HIV risk behaviors among male prisoners participating in a randomized clinical trial of methadone maintenance treatment: 12 month findings

Background: The “Methadone Maintenance for Prisoners” project examined benefits of providing methadone maintenance to prison inmates nearing release. The current study examined differences in HIV-risk behaviors of these inmates over a 12-month time period.

Methods: Linear mixed model analyses determined differences on items from the TCU AIDS Risk Assessment in 211 pre-release males with pre-incarceration heroin dependence who met criteria for methadone treatment. Participants were randomly assigned to one of three conditions: 1) Counseling Only: counseling in prison and passive referral to community-based drug treatment; 2) Counseling+Transfer: counseling in prison and transfer to methadone maintenance in the community upon release; or, 3) Counseling+Methadone: counseling and methadone in prison with transfer to methadone treatment in the community upon release. Data were examined at study intake (Baseline, 30 days prior to most recent incarceration) and at 4 follow-up Time points (1, 3, 6 and 12 months after release from prison).

Results: There were significant changes in HIV-risk behaviors over Time. In particular, number of times injected decreased in the first 30 days post-release from baseline [M=110.4 (SE=10.5) to 1-Month [M=13.8 (SE=2.7)] post-release, p<.01. Sex without a condom decreased from baseline [M=19.4 (SE=2.1)] to 1- [M=8.8 (SE=1.0)] and to 12-months [M=10.3 (SE=1.3)] post–release, p<.02.

Conclusions: Inmates may be more likely to engage in HIV-risky drug and sexual behaviors prior to incarceration. These behaviors appear to decrease within the first 30 days and 12 months post-release.