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AJPH First Look, published online ahead of print Sep 17, 2008
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June 2009, Vol 99, No. 6 | American Journal of Public Health 1100-1107
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2007.121186

RESEARCH AND PRACTICE

Reducing Risky Sexual Behavior and Substance Use Among Currently and Formerly Homeless Adults Living With HIV

Mary Jane Rotheram-Borus, PhD, Katherine Desmond, MS, W. Scott Comulada, DrPH, Elizabeth Mayfield Arnold, PhD and Mallory Johnson, PhD

Mary Jane Rotheram-Borus, Katherine Desmond, W. Scott Comulada, and the Healthy Living Trial Group are with the Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Elizabeth Mayfield Arnold is with the Wake Forest University School of Medicine, Winston-Salem, NC. Mallory Johnson is with the Department of Medicine, University of California, San Francisco.

Correspondence: Requests for reprints should be sent to Mary Jane Rotheram-Borus, PhD, 10920 Wilshire Blvd, Suite 350, Los Angeles, CA 90024 (e-mail: rotheram{at}ucla.edu).

Objectives. We examined the efficacy of the Healthy Living Program in reducing risky sexual behavior and substance use among adults with HIV infection who were marginally housed (i.e., homeless at some point over a 37-month period).

Methods. We had previously conducted a randomized controlled trial with 936 adults living with HIV infection. In that study, 3 intervention modules of 5 sessions each addressed different goals: reducing risky sexual acts and drug use, improving the quality of life, and adhering to healthful behaviors. Participants were interviewed at baseline and at 5, 10, 15, 20, and 25 months; 746 completed 4 or more assessments. In this study, we analyzed sexual behavior and drug use outcomes for the 35% (n = 270 of 767) of participants who were considered marginally housed.

Results. Among the marginally housed participants, there were significantly greater reductions in unprotected risky sexual acts, the number of sexual partners of HIV negative or unknown serostatus, alcohol or marijuana use, and hard drug use among the intervention group than among the control group.

Conclusions. Intensive, skill-focused intervention programs may improve the lives of marginally housed adults living with HIV infection.






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