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J Addict Med. 2013 Nov-Dec;7(6):410-6. doi: 10.1097/ADM.0b013e3182a3b603.

HIV testing and sexual risk reduction counseling in office-based buprenorphine/naloxone treatment.

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From the Department of Internal Medicine (EJE, SC, DAF, LEF), Yale School of Medicine, New Haven, CT; Center for Interdisciplinary Research on AIDS (EJE, DAF, LEF), Yale School of Public Health, New Haven, CT; Department of Psychiatry (BAM, SC, RSS), Yale School of Medicine, New Haven, CT; Departments of Psychology, Neuroscience and Global Health, Psychiatry and Behavioral Science (KJS), Duke University, Durham, NC; and Department of Adult and Family Medicine (ESJ), The Permanente Medical Group, Oakland, CA.



We assessed the feasibility and preliminary efficacy of human immunodeficiency virus (HIV) testing with sexual risk reduction counseling for opioid-dependent patients initiating office-based buprenorphine/naloxone treatment.


We conducted a 14-week randomized, controlled trial with 30 patients (original target of 114) assigned to receive buprenorphine/naloxone induction/stabilization and HIV testing with Brief Sexual Risk Management (BSRM) or Enhanced Sexual Risk Management (ESRM). We evaluated process measures and compared outcomes at baseline and during the 3-month follow-up.


Similar proportions of patients receiving BSRM and ESRM underwent HIV testing (93% vs 80%; P = 0.28) and completed counseling sessions (80% vs 67%; P = 0.40). Brief Sexual Risk Management sessions were shorter than ESRM sessions (15.4 vs 23.4 minutes), with comparable manual adherence (P = 0.80). Outcomes did not vary by BSRM versus ESRM.


Although the recruitment of opioid-dependent patients with sexual risk behaviors is challenging, HIV testing with sexual risk reduction counseling in office-based buprenorphine/naloxone treatment practice is feasible. Interventions to decrease sexual risk behaviors among a segment of this population are necessary.

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