Injection Drug Use and Syringe Sharing Among Sexually Transmitted Disease Clinic Patients in the U.S
Methods: Project AWARE randomized 5012 participants from 9 STD clinics to receive a rapid HIV test with (1) brief risk-reduction counseling or (2) information only, complete a behavioral risk assessment, and be assessed for STDs at baseline and 6-month follow-up. A GEE model was used to examine the change of syringe sharing between visits. Predictors were: treatment group, participant and partner gender, visit and the interaction of treatment group and visit.
Results: In the counseling group, 145 (5.79%) and 112 (5.14%) participants reported injection drug use (IDU) at baseline and follow-up, respectively. In the information only group, 160 (6.38%) and 113 (5.17%) participants reported IDU at baseline and follow-up, respectively. There was a decrease in the number of injectors across time (χ2=5.33, p=0.0210), but there was no difference in the decrease between groups (χ2=0.56, p=0.4552). Among injectors at baseline, 31 (21.4%) in the counseling group and 28 (17.5%) in the information only group shared syringes; at follow-up, 16 (14.3%) in the counseling group and 6 (5.3%) in the information only group shared syringes. There was a decrease in the rate of syringe sharing across time (χ2=21.45, p<0.0001); the rate in the information group decreased more than in the counseling group (χ2=4.33, p=0.0375).
Discussion: Brief risk-reduction counseling may not be appropriate in addressing IDU and syringe sharing among STD clinic patients at the time of HIV testing.
Learning Areas:Public health or related research
Social and behavioral sciences
Assess the effect of risk-reduction counseling with a rapid HIV test on injection drug use and syringe sharing among sexually transmitted disease clinic patients
Keyword(s): HIV Risk Behavior, Drug Abuse
Qualified on the content I am responsible for because: Over the past 6 years I have served as Project Coordinator or Director on several clinical trials involving: 1) HIV testing among individuals at risk for contracting HIV, 2) linking substance users to substance use disorder (SUD) treatment services, and 3) linking and retaining HIV-infected substance users to HIV care and SUD treatment. Additionally, I have been a co-author on several abstracts and manuscripts involving HIV and/or SUD treatment.
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.