READMISSIONS TO DRUG-ABUSE TREATMENT AND HIV RISK BEHAVIOR

The objectives of the study were (a) to investigate the characteristic s of drug abuse treatment clients who return to treatment and (b) amon g those with readmissions, to describe changes over time in risk behav ior for human immunodeficiency virus (HN) infection and to identify fa ctors associated with behavior change. Data were derived from a multis ite HIV surveillance program in a single community; the program used a unique identifier to link: HN rest results and behavioral information from multiple contacts. During a 30-month period, 1944 clients were a dmitted to three satellite facilities of a single treatment agency: de toxification, long-term residential, and outpatient. Of these clients, 574 (29%) had one or more readmissions to the same or a different fac ility during the 24 months following the index admission. Drug injecto rs, those tested for HIV, and those living in the community were more likely to be readmitted to treatment. There was little overall change in HIV risk behavior between the index admission and the readmission f urthest in time from the index admission. Clients whose index visit wa s at the residential facility were more likely to reduce their injecti on risk behavior than those admitted to the other facilities. Clients readmitted to either the residential or the outpatient facility were m ore Likely to have reduced their injection risk behavior than those re admitted to detoxification. Treatment facility was not associated with sexual risk behavior change. Men were more likely than women to reduc e their high-risk sexual behaviors. The results underscore the need fo r treatment programs to make HIV testing readily available to their cl ients and to make special efforts to assist female clients to reduce t heir HIV risk.