title: Couple-based HIV prevention for low-income drug users from New York City: a randomized controlled trial to reduce dual risks.
abstract: OBJECTIVE
  Dual threats of injection drug use and risky sexual practices continue to increase transmission of HIV and other sexually transmitted Infections (STIs) among drug-using couples in low-income communities in the United States. Two hypotheses were tested: (1) "intervention effect"-whether the HIV risk-reduction intervention provided to the couple or individual partners would be more efficacious in decreasing number of unprotected sexual acts and having a lower cumulative incidence of biologically confirmed STIs over the 12-month follow-up period compared with the attention control condition; and (2) "modality effect"-whether the HIV risk-reduction intervention would be more likely to decrease the number of unprotected sexual acts and have a lower cumulative STI incidence when delivered to a couple compared with the same intervention delivered to an individual.
  
  
  METHODS
  Using a randomized controlled trial, 282 HIV-negative drug-using couples (564 individuals) were randomly assigned to receive either of the following: (1) couple-based risk reduction; (2) individual-based HIV risk reduction, or (3) couple-based wellness promotion, which served as an attention control condition.
  
  
  RESULTS
  Over 12-month follow-up, there was a 30% reduction in the incidence rate of unprotected acts of intercourse with the study partners compared with participants in the attention control arm. Moreover, over 12-month follow-up there was a 29% reduction in the same outcome in the couple arm compared with the individual arm with a 41% reduction at the 12-month follow-up.
  
  
  CONCLUSIONS
  A couple-based approach that addresses drug and sexual risks and targets low-income active drug users may help curb the HIV epidemic.
authors: Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY 10023, USA. ne5@columbia.edu
authors: Nabila
authors: N
authors: El-Bassel
authors: Louisa
authors: L
authors: Gilbert
authors: Elwin
authors: E
authors: Wu
authors: Susan S
authors: SS
authors: Witte
authors: Mingway
authors: M
authors: Chang
authors: Jennifer
authors: J
authors: Hill
authors: Robert H
authors: RH
authors: Remien
mesh_terms: D000328:Adult; D055030:Drug Users; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D009519:New York City; D011203:Poverty; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D057566:Self Report; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D015819:Substance Abuse, Intravenous / Q000517:prevention & control*; D047568:Unsafe Sex / Q000517:prevention & control*
chemical_list: D013287:Illicit Drugs