Utility of the AIDS risk assessment for crack cocaine and sex risk behaviours among homeless persons addicted to crack undergoing behavioural day treatment

The primary aim of this study was to assess the impact of an HIV and drug addiction intervention on reported sexual transmission HIV risk and drug use among homeless persons in two treatments for cocaine addiction. The ARA‐C study (n=104) included 74 (71.2%) men and 30 (28.8%) women with an average age of 37.8 (SD=6.9) years. Most participants were African American (90, 86.5%) and the remainder were Caucasian (14, 13.5%). All participants met criteria for homelessness, nonpsychotic mental distress, and admitted to smoking crack cocaine within the 2 weeks prior to treatment. It appears that, overall, behavioural day treatment for cocaine disorders among homeless persons can have a short‐ and long‐term impact on the reduction of sexual transmission HIV risk among this population with a minimal sexual transmission HIV risk intervention. The causal factors of this outcome still remain unclear. Treatment group differences did not sufficiently explain sexual transmission risk reductions and the impact of the HIV risk education programme was impossible to explain because it was provided to all participants and was only a small part of the overall programme. There did seem to be a small contribution of drug abstinence in the reduction of sexually transmitted risk, but this was at one time point for the Sex and Crack subscale only. This study demonstrates that there may be promise in providing drug addiction treatment combined with sexual transmission HIV risk reduction prevention programming for this extremely vulnerable group, and that future interventions should be better designed and tested using more robust research.