California: Harm-Reduction Program Optimizes HIV/AIDS Prevention

May 6, 2014

This article was reported by Medical Xpress.

Medical Xpress reported on a study of a harm-reduction substance use treatment program to help participants reduce stimulant use and decrease sexual risk behavior. Researchers from the University of California, San Francisco (UCSF) and the San Francisco AIDS Foundation (SFAF) evaluated 211 methamphetamine-using men who have sex with men (MSM) who enrolled in the Stonewall Project, an SFAF program for substance-using gay and bisexual men and other MSM. The program uses evidence-based cognitive-behavioral substance use treatment.

Clients could choose abstinence or use harm-reduction strategies such as less potent types of drug use or reducing sexual risk-taking while under the influence. The risk-reduction strategies include condom use during sex, seroadaptive behaviors, and decreasing the number of sex partners. The researchers explained that stimulant use is a key barrier to HIV prevention and care, but the program does not insist on abstinence. Instead, it worked with clients whether or not they were able to stop using, to teach them better ways of caring for themselves and improving their lives.

Adam W. Carrico, Ph.D., UCSF assistant professor of nursing, noted that participants reported that even when they used methamphetamine, they followed HIV risk-reduction strategies after participating in Stonewall. Michael V. Discepola, MA, director for the Stonewall Project at SFAF, concluded that helping HIV-positive clients adhere to their treatment program not only improved their health, but also reduced the likelihood of HIV transmission. Carrico suggested a larger randomized controlled trial comparing abstinence-based and harm-reduction approaches as a follow-up to this study.

The full report, "Community-Based Harm Reduction Substance Abuse Treatment With Methamphetamine -- Using Men Who Have Sex With Men," was published online in the Journal of Urban Health (2014; doi: 10.1007/s11524-014-9870-y).

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This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.

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