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Reducing Sex Under the Influence of Drugs or Alcohol for Patients in Substance Abuse Treatment.

Addiction 2010;105(1):100-108. [doi: 10.1111/j.1360-0443.2009.02812.x]

Donald A. Calsyn, PhD (Alcohol & Drug Abuse Institute, University of Washington, PN Node), Paul Crits-Christoph, PhD (Treatment Research Center, University of Pennsylvania School of Medicine, DV Node), Mary A. Hatch-Maillette, PhD (Alcohol & Drug Abuse Institute, University of Washington, PN Node), Suzanne R. Doyle, PhD (Alcohol & Drug Abuse Institute, University of Washington, PN Node), Yong S. Song, PhD (SF VA Medical Center, CA/AZ Node), Susan Coyer (Prestera Center, OV Node), Sarah Pelta (University of California San Francisco, CA/AZ Node).

In a previous report (Calsyn et al, 2009), the effectiveness of the Real Men Are Safe (REMAS) intervention in reducing the number of unprotected sexual occasions among male drug abuse treatment patients was demonstrated. A secondary aim of REMAS was to reduce the frequency with which men engage in sex under the influence (SUI) of drugs or alcohol. Men in methadone maintenance (n=173) or outpatient psychosocial treatment (n=104) completed assessments at baseline, 3 and 6 months post-intervention. The participants were assigned randomly to attend either REMAS (five sessions containing information, motivational exercises and skills training, including one session specifically targeting reducing SUI) or human immunodeficiency virus (HIV) education (HIV-Ed; one session containing HIV prevention information). SUI during the most recent sexual event served as the primary outcome in a repeated measures logistic regression model. Men assigned to the REMAS condition reporting SUI at the most recent sexual event decreased from 36.8% at baseline to 25.7% at 3 months compared to an increase from 36.9% to 38.3% in the HIV-Ed condition. No difference between the treatment groups was evident at 6-month follow-up. At each assessment time-point, sex with a casual partner versus a regular partner, and being in methadone maintenance versus psychosocial outpatient treatment, were associated with engaging in SUI. In summary, this study found that REMAS, an intensive skills-based HIV prevention intervention, was associated with greater reduction of SUI among men in substance abuse treatment compared to standard HIV education at the 3-month follow-up. The REMAS intervention has now been shown to reduce the number of unprotected sexual intercourse occasions and SUI events, highlighting the effectiveness of HIV prevention interventions in substance abuse treatment settings that go beyond the typical informational-focused interventions. (Article, Peer-Reviewed, PDF, English, 2010)

Keywords: Community health services | Condom use | CTN primary outcomes | Gender-specific interventions | HIV/AIDS | Real Men Are Safe (REMAS) | Sexual risk behavior | Sexually transmitted diseases | Addiction (journal)

Document No: 368, PMID: 20078464, PMCID: PMC2808629.

Submitted by Don Calsyn, Lead Investigator for CTN-0018, 12/16/2009.

AUTHORS SEARCH LINK
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Crits-Christoph, Paul search mail
Doyle, Suzanne search mail
Hatch-Maillette, Mary A. search mail
Pelta, Sarah search
Song, Yong S. search mail
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Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
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