This project assesses methods for decreasing HIV-risk behaviors in substance abusers, and assesses the safety and efficacy of pharmacological and behavioral treatments for opioid dependence in those already infected with HIV. A randomized clinical trial, nearing completion, examines whether sustained HIV-protective behaviors can be achieved by adding a cognitive-behavioral coping-skills and relapse- prevention intervention to voucher-based contingency management. Inner- city methadone-maintained cocaine abusers are taught: 1) to identify and seek out sources of reinforcement that do not carry risks of HIV; and 2) to develop adaptive problem-focused and emotion-focused coping responses to general and drug-specific stressors that might otherwise trigger HIV-risk behaviors. - opioid dependence, cocaine, methadone, heroin, HIV, HIV risk behaviors - Human Subjects
