My. Iguchi et al., CHANGES IN HIV RISK BEHAVIOR AMONG INJECTING DRUG-USERS - THE IMPACT OF 21 VERSUS 90 DAYS OF METHADONE DETOXIFICATION, AIDS, 10(14), 1996, pp. 1719-1728
Objective: To evaluate the hypothesis that long-term methadone detoxif
ication would produce greater HIV risk reduction among injecting drug
users (IDU) than short-term detoxification. Design: Random assignment
to 21 or 90 days of free detoxification. Setting: Storefront offices i
n two cities, with referrals to outpatient methadone detoxification. P
articipants: Out-of-treatment IDU (n = 1803), recruited through street
outreach and word of mouth, between April 1990 and March 1991. Of the
se, 62.6% were successfully located for 6-month follow-up. Main outcom
e measures: Self-reported drug injection and sexual practices at basel
ine and follow-up. Results: Substantial reductions in risk behavior we
re observed at follow-up. Substantial percentages of subjects reported
less frequent drug injection (54%), use of shooting galleries (85%),
needle-sharing (67%), and number of sex partners (73%), and more frequ
ent use of bleach to disinfect needles (67%) and condom use (31%). The
re were no significant differences in behavioral change between 21 and
90-day treatment, and subjects who entered treatment did not report s
ignificantly greater risk reduction than untreated subjects. Discrimin
ant analyses showed a marginal effect for duration of treatment on ris
k reduction, although results were inconsistent. Conclusions: Large sc
ale behavioral risk reduction appears to be occurring in this populati
on regardless of treatment condition. In minimal service methadone det
oxification, subjects treated under a longer-term detoxification proto
col demonstrated no greater risk reduction than those receiving short-
term detoxification.