Sexual HIV risk behavior outcomes of brief interventions for drug use in an inner-city emergency department: Secondary outcomes from a randomized controlled trial

Bonar, Erin E.; Walton, Maureen A.; Barry, Kristen L.; Bohnert, Amy S. B.; Chermack, Stephen T.; Cunningham, Rebecca M.; Massey, Lynn; Ignacio, Rosalinda V.; Blow, Frederic C.

doi:10.1016/j.drugalcdep.2017.10.036

Cited by 8 publications

(7 citation statements)

References 55 publications

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“…The design, procedures, sample and primary and secondary outcomes of the Healthi ER You trial have been described in detail in prior publications . Briefly, the trial involved a 3 × 2 factorial design where participants were initially randomized to one of three conditions delivered at the baseline ED visit: (1) 30‐minute CBI, (2) 30‐minute TBI or (3) EUC (review of health resources brochures in the ED, exceeding the standard of care) (see Bonar et al .…”

Section: Methodsmentioning

confidence: 99%

“…The interventions and EUC have been previously described in detail . Briefly, the interventions were grounded in motivational interviewing , with parallel content in the CBI and TBI.…”

Section: Methodsmentioning

confidence: 99%

“…More recently, Healthi ER You tested the efficacy of a computer‐guided BI (CBI) and a therapist‐delivered BI (TBI) relative to enhanced usual care (EUC) for drug‐using adults presenting to an ED in a predominately low‐income, urban community. The BIs were based on motivational interviewing (MI) and focused on reducing drug use, with HIV risk behaviors as a secondary behavioral target . At 3‐month follow‐up, participants were re‐randomized to receive either an adapted motivational enhancement therapy (AMET) booster or EUC.…”

Section: Introductionmentioning

confidence: 99%

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Therapist and computer‐based brief interventions for drug use within a randomized controlled trial: effects on parallel trajectories of alcohol use, cannabis use and anxiety symptoms

et al. 2019

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Background and Aims Despite their high comorbidity, the effects of brief interventions (BI) to reduce cannabis use, alcohol use and anxiety symptoms have received little empirical attention. The aims of this study were to examine whether a therapist‐delivered BI (TBI) or computer‐guided BI (CBI) to address drug use, alcohol consumption (when relevant) and HIV risk behaviors, relative to enhanced usual care (EUC), was associated with reductions in parallel trajectories of alcohol use, cannabis use and anxiety symptoms, and whether demographic characteristics moderated reductions over time. Design Latent growth curve modeling was used to examine joint trajectories of alcohol use, cannabis use and anxiety symptoms assessed at 3, 6 and 12 months after baseline enrollment. Setting Hurley Medical Center Emergency Department (ED) in Flint, MI, USA. Participants The sample was 780 drug‐using adults (aged 18–60 years; 44% male; 52% black) randomly assigned to receive either a TBI, CBI or EUC through the HealthiER You study. Interventions and comparator ED‐delivered TBI and CBIs involved touchscreen‐delivered and audio‐assisted content. The TBI was administered by a Master's‐level therapist, whereas the CBI was self‐administered using a virtual health counselor. EUC included a review of health resources brochures in the ED. Measurements Assessments of alcohol use (10‐item Alcohol Use Disorders Identification Test), cannabis use (past 30‐day frequency) and anxiety symptoms (Brief Symptom Inventory‐18) occurred at baseline and 3‐, 6‐ and 12‐month follow‐up. Findings TBI, relative to EUC, was associated with significant reductions in cannabis use [B = –0.49, standard error (SE) = 0.20, P < 0.05) and anxiety (B = –0.04, SE = 0.02, P < 0.05), but no main effect for alcohol use. Two of 18 moderation tests were significant: TBI significantly reduced alcohol use among males (B = –0.60, SE = 0.19, P < 0.01) and patients aged 18–25 years in the TBI condition showed significantly greater reductions in cannabis use relative to older patients (B = –0.78, SE = 0.31, P < 0.05). Results for CBI were non‐significant. Conclusions Emergency department‐based therapist‐delivered brief interventions to address drug use, alcohol consumption (when relevant) and HIV risk behaviors may also reduce alcohol use, cannabis use and anxiety over time, accounting for the overlap of these processes.

