Effects of Behavioral Intervention on Substance Use Among People Living With HIV: the Healthy Living Project Randomized Controlled Study

In the current study, the researchers examined reductions in substance use in response to an intensive intervention with people living with HIV.

A randomized controlled trial was conducted with 936 people with HIV in four US cities -- Milwaukee, San Francisco, New York, and Los Angeles -- who recently reported unprotected sexual risk acts. Substance use was assessed as the number of days of use of 19 substances over the last 90 days, evaluated at five-month intervals over a period of 25 months. Control participants received usual care; intervention participants received a 15-session case management intervention. An intention-to-treat analysis was conducted examining reductions on multiple indices of recent substance use calculated as the number of days of use.

Reductions in recent substance use were significantly higher for the intervention group than the control group: alcohol and/or marijuana use; any substance use; hard drug use and a weighted index adjusting for seriousness of the drug. Women in the intervention group showed larger reductions than men, though men also reduced their use. Compared to controls, gay and heterosexual men in the intervention group significantly reduced their use of alcohol and marijuana, any substance, stimulants and the drug severity-weighted frequency for use index. Also, gay men in the intervention significantly reduced their use of hard drugs compared to controls.

"A case management intervention model, delivered individually, is likely to result in significant and sustained reductions in substance use among people living with HIV," the authors concluded.

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