings, Judy Headley, Robert Johnson, Nicolasa Lopez, Yvonne Martinez, Jamilah Kim Mason, Virginia Mojica, Allison Molenda, Esosa Ogboghodo, Melissa Rambaud, Miguel Risco, Raymond Rodriguez, Devorath Ruiz, Stephanie Stapleton, Pamela Talbert, Kathy Vazquez, and Ebonie Woolcock, MD. Drs. Anita Raj and Katherine Tassiopoulos generously provided comments and suggestions.
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