Reductions in alcohol and cocaine use following a group coping intervention for HIV-positive adults with childhood sexual abuse histories
Article first published online: 15 SEP 2010
© 2010 The Authors, Addiction © 2010 Society for the Study of Addiction
Volume 105, Issue 11, pages 1942–1951, November 2010
How to Cite
Meade, C. S., Drabkin, A. S., Hansen, N. B., Wilson, P. A., Kochman, A. and Sikkema, K. J. (2010), Reductions in alcohol and cocaine use following a group coping intervention for HIV-positive adults with childhood sexual abuse histories. Addiction, 105: 1942–1951. doi: 10.1111/j.1360-0443.2010.03075.x
- Issue published online: 6 OCT 2010
- Article first published online: 15 SEP 2010
- Submitted 16 November 2009; initial review completed 18 January 2010; final version accepted 3 May 2010
- randomized controlled trial;
- sexual abuse;
- substance use
Aims Few interventions exist to reduce alcohol and non-injection drug use among people living with HIV/AIDS. This study tested the effects of a coping group intervention for HIV-positive adults with childhood sexual abuse histories on alcohol, cocaine and marijuana use.
Design Participants were assigned randomly to the experimental coping group or a time-matched comparison support group. Both interventions were delivered in a group format over 15 weekly 90-minute sessions.
Setting and Participants A diverse sample of 247 HIV-positive men and women with childhood sexual abuse were recruited from AIDS service organizations and community health centers in New York City.
Measurements Substance use was assessed pre- and post-intervention and every 4 months during a 12-month follow-up period. Using an intent-to-treat analysis, longitudinal changes in substance use by condition were assessed using generalized estimating equations.
Findings At baseline, 42% of participants drank alcohol, 26% used cocaine and 26% used marijuana. Relative to participants in the support group, those in the coping group had greater reductions in quantity of alcohol use (Wald χ2(4) = 10.77, P = 0.029) and any cocaine use (Wald χ2(4) = 9.81, P = 0.044) overtime.
Conclusions Many HIV patients, particularly those with childhood sexual abuse histories, continue to abuse substances. This group intervention that addressed coping with HIV and sexual trauma was effective in reducing alcohol and cocaine use, with effects sustained at 12-month follow-up. Integrating mental health treatment into HIV prevention may improve outcomes.