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J Urban Health. Mar 2005; 82(Suppl 1): i109–i119.
PMCID: PMC3456171
Recruiting drug-using men who have sex with men into behavioral interventions: A two-stage approach
David E. Kanouse, PhD,corresponding author1 Ricky N. Bluthenthal,1,2 Laura Bogart,1 Martin Y. Iguchi,1 Suzanne Perry,1 Kelly Sand,1 and Steven Shoptaw3,4
2Charles R. Drew University of Medicine and Science, Los Angeles, California
3Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, California
4Friends Research Institute, Los Angeles, California
1The RAND Corporation, 1776 Main Street, 90407-2138 Santa Monica, CA
David E. Kanouse, kanouse/at/rand.org.
corresponding authorCorresponding author.
Abstract
Drug-using men who have sex with men (MSM) are at high risk of acquiring or transmitting HIV infection. Efforts to change behaviors in this population have been hampered by difficulties in recruiting drug-using MSM into behavioral interventions. This study sought to develop an effective strategy for recruiting drug-using MSM into behavioral interventions that consist of motivational interviewing alone or motivational interviewing plus contingency management. MSM were recruited through advertising and community outreach into groups to discuss party drugs, party burnout, and sexual behavior, with the intervention subsequently described and enrollment offered in the group setting. Many more eligible MSM responded to advertisements for the discussion groups than advertisements for the interventions, and 58% of those who participated in the discussion groups volunteered for counseling. Men who entered counseling reported high levels of drug use and sexual activity and were racially and ethnically diverse; only 35% were willing to accept drug treatment. Results demonstrate that a two-stage strategy in which drug-using MSM are first recruited into discussion groups before they are offered a behavioral intervention can be an effective way to induce voluntary acceptance of an intervention employing a behavioral risk-reduction approach.
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Selected References
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1. From the Centers for Disease Control and Prevention Increases in unsafe sex and rectal gonorrhea among men who have sex with men—San Francisco, California, 1994–1997. JAMA. 1999;281:696–697. doi: 10.1001/jama.281.8.696. [PubMed] [Cross Ref]
2. From the Centers for Disease Control and Prevention Unrecognized HIV infection, risk behaviors, and perceptions of risk among young black men who have sex with men—six US cities, 1994–1998. JAMA. 2002;288:1344–1348. doi: 10.1001/jama.288.11.1344. [PubMed] [Cross Ref]
3. Fox KK, Rio C, Holmes KK, et al. Gonorrhea in the HIV era: a reversal in trends among men who have sex with men. Am J Public Health. 2001;91:959–964. [PubMed]
4. Kellogg T, McFarland W, Katz M. Recent increases in HIV serconversion among repeat anonymous testers in San Francisco. AIDS. 1999;13:2303–2304. doi: 10.1097/00002030-199911120-00013. [PubMed] [Cross Ref]
5. Wolitski RJ, Valdiserri RO, Denning PH, Levine WC. Are we headed for a resurgence of the HIV epidemic among men who have sex with men. Am J Public Health. 2001;91:883–888. doi: 10.2105/AJPH.91.6.883. [PubMed] [Cross Ref]
6. HIV/AIDS Surveillance Report 2002. Atlanta, GA: Centers for Disease Control and Prevention; 2003. pp. 14–14.
7. Courtenay-Quirk C, Wolitski RJ, Hoff C, Parsons JT. Interests in HIV prevention topics of HIV-seropositive men who have sex with men. AIDS Educ Prev. 2003;15:401–412. doi: 10.1521/aeap.15.6.401.24040. [PubMed] [Cross Ref]
8. Rotheram-Borus MJ, Rosario M, Meyer-Bahlburg HFL, Koopman C, Dopkins SC, Davies M. Sexual and substance use acts of gay and bisexual male adolescents in New York City. J Sex Res. 1994;31:47–57. doi: 10.1080/00224499409551729. [Cross Ref]
9. Stall R, McKusick L, Wiley J, Coates TJ, Ostrow DG. Alcohol and drug use during sexual activity and compliance with safe sex guidelines for AIDS. The AIDS Behavioral Research Project. Health Educ Q. 1986;13:359–371. [PubMed]
10. Catania JA, Osmond D, Stall RD, et al. The continuing HIV epidemic among men who have sex with men. Am J Public Health. 2001;91:907–914. [PubMed]
11. Shoptaw S, Reback CJ, Freese TE. Patient characteristics, HIV serostatus, and risk behaviors among gay and bisexual males seeking treatment for methamphetamine abuse and dependence in Los Angeles. J Addict Dis. 2002;21:91–105. doi: 10.1300/J069v21n01_08. [PubMed] [Cross Ref]
12. Outbreak of syphilis among men who have sex with men—Southern California, 2000. MMWR Morb Mortal Wkly Rep. 23, 50:117–120.
