title: Trajectory of substance use after an HIV risk reduction intervention.
abstract: BACKGROUND
  Research assessments can confound the results of treatment outcome studies and can be themselves an intervention or form of aftercare.
  
  
  OBJECTIVE
  To determine the trajectory of substance use and substance severity in a sample of African American cocaine users participating in a community-based sexual risk reduction trial.
  
  
  METHODS
  Out-of-treatment participants were recruited using Respondent-Driven Sampling in two African American majority counties in rural Arkansas. They participated in either the sexual risk reduction condition or an active control focused on access to social services. They were interviewed at baseline, post-intervention, and 6 and 12 months post-intervention. Substance use outcome measures were use of crack cocaine, powder cocaine, marijuana, alcohol, and the Addiction Severity Index Alcohol and Drug Severity composites. A random sample of participants completed qualitative interviews post-12-month interview.
  
  
  RESULTS
  251 were enrolled. Substance use outcomes did not differ among the two conditions at any point in the study. Use of measured substances and the ASI composites significantly decreased between baseline and post-intervention (p < 0.01), decreases that persisted at the 12-month assessment period compared to baseline. Qualitative findings suggested that many participants identified increased awareness of their drug use and need to control it through the programs. Participants also noted strong bonding with interviewers.
  
  
  CONCLUSIONS
  Clinical trials may have positive unexpected outcomes in terms of reduced substance use even though the trial is not substance use focused. Behavioral interventions for drug users that are not focused specifically on reducing drug use may nonetheless have unanticipated positive associations with reductions in drug use.
authors.affiliation: Department of Psychiatry .
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Booth
authors.forename: Patricia B
authors.initials: PB
authors.lastname: Wright
authors.forename: Songthip T
authors.initials: ST
authors.lastname: Ounpraseuth
authors.forename: Katharine E
authors.initials: KE
authors.lastname: Stewart
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D001131:Arkansas / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology; D040242:Risk Reduction Behavior; D012947:Social Work / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology*; D047568:Unsafe Sex / Q000517:prevention & control
keywords: Assessment effects; natural history; reactivity effects; trajectories