Cocaine abuse counseling as HIV prevention

The current study evaluated the efficacy of cocaine abuse counseling alone as a strategy to reduce HIV-related sexual risk behaviors. Participants were 232 cocaine-abusing or dependent individuals who received up to 26 weeks of Matrix counseling but no formal HIV-prevention interventions. One hundred fifty-seven (67.6%) participants completed assessments at admission, during treatment, and at 6 months following admission. Participants located for follow-up were significantly more likely to be Caucasian, to be better educated, and to complete longer treatment episodes than those not located. Main study findings indicated a statistically significant association between safer sex behavior and completion of a cocaine abuse counseling episode (chi 2 (2, n = 157) = 6.25, p < .05). Participants who completed counseling were more likely to change to safer sex or maintain safer sex over the 6-month period than participants who terminated counseling prematurely. The primary method for reducing sexual risk involved overall decreases in reported numbers of partners (Partners-baseline = 5.32, SD = 6.25; Partners6 Months = 2.47, SD = 2.62; F(1, 132) = 36.32, p < .001) among this group of mostly heterosexual (89.9%), Caucasian (69.0%), crack cocaine users (65.6%). We concluded that cocaine abuse counseling is a powerful intervention for reducing HIV-related sexual behaviors in this group at high risk for exposure to HIV. Study findings suggested that efforts to evaluate HIV prevention programs must also account for the effect of drug counseling.