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HIV/STD counseling in ED linked to less unprotected sex among drug users
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Researchers observed a decrease in unprotected sex and fewer sex acts among adult cocaine and heroin users who received voluntary testing and counseling for HIV or STDs when treated in the ED while taking illicit drugs.
“Our study findings represent the largest published data set of HIV/STD screening and testing and subsequent changes in sexual risk behaviors among a diverse ED patient population of cocaine and heroin users,” Edward Bernstein, MD, of the department of emergency medicine at Boston University School of Medicine, said in a press release. “The increase in condom use and the decrease in sex while high support the importance of easy access to HIV counseling and testing and ED drug screening and referral treatment.”
From November 2004 to May 2008, 46,208 ED patients aged 18 to 54 years were screened. The mean age of the patients was 35.8 years (67% male, 41% white).
Of those screened, 4.6% reported cocaine or heroin use; 1,030 of those screened were included in the study. Fifty percent reported injecting drugs; 53% had posttraumatic stress disorder; and 8.8% were HIV-positive.
All participants received voluntary HIV/STD counseling and referral to drug treatment; follow-up was at 6 months and 1 year. At 6 months, researchers observed a significant reduction in the percentage of unprotected sex acts after ED counseling (OR=0.7; 95% CI, 0.6-0.83), which was sustained at 1 year (OR=0.69; 95% CI, 0.58-0.82). In addition, a significant reduction of sex acts while taking illicit drugs at 6 months was observed (OR=0.31; 95% CI, 0.25-0.37), which was sustained at 1 year (OR=0.25; 95% CI, 0.2-0.3).
In an adjusted model, being male, older age and HIV-positive were associated with significant declines of unprotected sex acts. Older age and higher baseline drug severity predicted decreased sex acts while taking illicit drugs.
References:
- Bernstein E. Acad Emerg Med. 2012;19:386-395.
Disclosures:
- Dr. Bernstein reports no relevant financial disclosures. The study was funded by the NIH and the National Institute of Drug Abuse.