title: Continuation of high-risk behavior by HIV-positive drug users. Treatment implications.
abstract: Drug users who are positive for the human immunodeficiency virus (HIV) represent a major vector of HIV transmission, yet relatively little is known about their continued drug- and sex-related HIV-risk behavior, which may impede the development of effective risk-reduction interventions. In this study, 50 HIV-seropositive injection drug users entering methadone maintenance treatment completed a comprehensive risk assessment battery, including self-report of HIV-risk behavior since learning HIV serostatus, and measures of risk-reduction information, motivation, and behavioral skills. We found that a disconcertingly high proportion of patients (66%) reported having engaged in HIV-risk behavior since learning their HIV-seropositive status. Level of HIV-related knowledge did not predict high-risk behavior. Drug-related risk behavior was predicted by psychiatric severity and poor behavioral skills. Sex-related risk was predicted by low levels of motivation and poor behavioral skills. Implications of these findings for treatment are discussed.
authors.affiliation: Substance Abuse Center, Yale University School of Medicine, New Haven, CT 06519, USA. kelly.avants@yale.edu
authors.forename: S K
authors.initials: SK
authors.lastname: Avants
authors.forename: L A
authors.initials: LA
authors.lastname: Warburton
authors.forename: K A
authors.initials: KA
authors.lastname: Hawkins
authors.forename: A
authors.initials: A
authors.lastname: Margolin
mesh_terms: D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009293:Opioid-Related Disorders / Q000150:complications* / Q000523:psychology / Q000534:rehabilitation; D012008:Recurrence; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology*; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data