Reducing sex under the influence of drugs or alcohol for patients in substance abuse treatment.
OBJECTIVE
In a previous report, 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.


METHODS
Men in methadone maintenance (n = 173) or out-patient psychosocial treatment (n = 104) completed assessments at baseline, 3 and 6 months post-intervention.


METHODS
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.


RESULTS
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 a increase from 36.9% to 38.3% in the HIV-Ed condition (t(intervention) = -2.16, P = 0.032). 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 out-patient treatment, were associated with engaging in SUI.


CONCLUSIONS
Overall, a motivational and skills training HIV prevention intervention designed for men was associated with greater reduction in SUI than standard HIV education at the 3-month follow-up.
Calsyn
Donald A
DA
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98105, USA. calsyn@u.washington.edu
Crits-Christoph
Paul
P
Hatch-Maillette
Mary A
MA
Doyle
Suzanne R
SR
Song
Yong S
YS
Coyer
Susan
S
Pelta
Sara
S
D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D009042:Motivation; D009294:Narcotics / Q000627:therapeutic use; D015397:Program Evaluation; D012309:Risk-Taking; D012736:Sex Education / Q000379:methods*; D012725:Sexual Behavior / Q000187:drug effects / Q000523:psychology / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome
D009294:Narcotics; D008691:Methadone