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Section: Methodsmentioning

confidence: 99%

“…The interventions and EUC have been previously described in detail . Briefly, the interventions were grounded in motivational interviewing , with parallel content in the CBI and TBI.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Therapist and computer‐based brief interventions for drug use within a randomized controlled trial: effects on parallel trajectories of alcohol use, cannabis use and anxiety symptoms

et al. 2019

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“…Validated treatment paradigms include psychosocial interventions and pharmacological therapies, both of which have been shown to increase the likelihood of, and promote the longevity of, abstinence. [44][45][46] It is important to have a care coordination team that checks in with the patient and their progress while they are undergoing treatment. If the patient was referred to their PCP for substance abuse management, there should be continued communication with the PCP because continued checkins will help ensure the patient feels cared for and has a point-person invested in their recovery and ability to have surgery.…”

Section: Substance Usementioning

confidence: 99%

Movement if Life-Optimizing Patient Access to Total Joint Arthroplasty: Alcohol and Substance Abuse Disparities

Bernstein

Rankin

Green

2022

J Am Acad Orthop Surg

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Alcohol use disorders (AUDs) and substance use disorders (SUDs) place patients undergoing total joint arthroplasty at notable risk for complications. AUD and SUD disproportionately affect vulnerable communities and often coexist. Following is a discussion of the presence of these disorders in vulnerable populations and approaches to screening for them to optimize care and reduce the risks of joint arthroplasty surgery. 25.1% of American adults report binge drinking in the past year, and 5.8% of American adults carry a diagnosis of AUD. Alcohol consumption and AUD disproportionately affect American Indians/Alaskan Natives, and heavy episodic drinking is highest in Latinx and American Indians. AUD is higher in those who are unemployed, have lower education level, and those who are single/divorced. Alcohol use in the preoperative period is associated with difficulty maintaining blood pressure during surgery, infections, wound disruptions, and increased length of stay. In addition, patients with AUD or unhealthy alcohol use have a greater comorbidity burden, including liver disease and dementia, that predisposes them to poor surgical outcomes. Optimization in these vulnerable populations include proper screening, cessation programs, psychosocial interventions, assessment of support systems, and pharmacologic interventions. 38% of adults battle a drug use disorder. Twenty-one million Americans have at least one addiction, but only 10% receive treatment. Rates of opioid use and opioid-related deaths have continued to rise. Recreational drug use is highest in American Indians. Marijuana use is highest in Black and Latinx lesbian, gay, and bisexual women. Overall, substance use is associated with depression and anxiety; discrimination based on race, ethnicity, sex, or sexual preference is also deeply interwoven with depression, anxiety, and substance use. Preoperative use of opioids is the number one predictor of prolonged chronic postoperative opioid use. Optimization in these vulnerable groups begins with appropriate screening, followed by psychosocial interventions, social work and substance abuse counseling, and pharmacologic therapies.

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“…Finally, other mental health issues have also been associated with persisting transmission risk behavior among MSM living with HIV (Crepaz and Marks, 2002;Prince et al, 2007;Bonar et al, 2018). Approximately half of the people living with HIV are diagnosed with a psychiatric disorder during their lives (Crepaz et al, 2008).…”

Section: Persistent Hiv Transmission Risk Behavior Among Msmmentioning

confidence: 99%

Sex, Drugs, and Impulse Regulation: A Perspective on Reducing Transmission Risk Behavior and Improving Mental Health Among MSM Living With HIV

et al. 2020

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Unprotected sexual contact continues to be a main cause of HIV transmission and poses certain key populations at increased risk for HIV infection. One of the populations at high risk are men who have sex with men. A subset of MSM engages in chemsex, whereby consumption of illicit drugs is used to facilitate or enhance sexual activity. This practice can have several negative consequences, such as sexually transmitted infections (including HIV) and mental health problems (including compulsive sexual behavior, addiction, and mood disorders). In this article, we provide our perspective on the current situation that medical professionals dealing with MSM living with HIV often feel empty-handed in how to deal with these behavioral and psychological issues. Close collaboration between somatic and mental health professionals is key to address treatment needs of people living with HIV, regarding the negative consequences of chemsex and their overall quality of life. In this article, we discuss possibilities for psychological treatment, including behavioral skills training to improve impulse control and reduce compulsive sexual behaviors among MSM living with HIV who persistently engage in sexual transmission risk behavior, based on our experience with implementing such an intervention. Important barriers and facilitators for further implementation of behavioral interventions will be discussed. Reduction of HIV transmission risk behavior is needed to achieve the WHO aim to end HIV as a public health threat by 2030. We propose that close collaboration between somatic and mental health professionals and implementation of behavioral interventions for risk populations are key to achieve this goal.

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Sexual HIV risk behavior outcomes of brief interventions for drug use in an inner-city emergency department: Secondary outcomes from a randomized controlled trial

Abstract: A therapist-delivered BI for drug use and HIV risk behaviors, combined with a follow-up therapist-delivered booster, shows promise for reducing sexual HIV risk behaviors among a primarily marijuana using, non-injecting sample.

Cited by 8 publications

References 55 publications

Therapist and computer‐based brief interventions for drug use within a randomized controlled trial: effects on parallel trajectories of alcohol use, cannabis use and anxiety symptoms

Therapist and computer‐based brief interventions for drug use within a randomized controlled trial: effects on parallel trajectories of alcohol use, cannabis use and anxiety symptoms

Movement if Life-Optimizing Patient Access to Total Joint Arthroplasty: Alcohol and Substance Abuse Disparities

Sex, Drugs, and Impulse Regulation: A Perspective on Reducing Transmission Risk Behavior and Improving Mental Health Among MSM Living With HIV

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