Efficacy of adapted personalized cognitive counseling (PCC) for high-risk, HIV-negative, episodic substance-using MSM: Findings from project echo
Wednesday, November 6, 2013
Background: Episodic drug use and binge drinking are associated with sexual HIV risk behaviors among substance-using men who have sex with men (SUMSM), yet no evidence‐based HIV prevention interventions exist for these men. We adapted personalized cognitive counseling (PCC), addressing rationalizations for high-risk behavior, to SUMSM and evaluated the intervention. Methods: We conducted a randomized controlled trial (N=326) to test the efficacy of adapted PCC among HIV-negative, episodic SUMSM reporting recent UAI and concurrent use of methamphetamine, poppers, cocaine, or binge-drinking in the past 3 months. PCC participants (n=164) received HIV testing plus 2 counseling sessions; control participants (n=162) received HIV testing. Primary outcomes included number of UAI events, UAI partners, and UAI events with three most-recent non-primary partners. We examined linear trends in treatment effect using GEE Poisson models with robust standard errors and conducted sub-group analyses excluding 138 participants actually substance dependent at baseline. Results: Mean age was 33.6 years, 49% were white, 10% African American, 26% Latino; 96% completed 3 and 6 month follow-up. We observed parallel reductions in mean UAI events [PCC = 2.0 (4.7); control = 1.8 (4.4)], but no significant intervention effects in primary outcomes. For non-substance dependent men, UAI events with 3 most-recent non-primary partners declined among participants in PCC compared to control (RR=0.56, 0.34-0.92). Conclusion: We did not find evidence that adapted PCC was efficacious in reducing sexual risk behaviors in the overall sample, yet did observe a reduction in UAI events with recent partners among SUMSM not dependent on target substances.
Basic medical science applied in public health
Public health or related research
Social and behavioral sciences
Explain results of the randomized trial of adapted personalized cognitive counseling for substance-using men-who-have-sex-with-men.
Describe personalized cogntive counseling.
Keyword(s): Substance Abuse, Behavioral Research
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I am a research scientist at the San Francisco Department of Public Health and a Research Fellow at the University of California San Francisco. I have been conducting HIV prevention and substance use research for over 5 years.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.