Reducing sex under the influence of drugs or alcohol for patients in substance abuse treatment
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Reducing sex under the influence of drugs or alcohol for patients in substance abuse treatment.

Calsyn D.A., Crits-Christoph P., Hatch-Maillette M.A. et al.
Addiction: 2010, 105(1), p. 100–108.
Unable to obtain a copy by clicking title? Try asking the author for a reprint by adapting this prepared e-mail or by writing to Dr Calsyn at You could also try this alternative source.

At issue was whether among men in treatment for substance use problems the standard one session of HIV education could be improved on by five sessions including motivational exercises and skills training. In the short term there were greater reductions in sex under the influence but these did not last.

Summary Aims 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 was to reduce the frequency with which men engage in sex under the influence of drugs or alcohol.

Design 173 men in methadone maintenance and 104 in outpatient psychosocial treatment completed assessments at baseline and three and six months after intervention.

Participants The participants were randomly assigned to attend either:
• REMAS, consisting of five sessions of information, motivational exercises and skills training, including one session targeted at reducing sex under the influence; or
• one session of human immunodeficiency virus (HIV) education offering prevention information.

Sex under the influence during the most recent sexual event served as the primary outcome in a repeated measures logistic regression model.

Findings The proportion of men assigned to REMAS who reported sex under the influence at the most recent sexual event decreased from 36.8% at baseline to 25.7% at three months compared to an increase from 36.9% to 38.3% among those assigned to HIV education, a statistically significant difference. No difference between the groups was evident at the six-month follow-up. At each assessment, sex with a casual partner versus a regular partner, and being in methadone maintenance versus psychosocial outpatient treatment, were associated with engaging in sex under the influence.

Conclusions Overall, a motivational and skills training HIV prevention intervention designed for men was associated with greater reduction in sex under the influence than standard HIV education at the three-month follow-up.

Last revised 07 March 2011

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