Our objectives were to assess the effects of a psychoeducational (PE) program designed to reduce HIV risk behaviors in recovering drug abusers and to evaluate mediating variables associated with risk reduction as described by the AIDS Risk Reduction Model (ARRM). Consecutive admissions to a Department of Veterans Affairs drug dependence inpatient treatment program (n = 152) were randomly assigned to PE or a standard information (INFO) condition. PE involved a 6-hour small group intervention designed to enhance knowledge and attitudes regarding HIV prevention, improve skills in condom use and needle sterilization, and modify high-risk sex- and drug-related behaviors. The INFO condition involved presentation of audiovisual and printed HIV prevention material with similar content. Following intervention, PE subjects showed significantly enhanced self-efficacy, condom use skills, and sexual communication skills relative to the INFO group. At 3-month follow-up, the PE group showed significantly greater reductions on some measures of sexual HIV risk behaviors relative to the INFO group. Hypotheses derived from the ARRM regarding presumed relationships between positive changes in mediating variables (e.g., self-efficacy and sexual communication) and ultimate outcome variables (e.g., condom use) were supported.
PIP: The objectives were to assess the effects of a psychoeducational (PE) program designed to reduce HIV risk behaviors in recovering drug abusers and to evaluate mediating variables associated with risk reduction as described by the AIDS Risk Reduction Model (ARRM). African-American male participants with no evidence of HIV seropositivity were recruited over a 10-month period from among 235 consecutive admissions to the Department of Veteran's Affair Drug Dependence Treatment Program (DDTP). 176 subjects fulfilled eligibility criteria. 152 consecutive admissions to DDTP were randomly assigned to either or standard information (INFO) groups of equal size. PE involved a 6-hour small group intervention to enhance knowledge regarding HIV prevention, improve condom use and needle sterilization skills, and modify high-risk sex- and drug-related behaviors. The INFO condition involved presentation of HIV prevention materials with similar content. Subjects were an average of 35.5 years old with 13.06 years old with 13.06 years of education, and an estimated IQ of 105.4 Overall, subjects reported a significant reduction in high-risk behaviors at 3 months compared to preintervention levels (p .0001). 75% of the subjects in the PE group reported higher sexual risk behaviors before the intervention vs. 32% at 3 months (p .0001). Also, 75% of INFO subjects were at higher risk pretreatment, which decreased to 48% at 3 months (p .01). There was a trend toward greater risk reduction in the PE group. 25 (62.5%) of the 40 PE subjects at higher risk prior to the intervention were at lower risk at the 3-month follow-up. In the INFO group, 51.2% of the preintervention higher risk subjects were at lower risk 3 months postintervention. Among the 107 subjects completing the 3-month follow-up, significantly fewer reported more than one partner, from 75.5% preintervention to 50.5% at 3 months (p = .0001). 75.5% of PE subjects reported more than one sexual partner preintervention vs. 47.5% at 3 months (binomial p = .0001). In the INFO group, this declined from 75.9% to 59.3%, which was without statistical significance.