Harm-reduction program optimizes HIV/AIDS prevention

April 21, 2014 by Jeff Sheehy

(Medical Xpress)—New research from UC San Francisco and the San Francisco AIDS Foundation has found that clients participating in a harm-reduction substance use treatment program, the Stonewall Project, decrease their use of stimulants, such as methamphetamine, and reduce their sexual risk behavior.

Harm reduction is a public health philosophy and strategy designed to reduce the harmful consequences of various, sometimes illegal, human behaviors such as the use of alcohol and other drugs regardless of whether a person is willing or able to cease that behavior.

"We found that even when participants were using methamphetamine, they reported engaging in HIV risk-reduction strategies such as having fewer anal sex partners after enrolling in Stonewall," said the study's lead investigator, Adam W. Carrico, PhD., UCSF assistant professor of nursing.

The research findings appear online on April 18 in the Journal of Urban Health. The Stonewall Project, a San Francisco AIDS Foundation program, serves substance-using gay and bisexual men as well as other men who have sex with men. Stonewall implements evidence-based, cognitive-behavioral substance use treatment from a harm-reduction perspective. At Stonewall, clients have the option of abstinence, but may also use harm-reduction strategies such as transitioning to less potent modes of administration (e.g., injecting to snorting) or reducing sexual risk taking while they are under the influence.

Some sexual risk-reduction strategies delivered by the Stonewall Project are condom use promotion during sex, seroadaptive behaviors (having sex in ways that reduces the risk of acquiring or transmitting HIV) and decreasing the number of .

"We showed Stonewall can address stimulant use, a key barrier to HIV prevention and care, without insisting on abstinence. Our program, which is based on a willingness to work with clients regardless of their ability and/or willingness to stop using and teach them better ways to take care of themselves and improve their lives, has been borne out by these findings," said study co-investigator, Michael D. Siever, PhD, founder of the Stonewall Project.

Two-thirds of the 211 methamphetamine-using men who have sex men enrolled in the study were HIV positive, and there was some evidence to suggest that Stonewall's harm reduction counseling may also assist men in taking their anti-HIV medications effectively enough to achieve an undetectable level of HIV in their blood.

"By helping our HIV-positive clients succeed in treating their HIV, we're not only improving their health, but also reducing their likelihood of transmitting the virus," said study co-investigator, Michael V. Discepola, M.A., director of the Stonewall Project at SFAF.

The next step following the findings of this research would be conducting a larger randomized controlled trial comparing abstinence-based and harm reduction approaches, added Carrico.

Annesa Flentje, Valerie A. Gruber, William J. Woods, Samantha E. Dilworth, Torsten B. Neilands and Jennifer Jain, all from UCSF, are study co-investigators.

The research was funded by the California HIV/AIDS Research Program.

About San Francisco AIDS Foundation: No city experienced epidemic levels of HIV faster than San Francisco did. At San Francisco AIDS Foundation, we work to end the epidemic where it first took hold, and eventually everywhere. Established in 1982, our mission is the radical reduction of new infections in San Francisco. Through education, advocacy, and direct services for prevention and care, we are confronting HIV in communities most vulnerable to the disease. We refuse to accept that HIV transmission is inevitable.

Explore further: Good news for HIV treatment as prevention

More information: "Community-Based Harm Reduction Substance Abuse Treatment with Methamphetamine-Using Men Who Have Sex with Men." Adam W. Carrico, et al. Journal of Urban Health, Bulletin of the New York Academy of Medicine © The Author(s) 2014. DOI: 10.1007/s11524-014-9870-y

Related Stories

Good news for HIV treatment as prevention

March 7, 2014
The Kirby Institute at UNSW Australia welcomes early results from the PARTNER study, which has found that HIV positive gay men who are on treatment and have undetectable viral load are not transmitting HIV to their partners.

The double whammy of multiple sex partners and drinking in HIV/STI prevention

April 8, 2014
The more you drink and sleep around, the less likely you are to participate in HIV intervention counseling.

Cutting HIV in drug users can benefit others' AIDS mortality

March 26, 2014
(HealthDay)—Efforts to curb HIV transmission among people who inject drugs (PWID) and non-injecting drug users (NIDUs) may reduce AIDS and AIDS-related mortality among heterosexuals, according to a study published in the ...

Overcoming barriers to partner notification of HIV

February 5, 2014
(Medical Xpress)—Among the most difficult barriers to preventing the spread of HIV are those that hamper the notification of sexual and needle-sharing partners that they have been exposed to the infection. In a new study, ...

Gay men divided over use of HIV prevention drug

April 6, 2014
A drug hailed as a lifesaver for many people infected by HIV is at the heart of a rancorous debate among gay men, AIDS activists and health professionals over its potential for protecting uninfected men who engage in gay ...

How sexual contacts with outsiders contribute to HIV infections within communities

March 4, 2014
While a number of strategies can prevent and control HIV transmission and spread, their effective use depends on understanding the sexual networks within and between communities. A paper published in this week's PLOS Medicine ...

Recommended for you

Paris spotlight on latest in AIDS science

July 21, 2017
Some 6,000 HIV experts gather in Paris from Sunday to report advances in AIDS science as fading hopes of finding a cure push research into new fields.

Scientists elicit broadly neutralizing antibodies to HIV in calves

July 20, 2017
Scientists supported by the National Institutes of Health have achieved a significant step forward, eliciting broadly neutralizing antibodies (bNAbs) to HIV by immunizing calves. The findings offer insights for HIV vaccine ...

Heart toxin reveals new insights into HIV-1 integration in T cell genome

July 20, 2017
Human immunodeficiency virus (HIV)-1 may have evolved to integrate its genetic material into certain immune-cell-activating genes in humans, according to new research published in PLOS Pathogens.

Scientists capture first high-resolution image of key HIV protein transitional state

July 13, 2017
A new, three-dimensional snapshot of HIV demonstrates the radical structural transformations that enable the virus to recognize and infect host cells, according to a new study led by scientists at The Scripps Research Institute ...

Barrier to autoimmune disease may open door to HIV, study suggests

July 11, 2017
Researchers from the University of Colorado School of Medicine have discovered that a process that protects the body from autoimmune disease also prevents the immune system from generating antibodies that can neutralize the ...

Team tests best delivery mode for potential HIV vaccine

June 20, 2017
For decades, HIV has successfully evaded all efforts to create an effective vaccine but researchers at The Scripps Research Institute (TSRI) and the La Jolla Institute for Allergy and Immunology (LJI) are steadily inching ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.