Case management for substance abusers with HIV/AIDS: a randomized clinical trial.
In a random assignment study, substance-abusing patients with HIV/AIDS in a public general hospital received a brief contact condition or received 12 months of case management delivered by paraprofessionals. Patient outcomes included substance use, HIV transmission risk, physical health, psychological status, and quality of living situation. In both conditions, a significant decrease occurred in a range of problems from Intake to the 6-month interview, followed by no significant pattern of change at 12- and 18-month interviews. On major outcome variables, there were no significant differences between the brief contact and case management conditions. Sixteen percent had died by the 18-month interview. Process data indicated wide variation in the amount of case management received by participants, and the amount of case management was not related to improvement in the outcome measures. The study has limitations yet does not support the hypothesis that case management improves outcomes better than brief contact for this population.
Department of Psychiatry, San Francisco General Hospital, University of California, San Francisco, California, USA. james@itsa.ucsf.edu
James L
JL
Sorensen
James
J
Dilley
Julie
J
London
Robert L
RL
Okin
Kevin L
KL
Delucchi
Ciaran S
CS
Phibbs
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000628:therapy; D000328:Adult; D019090:Case Management / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010352:Patient Dropouts; D018579:Patient Selection; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000150:complications* / Q000628:therapy; D016896:Treatment Outcome