A randomized controlled trial of the community-friendly health recovery program (CHRP) among high-risk drug users in treatment

Abstract

Existing evidence-based HIV risk reduction interventions have not been designed for implementation within clinical settings, such as methadone maintenance programs, where many high-risk drug users seek treatment services. We therefore systematically developed an adapted, significantly shortened, version of a comprehensive evidence-based intervention called the Community-friendly Health Recovery Program (CHRP) which has demonstrated preliminary evidence of efficacy in a feasibility/acceptability study already published. In a randomized controlled trial reported here, we tested the efficacy of the CHRP intervention among high-risk drug users newly enrolled in drug treatment at an inner-city methadone maintenance program. The CHRP intervention produced improvements in drug risk reduction knowledge as well as demonstrated sex- and drug-risk reduction skills. Support was found for the IMB model of health behavior change. Implications for future intervention research and practice are considered.

Figures

Fig. 1

Participant flow through phases of the study

Fig. 2

Demonstrated drug risk reduction skills over time by group

Fig. 3

Demonstrated drug risk reduction skills over time by gender

Fig. 4

Demonstrated female and male condom application skills by group

Fig. 5

IMB model of drug risk reduction skills and behavior among all participants after the intervention onwards. The good fitting indices were: χ2(4) = 4.68, p = 0.32, CFI = 0.97, RMSEA = 0.025 (0.000, 0.098). Standardized coefficients in the parentheses. *p <0.05; **p <0.01; ***p <0.001

Fig. 6

IMB model of sex risk reduction skills and behavior among all participants after the intervention onwards. χ2(11) = 10.33, p = 0.50, CFI = 1.00, RMSEA = 0.00 (0.00, 0.07). Standardized coefficients in the parentheses. +p <0.10, *p <0.05; *** p <0.001