An urgent need exists for treatments to reduce HIV risk behaviors among HIV-seropositive injection drug users as well as to determine optimal treatment intensity to accomplish this goal. The proposed study is a Stage 2 behavioral therapies development project (#PA-94-078) in response to Addendum (NIH Guide, Vol. 12, #40) requesting proposals investigating therapies for reducing AIDS risk behaviors. One hundred HIV-seropositive cocaine-abusing methadone-maintained patients will be stratified by severity of cognitive impairment and randomly assigned to receive either a comprehensive Risk Reduction Methadone Program, developed specifically for HIV-positive injection drug users, or a standard methadone program that includes NIDA's HIV Counseling and Education Intervention.
The specific aims of this study are: (a) to determine the relative efficacy of a specialized Risk Reduction Methadone Program for reducing high risk behaviors and increasing compliance with medical regimens in HIV-seropositive injection drug users, at treatment completion and at a three-month follow-up; and (b) to explore predictors of treatment outcome, such as cognitive ability, disease progression, psychosocial functioning, and motivation for behavior change.
