Brief counseling for reducing sexual risk and bacterial STIs among drug users--results from project RESPECT.
OBJECTIVE
Project RESPECT's brief risk reduction counseling (BRRC) reduced sexual risk and bacterial STIs among at-risk heterosexuals and has been packaged for use with this population. We assessed BRRC's efficacy with RESPECT participants who used drugs and examined BRRC's applicability to present-day users of heroin, cocaine, speedball, or crack.


METHODS
We compared baseline demographic and economic variables, risk behaviors, and prevalence and correlates of bacterial STIs for ever-injectors ([EIs], N=335) and never-injectors ([NIs], N=3963). We assessed changes in risk behaviors and bacterial STIs for EIs and NIs at 12 months. We compared prevalence of HSV-2, hepatitis B core antigen virus (HBV), hepatitis C virus (HCV), and trichomonas among EIs with recently reported rates among drug users.


RESULTS
At baseline, 19% of EIs and 29% of NIs had bacterial STIs. Both groups had similar baseline STI correlates. At 12 months, 4% of EIs and 7% of NIs had bacterial STIs. Twelve-month cumulative incidence of bacterial STIs in BRRC was 21% lower among EIs and 18% lower among NIs compared to the informational condition. At 12 months, EIs reported fewer sexual risk behaviors than at baseline. Baseline positivity rates of trichomoniasis in EIs (female: 15%) and in male and female EIs of HSV-2 (39%, 68%), HBV (41%, 37%), and HCV (60%, 58%) were similar to rates in present-day drug users.


CONCLUSIONS
Efficacy of BRRC in reducing sexual risk and bacterial STIs in EIs, and similar profiles for EIs and present-day drug users suggest evaluating BRRC with present-day drug users.
Semaan
Salaam
S
Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Office of the Director, 1600 Clifton Rd, NE, E-07, Atlanta, GA 30333, United States. ssemaan@cdc.gov
Neumann
Mary Spink
MS
Hutchins
Kathleen
K
D'Anna
Laura Hoyt
LH
Kamb
Mary L
ML
D000328:Adult; D019970:Cocaine-Related Disorders / Q000150:complications / Q000523:psychology; D003376:Counseling; D005260:Female; D006526:Hepatitis C / Q000097:blood; D006556:Heroin Dependence / Q000150:complications / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012309:Risk-Taking; D012725:Sexual Behavior; D015231:Sexually Transmitted Diseases, Bacterial / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control*; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology*; D013587:Syphilis / Q000517:prevention & control