The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64529

C. Amalia Marrero, MPH, Rafaela R. Robles, EdD, Héctor M. Colón, PhD, Juan C. Reyes, EdDc, and Tomás D. Matos, MS. Center for Addiction Studies, School of Medicine, Universidad Central del Caribe, PO Box 60327, Bayamón, PR 00960-6032, 787-288-0200, amarrero@uccaribe.edu

Introduction: Retaining severely addicted individuals in treatment is one of the main challenges currently facing the drug treatment field. This study examined factors associated with early treatment dropout among IDU participants of an HIV prevention trial in Puerto Rico. Methods: A sample of 526 IDUs recruited in the street was randomly assigned to either a standard intervention or an enhanced intervention using motivational interviewing strategies. The enhanced intervention sought to assist IDUs to seek and enter drug treatment and reduce HIV risk behaviors. Six months after the baseline interview, 412 (78.3%) of the participants were re-assessed. Results: At follow-up, 124 (30.1%) participants had entered drug treatment, 24.9% of those assigned to the standard intervention and 37.9% of those assigned to the enhanced intervention (p = 0.01). Of the 124 subjects that entered drug treatment, 33 (26.6%) dropped-out before completing the treatment. The results of multivariate logistic regression analysis indicated that homelessness (OR = 8.0, p = 0.01), use of speedball (OR = 11.2, p = <0.01), and low scores in the vitality measure of the SF-36 health scale (OR = 1.82, p = 0.01) were all significantly associated with early dropout. Receiving relapse prevention services during treatment reduced the odds of early dropout (OR = 0.16, p = 0.01). Conclusions: These findings suggest that drug treatment programs should focus retention efforts on patients with increased severity markers (e.g. homelessness, low health status) and should provide retention enhancing services such as relapse prevention sessions early on during the course of treatment.

Learning Objectives:

• 1.Identify sociodemografics and pre-treatment variables associated with drug treatment dropout among IDUs.
• 2.Discuss program factors that predict drug treatment retention, and their implications.

Keywords: Injection Drug Users, Drug Abuse Treatment

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.