Adapted personalized cognitive counseling for episodic substance-using men who have sex with men: a randomized controlled trial

Abstract

Episodic drug use and binge drinking are associated with HIV risk among substance-using men who have sex with men (SUMSM), yet no evidence-based interventions exist for these men. We adapted personalized cognitive counseling (PCC) to address self-justifications for high-risk sex among HIV-negative, episodic SUMSM, then randomized men to PCC (n = 162) with HIV testing or control (n = 164) with HIV testing alone. No significant between-group differences were found in the three primary study outcomes: number of unprotected anal intercourse events (UAI), number of UAI partners, and UAI with three most recent non-primary partners. In a planned subgroup analysis of non-substance dependent men, there were significant reductions in UAI with most recent non-primary partners among PCC participants (RR = 0.56; 95 %CI 0.34-0.92; P = 0.02). We did not find evidence that PCC reduced sexual risk behaviors overall, but observed significant reductions in UAI events among non-dependent SUMSM. PCC may be beneficial among SUMSM screening negative for substance dependence.

Conflict of interest statement

Conflict of interest Authors declare no conflicts of interest.

Figures

Fig. 1

Flow diagram of Project ECHO participant enrollment, allocation, and retention, San Francisco, 2010–2012 Legend: PCC personalized cognitive counseling, ITT intent to treat, SDS severity of dependence scale

Fig. 2

Unprotected anal intercourse with three most recent non-primary partners among non-dependent substance-using MSM (N = 186) by treatment arm, Project ECHO, San Francisco, 2010–2012 Legend: UAI unprotected anal intercourse, PCC personalized cognitive counseling