Substance use and drinking outcomes in Personalized Cognitive Counseling randomized trial for episodic substance-using men who have sex with men.
Glenn-Milo Santos, Phillip O Coffin, Eric Vittinghoff, Erin DeMicco, Moupali Das, Tim Matheson, Jerris L Raiford, Monique Carry, Grant Colfax, Jeffrey H Herbst, James W Dilley
Author Information
Glenn-Milo Santos: San Francisco Department of Public Health, Substance Use Research Unit, San Francisco, CA, USA; University of California, San Francisco, San Francisco, CA, USA. Electronic address: glenn-milo.santos@sfdph.org.
Phillip O Coffin: San Francisco Department of Public Health, Substance Use Research Unit, San Francisco, CA, USA; University of California, San Francisco, San Francisco, CA, USA.
Eric Vittinghoff: University of California, San Francisco, San Francisco, CA, USA.
Erin DeMicco: San Francisco Department of Public Health, Substance Use Research Unit, San Francisco, CA, USA.
Moupali Das: San Francisco Department of Public Health, Substance Use Research Unit, San Francisco, CA, USA; University of California, San Francisco, San Francisco, CA, USA.
Tim Matheson: San Francisco Department of Public Health, Substance Use Research Unit, San Francisco, CA, USA.
Jerris L Raiford: Centers for Disease Control and Prevention (CDC), National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA, USA.
Monique Carry: Centers for Disease Control and Prevention (CDC), National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA, USA.
Grant Colfax: San Francisco Department of Public Health, Substance Use Research Unit, San Francisco, CA, USA.
Jeffrey H Herbst: Centers for Disease Control and Prevention (CDC), National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA, USA.
James W Dilley: University of California, San Francisco, San Francisco, CA, USA.
BACKGROUND: Non-dependent alcohol and substance use patterns are prevalent among men who have sex with men (MSM), yet few effective interventions to reduce their substance use are available for these men. We evaluated whether an adapted brief counseling intervention aimed at reducing HIV risk behavior was associated with secondary benefits of reducing substance use among episodic substance-using MSM (SUMSM). METHODS: 326 episodic SUMSM were randomized to brief Personalized Cognitive Counseling (PCC) intervention with rapid HIV testing or to rapid HIV testing only control. Both arms followed over 6 months. Trends in substance use were examined using GEE Poisson models with robust standard errors by arm. Reductions in frequency of use were examined using ordered logistic regression. RESULTS: In intent-to-treat analyses, compared to men who received rapid HIV testing only, we found men randomized to PCC with rapid HIV testing were more likely to report abstaining from alcohol consumption (RR=0.93; 95% CI=0.89-0.97), marijuana use (RR=0.84; 95% CI=0.73-0.98), and erectile dysfunction drug use (EDD; RR=0.51; 95% CI=0.33-0.79) over the 6-month follow-up. PCC was also significantly associated with reductions in frequency of alcohol intoxication (OR=0.58; 95% CI=0.36-0.90) over follow-up. Furthermore, we found PCC was associated with significant reductions in number of unprotected anal intercourse events while under the influence of methamphetamine (RR=0.26; 95% CI=0.08-0.84). CONCLUSION: The addition of adapted PCC to rapid HIV testing may have benefits in increasing abstinence from certain classes of substances previously associated with HIV risk, including alcohol and EDD; and reducing alcohol intoxication frequency and high-risk sexual behaviors concurrent with methamphetamine use.
