COCAINE ABUSE COUNSELING AS HIV PREVENTION

The current study evaluated the efficacy of cocaine abuse counseling a lone as a strategy to reduce HIV-related sexual risk behaviors. Partic ipants were 232 cocaine-abusing or dependent individuals who received up to 26 weeks of Matrix counseling but no formal HIV-prevention inter ventions, One hundred fifty-seven (67.6%) participants completed asses sments at admission, during treatment, and at 6 months following admis sion. Participants located for follow-up were significantly more likel y to be Caucasian, to be better educated, and to complete longer treat ment episodes than those not located. Main study findings indicated a statistically significant association between safer sex behavior and c ompletion of a cocaine abuse counseling episode (chi(2)(2, n = 157) = 6.25, p < .05). Participants who completed counseling were more likely to change to safer sex or maintain safer sex over the 6-month period than participants who terminated counseling prematurely. The primary m ethod for reducing sexual risk involved overall decreases in reported numbers of partners (Partners(baseline) = 532, SD = 6.25; Partners(6 M onths) = 2.47, SD = 2.62; F(1, 132) = 36.32, p < .001) among this grou p of mostly heterosexual (89.9%), Caucasian (69.0%), crack cocaine use rs (65.6%). We concluded that cocaine abuse counseling is a powerful i ntervention for reducing HIV-related sexual behaviors in this group at high risk for exposure to HIV. Study findings suggested that efforts to evaluate HIV prevention programs must also account for the effect o f drug counseling.