Evaluation of a cognitive‐behavioural intervention for pregnant injecting drug users at risk of HIV infection

Abstract

Pregnant injecting drug users were randomly assigned to: (i) individually receive a six-session cognitive-behavioural intervention in addition to their usual methadone maintenance treatment (intervention condition (I) (n = 40)); or (ii) their usual methadone maintenance treatment only (control condition (C) (n = 40)). There was no change in drug use per se in either group after the intervention. However, at 9-month follow-up the I group had significantly reduced some HIV risk-taking behaviours (in particular injecting risk behaviours). The I group reduced the needle risk associated both with "typical" use (drug use in the month before interview) and "binge" use (drug use in the month nominated as the heaviest month of drug use in the previous 6 months). The intervention had no effect on sexual risk behaviours. The finding of reduced injecting risk behaviour following the six-session intervention suggests that such an intervention may be of benefit for individuals persisting with injecting risk behaviours despite methadone maintenance treatment and the availability of sterile injection equipment.

Psychosocial interventions for pregnant women in outpatient illicit drug treatment programs compared to other interventions

“…Thirteen trials reported age and the mean age for those was 28.8 years. Two trials did not report the ethnicity of participants (O'Neill 1996; Yonkers 2012). All but three RCTs had a majority of African American participants.…”

“…Of the trials that reported ethnicity, on average 63.12% of participants were African American. All trials but O'Neill 1996 and Yonkers 2012 reported marital status. Overall, 79.8% of participants were single, never married, or divorced.…”

“…Overall, 79.8% of participants were single, never married, or divorced. All trials except O'Neill 1996 reported employment status for all participants. Overall, 88.6% of the trial participants were unemployed.…”

“…In Mullins 2004, participants in the intervention group received three one-hour MIB sessions. In O'Neill 1996, the participants received a total of six sessions lasting 60 to 90 minutes each. The first session was MIB, whereas the subsequent sessions addressed strategies for avoiding high risk behaviours, including relaxation techniques and problem-solving techniques.…”

Substance Abuse in Young People

“…However, in White's review, few targeted interventions were included because of the lack of scientific rigour. Nevertheless he reported on some promising approaches ; relapse prevention techniques to dependent users, targeting of safer injecting techniques, and intervention directed at groups of pregnant users (Latkin, Mandell, Vlahov, Oziemkowska, & Celentano, 1996 ;O'Neill et al, 1996 ;Stephens, Roffman, & Simpson, 1994 ;Weeks et al, 1996). Further research in an effort to improve effectiveness of prevention programmes needs to address the role of drugs at different developmental stages and in different drug-using careers.…”