AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #179 - HIV risk and treatment among opiate injectors
Authors: Presenting Author: Dr. Karen Corsi - University of Colorado Denver School of Medicine
Additional Authors: Dr. Sung-Joon Min, Mr. Mark Royer, Mr. Robert Booth,
Aim: This study examines two interventions for opiate-using injection drug users (IDUs). The two interventions are strengths-based case management (CM) vs. strengths-based case management plus a facilitated therapeutic alliance (CM/FTA). In the FTA, case managers facilitate a relationship between treatment counselors and clients. Outcomes include methadone treatment engagement and retention, and reduction of HIV risk.
Method / Issue: Four hundred and ten IDUs were recruited through street outreach in Denver from 2007-2010. Subjects were randomly assigned to receive either CM (n=205) or CM/FTA (n=205) intervention. There were no significant demographic or HIV risk differences at baseline between the participants assigned to CM vs. CM/FTA. Participants were 54% white, 74% male and averaged 41 years old. Two hundred and thirty-seven participants were followed at 6 months.
Results / Comments: Participants in the CM/FTA condition were significantly more likely to stay in treatment for more than 90 days than those in CM (74% vs. 48%, p=0.02). Treatment entry was associated with significantly more reduction in injection drug use in the 30 days prior to 6-month follow up (p<0.0001). When looking at baseline differences in treatment entry, those who entered treatment reported more heroin (p=0.001) and drug use (p=0.04) and were more likely to be employed (p<0.0001). For those who stayed in treatment for more than 90 days, they were significantly more likely to report a reduction in injection drug use (p=0.047) and HIV risk behavior (p=0.045) at 6-month follow up than those who left treatment before 90 days. This trend remained for women when analyzed separately. Finally, multiple logistic regression revealed that being employed (p=0.0001), injecting more heroin (p<0.0006) and not having sex with an IDU (p=0.045) at baseline predicted treatment entry.
Discussion: Evidence was found for the effectiveness of adding the FTA to CM for treatment retention. This study also shows the benefit of treatment entry and retention on HIV risk behaviors and drug use.
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