title: HIV testing and sexual risk reduction counseling in office-based buprenorphine/naloxone treatment.
abstract: OBJECTIVE
  We assessed the feasibility and preliminary efficacy of human immunodeficiency virus (HIV) testing with sexual risk reduction counseling for opioid-dependent patients initiating office-based buprenorphine/naloxone treatment.
  
  
  METHODS
  We conducted a 14-week randomized, controlled trial with 30 patients (original target of 114) assigned to receive buprenorphine/naloxone induction/stabilization and HIV testing with Brief Sexual Risk Management (BSRM) or Enhanced Sexual Risk Management (ESRM). We evaluated process measures and compared outcomes at baseline and during the 3-month follow-up.
  
  
  RESULTS
  Similar proportions of patients receiving BSRM and ESRM underwent HIV testing (93% vs 80%; P = 0.28) and completed counseling sessions (80% vs 67%; P = 0.40). Brief Sexual Risk Management sessions were shorter than ESRM sessions (15.4 vs 23.4 minutes), with comparable manual adherence (P = 0.80). Outcomes did not vary by BSRM versus ESRM.
  
  
  CONCLUSIONS
  Although the recruitment of opioid-dependent patients with sexual risk behaviors is challenging, HIV testing with sexual risk reduction counseling in office-based buprenorphine/naloxone treatment practice is feasible. Interventions to decrease sexual risk behaviors among a segment of this population are necessary.
authors.affiliation: From the Department of Internal Medicine (EJE, SC, DAF, LEF), Yale School of Medicine, New Haven, CT; Center for Interdisciplinary Research on AIDS (EJE, DAF, LEF), Yale School of Public Health, New Haven, CT; Department of Psychiatry (BAM, SC, RSS), Yale School of Medicine, New Haven, CT; Departments of Psychology, Neuroscience and Global Health, Psychiatry and Behavioral Science (KJS), Duke University, Durham, NC; and Department of Adult and Family Medicine (ESJ), The Permanente Medical Group, Oakland, CA.
authors.forename: E Jennifer
authors.initials: EJ
authors.lastname: Edelman
authors.forename: Brent A
authors.initials: BA
authors.lastname: Moore
authors.forename: Sarah
authors.initials: S
authors.lastname: Caffrey
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Sikkema
authors.forename: Emlyn S
authors.initials: ES
authors.lastname: Jones
authors.forename: Richard S
authors.initials: RS
authors.lastname: Schottenfeld
authors.forename: David A
authors.initials: DA
authors.lastname: Fiellin
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Fiellin
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use*; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology; D006801:Humans; D008297:Male; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods; D040242:Risk Reduction Behavior; D012731:Sex Counseling / Q000379:methods*; D012725:Sexual Behavior; D016896:Treatment Outcome
chemical_list: D009292:Narcotic Antagonists; D009270:Naloxone; D002047:Buprenorphine