Facilitation into Drug Treatment or Self-Help among out-of-Treatment IDUS in Portland: You Can Lead a Horse to Water,But…

Abstract

This study's purpose was to encourage out-of-treatment injection drug users (IDUs) to participate in drug treatment or self-help, and thereby reduce their injection drug use and HIV risk. In Portland, Oregon, IDUs were recruited for HIV counseling and testing and were randomly assigned to a standard intervention (SI) or one of two enhanced intervention (EI) groups. SI subjects received two sessions of counseling and testing only. In addition to counseling and testing, EI subjects received social support and incentives designed to facilitate their entrance into either drug treatment (DT) or self-help (SH). Compared to SI subjects, a higher proportion of DT subjects initiated drug treatment, and more SH subjects initiated self-help. There was, however, rapid dropout from DT and SH among EI participants, and no difference was found between SI and EI subjects in injecting at a 6-month follow-up. Subjects retained in DT or SH had reduced injection drug use, suggesting the need to determine factors that make DT and SH more intrinsically appealing.