TY - JOUR
T1 - The effects of psychiatric comorbidity on response to an HIV prevention intervention
AU - Compton, Wilson M.
AU - Cottler, Linda B.
AU - Ben-Abdallah, Arbi
AU - Cunningham-Williams, Renee
AU - Spitznagel, Edward L.
N1 - Funding Information:
This study was supported by grants from the National Institutes of Health National Institute on Drug Abuse number DA00209 and DA08324. An earlier version of this paper was presented at the annual meeting of the College on Problems of Drug Dependence in Scottsdale Arizona, June, 1998.
PY - 2000/3/1
Y1 - 2000/3/1
N2 - Drug abusers with psychiatric comorbidity are at high risk for becoming exposed to HIV. To address this compelling public health issue, our randomized HIV prevention study compares the effectiveness of the NIDA standard HIV testing and counseling protocol to a four session, peer-delivered, educational intervention for out-of-treatment cocaine users with and without antisocial personality disorder (ASPD) and major depression. Among the 966 out-of-treatment cocaine users who have completed the 3 month follow-up, all groups, regardless of assignment to standard vs. peer-delivered intervention or psychiatric status, improved significantly in: crack cocaine use, injection drug use, number of IDU sex partners and overall number of sex partners, but not in condom use. Nevertheless, when stratified by psychiatric status, ASPD was associated with significantly less improvement in crack cocaine use (P=0.04) and with a trend for less improvement in having multiple sex partners and having IDU sex partners (P=0.06 and 0.08, respectively). ASPD status was not associated with change in injection drug use or condom use. Depression was associated with a trend (P=0.07) for greater improvement in crack cocaine use but not in any of the other behaviors. When examining the standard and peer intervention groups separately, no consistent differences in the association of psychiatric comorbidity with outcome were discerned between the two groups. We conclude that persons with ASPD and depression respond well to standard HIV prevention interventions, but these psychiatric disorders respectively attenuate and enhance response somewhat. Behavioral interventions tailored for persons with these conditions may be indicated if long-term change in HIV risk behaviors is to be achieved. Copyright (C) 2000 Elsevier Science Ireland Ltd.
AB - Drug abusers with psychiatric comorbidity are at high risk for becoming exposed to HIV. To address this compelling public health issue, our randomized HIV prevention study compares the effectiveness of the NIDA standard HIV testing and counseling protocol to a four session, peer-delivered, educational intervention for out-of-treatment cocaine users with and without antisocial personality disorder (ASPD) and major depression. Among the 966 out-of-treatment cocaine users who have completed the 3 month follow-up, all groups, regardless of assignment to standard vs. peer-delivered intervention or psychiatric status, improved significantly in: crack cocaine use, injection drug use, number of IDU sex partners and overall number of sex partners, but not in condom use. Nevertheless, when stratified by psychiatric status, ASPD was associated with significantly less improvement in crack cocaine use (P=0.04) and with a trend for less improvement in having multiple sex partners and having IDU sex partners (P=0.06 and 0.08, respectively). ASPD status was not associated with change in injection drug use or condom use. Depression was associated with a trend (P=0.07) for greater improvement in crack cocaine use but not in any of the other behaviors. When examining the standard and peer intervention groups separately, no consistent differences in the association of psychiatric comorbidity with outcome were discerned between the two groups. We conclude that persons with ASPD and depression respond well to standard HIV prevention interventions, but these psychiatric disorders respectively attenuate and enhance response somewhat. Behavioral interventions tailored for persons with these conditions may be indicated if long-term change in HIV risk behaviors is to be achieved. Copyright (C) 2000 Elsevier Science Ireland Ltd.
KW - AIDS
KW - Antisocial personality
KW - Comorbidity
KW - Depression
KW - Drug abuse
KW - HIV prevention
UR - http://www.scopus.com/inward/record.url?scp=0034159921&partnerID=8YFLogxK
U2 - 10.1016/S0376-8716(99)00097-6
DO - 10.1016/S0376-8716(99)00097-6
M3 - Article
C2 - 10759035
AN - SCOPUS:0034159921
SN - 0376-8716
VL - 58
SP - 247
EP - 257
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
IS - 3
ER -