Episodic drug use and binge drinking are associated with HIV risk among substance-using men who have sex with men (SUMSM), yet no evidence-based interventions exist for these men. We adapted personalized cognitive counseling (PCC) to address self-justifications for high-risk sex among HIV-negative, episodic SUMSM, then randomized men to PCC (n = 162) with HIV testing or control (n = 164) with HIV testing alone.
No significant between-group differences were found in the three primary study outcomes: number of unprotected anal intercourse events (UAI), number of UAI partners, and UAI with three most recent non-primary partners. In a planned subgroup analysis of non-substance dependent men, there were significant reductions in UAI with most recent non-primary partners among PCC participants (RR = 0.56; 95 %CI 0.34–0.92; P = 0.02).
We did not find evidence that PCC reduced sexual risk behaviors overall, but observed significant reductions in UAI events among non-dependent SUMSM. PCC may be beneficial among SUMSM screening negative for substance dependence.
I thought to myself
|Part of me is saying this is risky, but another part is telling me to go for it||130||42||39|
|Alcohol and/or drugs make it easier to have sex (or different kinds of sex)||125||44||38|
|This feels more natural. Sex is just better without condoms||107||40||33|
|He said he was negative, and I have been tested. So it must be safe||106||38||26|
|I drank/used more than I’d planned and it just happened||106||21||21|
|I didn’t want to fuck without a condom but the alcohol and/or drugs made me so horny I did it anyway||104||27||20|
|Topping isn’t that risky||100||37||33|
|I didn’t intend to have sex without a condom, but I was too fucked up and I couldn’t think properly||95||28||16|
|This guy is really into me. It feels good to be wanted so much||90||29||22|
|He would have told me if he were positive||87||22||18|
|Condoms take all the feeling away||85||27||21|
|I’m still negative and I’ve done this before so it can’t be that risky||83||33||25|
|Sex is better when I am drunk or high||80||30||26|
|All the alcohol and/or drugs have made me so horny, I just need to fuck||80||23||17|
|I know enough about this guy, I figure I can trust him||79||28||16|
aNumber of participants who completed 3-month self-justification elicitation instruments and persistently endorsed the respective self-justification at baseline and 3-month visit
Full article at: http://goo.gl/9HcUF4
By: Phillip O. Coffin, Glenn-Milo Santos, Grant Colfax, Moupali Das, Tim Matheson, Erin DeMicco, James Dilley, Eric Vittinghoff, Jerris L. Raiford, Monique Carry, and Jeffrey H. Herbst
Phillip O. Coffin, Substance Use Research Unit, San Francisco Department of Public Health, 25 Van Ness Ave, Suite 500, San Francisco, CA 904102, USA; University of California, San Francisco, San Francisco, CA, USA;
More at: https://twitter.com/hiv_insight