The Impact of a Brief Motivational Intervention on Unprotected Sex and Sex While High Among Drug-Positive Emergency Department Patients Who Receive STI/HIV VC/T and Drug Treatment Referral as Standard of Care

Abstract

This randomized, controlled trial, conducted among out-of-treatment heroin/cocaine users at an emergency department visit, tests the impact on sexual risk of adding brief motivational intervention (B-MI) to point-of-service testing, counseling and drug treatment referral. 1,030 enrollees aged 18-54 received either voluntary counseling/testing (VC/T) with drug treatment referral, or VC/T, referral, and B-MI, delivered by an outreach worker. We measured number and proportion of non-protected sex acts (last 30 days) at 6 and 12 months (n = 802). At baseline, 70% of past-30-days sex acts were non-protected; 35% of sex acts occurred while high; 64% of sexual acts involved main, 24% casual and 12% transactional sex partners; 1.7% tested positive for an STI, and 8.8% for HIV. At six or 12 month follow-up, 20 enrollees tested positive for Chlamydia and/or Gonorrhea, and 6 enrollees HIV sero-converted. Self-reported high-risk behaviors declined in both groups with no significant between-group differences in behaviors or STI/HIV incidence.

Transactional Sex Involvement: Exploring Risk and Promotive Factors Among Substance-Using Youth in an Urban Emergency Department

“…Prior research examining TS involvement among adults receiving ED services has been documented. Berstein et al (2012) conducted a study examining a brief intervention with adult heroin/cocaine users through an ED and found that 12% of the sample reported TS involvement. In another study examining TS involvement among adult substance users, Burnette et al (2008) found that ED care was associated with TS involvement for women.…”

Brief motivational intervention to reduce alcohol and HIV/sexual risk behavior in emergency department patients: A randomized controlled trial.

“…The results showed reductions in both risky behaviors, leading the authors to call for a future randomized controlled trial to assess efficacy. Another study, conducted during an ED visit involved heroin/cocaine users and risky sexual behavior (Bernstein et al, 2012). While that study found reductions in both targeted risky behaviors, there were no differences between a condition that involved a brief motivational intervention (MI) with voluntary counseling/testing vs. the voluntary counseling/testing control alone.…”

Preventing blood-borne virus infection in people who inject drugs in the UK: systematic review, stakeholder interviews, psychosocial intervention development and feasibility randomised controlled trial

“…[83][84][85][86] Eighty-nine articles were excluded for the following reasons: they were not RCTs (n = 34); 47,68, the outcomes of interest for this review were not assessed or presented at follow-up (n = 29); 86, outcomes were not presented by PWID (n = 6); [147][148][149][150][151][152] the number of PWID was not reported (n = 4); [153][154][155][156] or the intervention studied was not psychosocial (n = 4). [157][158][159][160] Additionally, 10 manuscripts were excluded as the results did not compare intervention groups [161][162][163][164][165][166] or did not evaluate the effect of the intervention. [167][168][169][170] One further manuscript was excluded because the same psychosocial intervention was delivered to each treatment group, and the difference between treatment groups was receipt of a coupon for 90 days of free methadone maintenance treatment (MMT).…”