HIV prevention counseling with substance using clients: Factors associated with substance use treatment providers' use of HIV prevention in New York City

Background: In the US, approximately three million individuals enrolled in substance use (SU) treatment are at risk for HIV because of injection drug use and/or unprotected sex, representing a vulnerable population in need of HIV prevention counseling. Providers of SU treatment (e.g., counselors, medical staff) are not routinely offering HIV prevention despite this public health imperative. This study examines factors associated with providers’ use of HIV prevention with substance using clients.

Methods: Cross-sectional computerized surveys were collected from providers (N=281) within 24 community-based agencies in New York City. Multivariate linear regression was used to assess the relative influence of demographics, training, education, peer support, and participation in research (e.g., data collection, recruitment) upon providers’ use of HIV prevention counseling.

Results: Sample:101 male; 176 female; 4 transgender, 144 Black, 73 White, 10 Asian, 49 multi-racial, 1 Pacific Islander, 4 Native American, mean age was 41 years. 96 held a Bachelor’s, 75 Master’s, 67 H.S. diploma/GED, 37 Associate’s, 4 less than H.S. and 2 Doctoral. Having had training in specific types of counseling interventions for substance use (p<0.05), formal HIV training (p<0.00), flexible support from colleagues (p<0.05), and having participated in research (p<0.10) were positively associated with HIV prevention counseling.  

Conclusions: This study demonstrates that training in counseling interventions, peer support, and research experiences are associated with providers’ use of HIV prevention counseling with substance using clients.  Knowing modifiable factors may help inform targets for the development of educational resources for providers and for the improvement of research partnerships between providers and researchers.