Voluntary testing, counseling for HIV decreases unprotected sex acts among cocaine, heroin users

Voluntary testing and counseling (VT/C) for HIV or sexually transmitted infections (STI) among cocaine and heroin users who were treated in the emergency department (ED), accompanied by referral to drug treatment, was associated with reduction in unprotected sex acts and fewer sex acts while high according to researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC).

These findings currently appear on-line in Academic Emergency Medicine.

In the United States, sexual risk behaviors are a greater source of HIV transmission than injection drug use. Although recent articles have focused on the opportunity for early HIV detection and treatment through an array of ED screening and testing strategies, the effect of VT/C and referral to drug treatment on the sexual behaviors of out-of-treatment drug users over time has not yet been reported.

From November 2004 to May 2008, the researchers screened 46,208 urban ED patients age 18-54, of which 1,030 were enrolled in the study. Follow-up appointments were conducted at both six- and 12-month intervals.

The researchers found an increase in condom use among participants on longitudinal follow up at six-month and 12-months. Males, older patients and HIV positive patients were more likely to use condoms in their sexual encounters. Over the same period the researchers also found a significant decline in sex acts while high.

"Our study findings represent the largest published data set of HIV⁄ STI screening and testing and subsequent changes in sexual risk behaviors among a diverse ED patient population of cocaine and heroin users," explained Edward Bernstein, MD, from the department of Emergency Medicine at BUSM and BMC. "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."