13. Chesney MA, Barrett DC, Stall R. Histories of substance use and risk behavior: precursors to HIV seroconversion in homosexual men. Am J Public Health. 1998;88:113–116. [PubMed]
14. Gorman EM, Carroll RT. Substance abuse and HIV: considerations with regard to methamphetamines and other recreational drugs for nursing practice and research. J Assoc Nurses AIDS Care. 2000;11:51–62. doi: 10.1016/S1055-3290(06)60286-0. [PubMed] [Cross Ref]
15. Halkitis PN, Parsons JT, Stirratt MJ. A double epidemic: crystal methamphetamine drug use in relation to HIV transmission among gay men. J Homosex. 2001;41:17–35. doi: 10.1300/J082v41n02_02. [PubMed] [Cross Ref]
16. Frosch D, Shoptaw S, Huber A, Rawson RA, Ling W. Sexual HIV risk among gay and bisexual male methamphetamine abusers. J Subst Abuse Treat. 1996;13:483–486. doi: 10.1016/S0740-5472(96)00098-0. [PubMed] [Cross Ref]
17. Gleghorn AA, Marx R, Vittinghoff E, Katz MH. Association between drug use patterns and HIV risks among homeless, runaway, and street youth in northern California. Drug Alcohol Depend. 1998;51:219–227. doi: 10.1016/S0376-8716(98)00042-8. [PubMed] [Cross Ref]
18. McNall M, Remafedi G. Relationship of amphetamine and other substance use to unprotected intercourse among young men who have sex with men. Arch Pediatr Adolesc Med. 1999;153:1130–1135. [PubMed]
19. Semple SJ, Patterson TL, Grant I. Motivations associated with methamphetamine use among HIV+men who have sex with men. J Subst Abuse Treat. 2002;22:149–156. doi: 10.1016/S0740-5472(02)00223-4. [PubMed] [Cross Ref]
20. Sheeran P, Orbell S. Do intentions predict condom use? Meta-analysis and examination of six moderator variables. Br J Soc Psychol. 1998;37:231–250. [PubMed]
21. Reback CJ, Grella CE. HIV risk behaviors of gay and bisexual male methamphetamine users contacted through Street Outreach. J Drug Issues. 1999;29:155–166.
22. Reback CJ, Larkins S, Shoptaw S. Changes in the meaning of sexual risk behaviors among gay and bisexual male methamphetamine abusers before and after drug treatment. AIDS Behav. 2004;8:87–98. doi: 10.1023/B:AIBE.0000017528.39338.75. [PubMed] [Cross Ref]
23. Edlin BR, Irwin KL, Faruque S, et al. Intersecting epidemics—crack cocaine use and HIV infection among inner-city young adults. Multicenter Crack Cocaine and HIV Infection Study Team. N Engl J Med. 1994;331:1422–1427. doi: 10.1056/NEJM199411243312106. [PubMed] [Cross Ref]
24. Janssen RS, Holtgrave DR, Valdiserri RO, Shepherd M, Gayle HD, Cock KM. The serostatus approach to fighting the HIV epidemic: prevention strategies for infected individuals. Am J Public Health. 2001;91:1019–1024. [PubMed]
25. Moss AR, Vranizan K, Gorter R, Bacchetti P, Watters J, Osmond D. HIV seroconversion in intravenous drug users in San Francisco, 1985–1990. AIDS. 1994;8:223–231. [PubMed]
26. Shoptaw S, Reback CJ, Frosch DL, Rawson RA. Stimulant abuse treatment as HIV prevention. J Addict Dis. 1998;17:19–32. [PubMed]
27. Baker A, Heather N, Wodak A, et al. Evaluation of a cognitive-behavioural intervention for HIV prevention among injecting drug users. AIDS. 1993;7:247–256. [PubMed]
28. Baker A, Kochan N, Dixon J, Heather N, Wodak A. Controlled evaluation of a brief intervention for HIV prevention among injecting drug users not in treatment. AIDS Care. 1994;6:559–570. [PubMed]
29. Boatler JF, Knight K, Simpson DD. Assessment of an AIDS intervention program during drug abuse treatment. J Subst Abuse Treat. 1994;11:367–372. doi: 10.1016/0740-5472(94)90047-7. [PubMed] [Cross Ref]
30. Lewis JR, Boyle DP, Lewis LS, Evans M. Reducing AIDS and substance abuse risk factors among homeless, HIV-infected, drug-using persons. Res Soc Work Pract. 2000;10:15–33.
