An outcome evaluation to measure changes in sexual risk-taking among gay men undergoing substance use disorder treatment

Objective: To evaluate the effects of safe sex intervention at a substance use disorder treatment agency designed to serve gay men. Method: Of all eli gible men, 456 (78%) were recruited as they entered treatment for a substan ce use disorder. This cohort was followed for five waves of data collection , each wave measuring the previous 90 days. Assigned to the experimental co ndition (treatment for substance use disorder plus a safe sex intervention) were 82 men; 65 were assigned to the regular substance use disorder treatm ent. Results: Although levels of risk within each wave were never significa ntly different between the two treatment groups, reductions in unprotected anal intercourse (UAI) with a nonmonogamous partner for both groups from th e baseline Wave-1 levels were uniformly significant (all p's < .05). Such h igh-risk sex in the year-long follow-up period was correlated with UAI repo rted at intake, enjoyment of UAI, relative youth, heavier concurrent use of alcohol or amphetamines and greater numbers of sexual partners. Conclusion s: We conclude that: (1) substantial HIV risk reductions can occur after in itiation of treatment for substance use disorder among gay men; (2) risk re ductions begin soon after treatment begins; (3) lapses to unsafe sex are co mmon during treatment; (4) continued UAI is most likely among those men who are riskier at intake, who continue to be more sexually active and who are more likely to combine substance use and sexual behavior; (5) AIDS prevent ion activities conducted at treatment agencies cannot reach all high-risk s ubstance-using gay men.