Reducing High Risk Behavior in Treatment Court

Delivering HIV Risk Reduction Services in Treatment Court

This study will be the first to examine the efficacy of using a brief, computerized HIV risk reduction intervention in treatment courts.

Study Overview

• Status: Completed
• Conditions: HIV; Substance Abuse
• Intervention / Treatment: Behavioral: Attention Control; Behavioral: Computer-facilitated HIV intervention

Detailed Description

Four hundred consenting treatment drug court participants will be randomly assigned to either an HIV intervention group (n = 200) or an attention control group. All clients will attend their regularly scheduled status hearings which are scheduled approximately every six weeks. Clients in the HIV intervention group will receive a brief computerized, self-administered HIV risk reduction intervention following each of their first three status hearings. Clients in the attention control condition will view a series of educational life-skill videos of matched length following each of their first three status hearings. The primary outcome will be engagement in high risk behaviors as measured by the Risk Assessment Battery (RAB). Secondary HIV-related outcomes will include: (1) rate of HIV testing, (2) condom procurement, and (3) self-reported condom use. Tertiary outcomes related to treatment court compliance will include: (1) drug court graduation, (2) urinalysis-confirmed drug abstinence, (3) case management attendance, and (4) satisfaction with case management. In addition, we will conduct preliminary cost and cost-effectiveness analyses on the delivery of the brief computerized HIV intervention. Assessments will be conducted at baseline and 9- and 15-months post admission.

• Study Type: Interventional
• Enrollment (Actual): 371
• Phase: Phase 1

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19107
      • Philadelphia Treatment Court

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. be at least 18 years of age;
2. be charged with a non-violent felony offense
3. have no more than two prior non-violent convictions or diversionary opportunities
4. be willing to participate in the treatment court program for at least 12 months
5. be in need of treatment for substance abuse or dependence as assessed by case management.

Exclusion Criteria:

• Elderly subjects and those with medical problems will be included in the research as long as they do not have any physical or psychiatric condition that would impede their ability to give competent consent to research participation or to understand the research instruments.
• Those individuals who are intoxicated, cognitively impaired, or psychiatrically unstable when approached will not be included; however, such individuals may subsequently be included if the disqualifying condition subsides.
• Spanish speaking only individuals.
• Client remanded to jail or residential treatment facilities at the time of Treatment Court enrollment.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Attention Control	Behavioral: Attention Control; Life skills training DVDs that match the duration of the anticipated experimental condition. The DVDs address topics such as positive listening skills, anger management, and stress reduction.
Experimental: Computer-facilitated HIV intervention	Behavioral: Computer-facilitated HIV intervention; Individuals assigned to the experimental condition will complete the self-directed CARE HIV intervention during each of their first three sessions. The 20 minute intervention sessions involve several components including a brief risk assessment, review of identified risks, structured skill building videos, and the development of a risk prevention action plan. Because of the adaptive nature of the CARE program, the content of each session will be tailored to address the current risks of the participant. While the main focus of the intervention is on risk, individuals who report being HIV infected will receive a referral to treatment if they are not currently receiving medical care and their session will address, among other things, adherence to HIV care.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Engagement in high risk behaviors	Measured by the Risk Assessment Battery (RAB)	15 month follow-up

Secondary Outcome Measures

Outcome Measure	Time Frame
Rate of HIV testing	15 month follow-up
Condom Procurement	15 month follow-up
Self-reported Condom Use	15 month follow-up

Collaborators and Investigators

• Sponsor: Treatment Research Institute
• Collaborators: National Institute on Drug Abuse (NIDA)
• Investigators: Principal Investigator: David S Festinger, Ph.D., Treatment Research Institute

Study record dates

Study Major Dates

• Study Start: September 1, 2012
• Primary Completion (Actual): December 1, 2016
• Study Completion (Actual): December 1, 2016

Study Registration Dates

• First Submitted: November 18, 2011
• First Submitted That Met QC Criteria: November 28, 2011
• First Posted (Estimate): November 29, 2011

Study Record Updates

• Last Update Posted (Actual): March 28, 2023
• Last Update Submitted That Met QC Criteria: March 27, 2023
• Last Verified: March 1, 2023

More Information

Terms related to this study

• Keywords: Substance abuse; HIV intervention; High risk behavior; Drug court clients; Treatment Court Clients
• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Substance-Related Disorders
• Other Study ID Numbers: #1002; R01DA030257 (U.S. NIH Grant/Contract)