31. Deren S, Estrada AL, Stark M, Goldstein M. Sexual orientation and HIV risk behaviors in a national sample of injection drug users and crack smokers. Drug Soc. 1996;9:97–108.
32. Johnson WD, Hedges LV, Diaz RM. Interventions to modify sexual risk behaviors for preventing HIV infection in men who have sex with men. Cochrane Database Syst Rev. 2003;(1):CD001230.
33. Practice guidelines for the treatment of patients with substance use disorders: alcohol, cocaine, opioids. American Psychiatric Association. Am J Psychiatry. 1995;152(suppl 11):1–59.
34. Humphreys K. Clinicians’ referral and matching of substance abuse patients to self-help groups after treatment. Psychiatr Serv. 1997;48:1445–1449. [PubMed]
35. Management of Substance Use Disorders in the Primary and Specialty Care. Washington, DC: Veterans Health Administration, Office of Quality and Performance and the Veterans Affairs, Department of Defense Development Work Group; 2001.
36. Kelly JF, Moos R. Dropout from 12-step self-help groups: prevalence, predictors, and counteracting treatment influences. J Subst Abuse Treat. 2003;24:241–250. doi: 10.1016/S0740-5472(03)00021-7. [PubMed] [Cross Ref]
37. Hicks D. The importance of specialized treatment programs for lesbian and gay patients. In: Guss JR, Drescher J, editors. Addictions in the Gay and Lesbian Community. New York, NY: Haworth Press; 2000.
38. Stall RD, Paul JP, Barrett DC, Crosby GM, Bein E. An outcome evaluation to measure changes in sexual risk-taking among gay men undergoing substance use disorder treatment. J Stud Alcohol. 1999;60:837–845. [PubMed]
39. Morgenstern J, Irwin TW. Offering responsive alcohol treatment interventions: who responds? Paper presented at: New Dynamics of HIV Risk among Drug-Using MSM; March 1–2, 2004; Bethesda, MD.
40. Burger JM. The foot-in-the-door compliance procedure: a multiple-process analysis and review. Pers Soc Psychol Rev. 1999;3:303–325. doi: 10.1207/s15327957pspr0304_2. [PubMed] [Cross Ref]
41. Freedman JL, Fraser SC. Compliance without pressure: the foot-in-the-door technique. J Pers Soc Psychol. 1966;4:195–202. [PubMed]
42. Bem DJ. Self-perception theory. In: Berkowitz L, editor. Advances in Experimental Social Psychology. New York, NY: Academic; 1972. pp. 63–108.
43. Burke BL, Arkowitz H, Menchola M. The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials. J Consult Clin Psychol. 2003;71:843–861. doi: 10.1037/0022-006X.71.5.843. [PubMed] [Cross Ref]
44. Dunn C, Deroo L, Rivara FP. The use of brief interventions adapted from motivational interviewing across behavioral domains: a systematic review. Addiction. 2001;96:1725–1742. doi: 10.1046/j.1360-0443.2001.961217253.x. [PubMed] [Cross Ref]
45. Higgins ST, Budney AJ, Bickel WK, Hughes JR, Foerg F, Badger G. Achieving cocaine abstinence with a behavioral approach. Am J Psychiatry. 1993;150:763–769. [PubMed]
46. Higgins ST, Silverman K. Motivating Behavior Change Among Illicit-Drug Abusers. Washington, DC: American Psychological Association; 1999.
47. Higgins ST, Wong CJ, Badger GJ, Ogden DE, Dantona RL. Contingent reinforcement increases cocaine abstinence during outpatient treatment and 1 year of follow-up. J Consult Clin Psychol. 2000;68:64–72. doi: 10.1037/0022-006X.68.1.64. [PubMed] [Cross Ref]
48. Shoptaw S, Reback CJ, Peck JA, et al. Behavioral treatment approaches for methamphetamine dependence and HIV-related sexual risk behaviors among urban gay and bisexual men. Drug Alcohol Depend. In press.
49. Morral AR, Iguchi MY, Belding MA, Lamb RJ. Natural classes of treatment response. J Consult Clin Psychol. 1997;65:673–685. doi: 10.1037/0022-006X.65.4.673. [PubMed] [Cross Ref]
50. Iguchi MY, Bux DA., Jr Reduced probability of HIV infection among crack cocaine—using injection drug users. Am J Public Health. 1997;87:1008–1012. [PubMed]
51. Festinger L. A Theory of Cognitive Dissonance. Stanford, CA: Stanford University Press; 1957.
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