title: Sex, drugs and HIV counseling and testing: a prospective study of behavior-change among methadone-maintenance clients in New England.
abstract: OBJECTIVE
  To determine whether changes in injecting drug use and sexual behavior over a 12-month follow-up are associated with HIV counseling and testing (C and T) of injecting drug users in methadone maintenance treatment programs (MMTP) in Massachusetts and Connecticut.
  
  
  METHODS
  Clients were invited to participate in a longitudinal study involving five interviews. Data were also obtained by ethnographers and from clinical records. Behavioral outcomes of interest were number of drug injections, sharing of unclean 'works' (injecting equipment), number of unprotected sex partners, and number of unprotected sexual episodes. Data analyses included multiple regression, odds ratios, and quantitative analysis of text-based data.
  
  
  RESULTS
  Subjects reported reductions in both injecting drug use and sexual behavior Primary associations with reduced injecting drug use were remaining in the MMTP and attending HIV-positive support groups. A reduction in high-risk sexual behavior was associated with an HIV-positive test result and duration of HIV counseling in the MMTP. Increase in drug injecting use was associated with an HIV-positive test result. Inconsistent condom use was associated with enrollment in the MMTP where condoms were available only upon request and abstinence and monogamy between uninfected partners were promoted.
  
  
  CONCLUSIONS
  Injecting drug users who self-select to participate in MMTP and HIV C and T, two public health HIV-prevention interventions, reduce their HIV-risk behaviors. Clients should be encouraged to remain in MMTP and HIV-infected clients should attend support groups for HIV-positive persons. MMTP staff should promote a variety of safer sex behaviors and provide condoms without request.
authors.affiliation: National Center for HIV/STD/TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: MacGowan
authors.forename: R M
authors.initials: RM
authors.lastname: Brackbill
authors.forename: D L
authors.initials: DL
authors.lastname: Rugg
authors.forename: N M
authors.initials: NM
authors.lastname: Swanson
authors.forename: B
authors.initials: B
authors.lastname: Weinstein
authors.forename: A
authors.initials: A
authors.lastname: Couchon
authors.forename: J
authors.initials: J
authors.lastname: Scibak
authors.forename: S
authors.initials: S
authors.lastname: Molde
authors.forename: P
authors.initials: P
authors.lastname: McLaughlin
authors.forename: T
authors.initials: T
authors.lastname: Barker
authors.forename: R
authors.initials: R
authors.lastname: Voigt
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003237:Connecticut; D003376:Counseling; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008404:Massachusetts; D008691:Methadone / Q000627:therapeutic use*; D011446:Prospective Studies; D012725:Sexual Behavior; D012747:Sexual Partners; D015819:Substance Abuse, Intravenous / Q000523:psychology* / Q000534:rehabilitation
chemical_list: D008691:Methadone