Sexual-risk reduction following the referral of syringe exchange registrants to methadone maintenance: Impact of gender and drug use.

This study evaluates the impact of enrolling syringe exchange registrants in methadone maintenance on change in sexual-risk behaviors. Baltimore Needle Exchange Program (BNEP) registrants (n = 210) participated in a parent study evaluating strategies for initiating methadone maintenance treatment and the study followed them for six months. Study staff administered the Risk Assessment Battery (RAB; Metzger, 1993) monthly throughout treatment. Staff conducted urinalysis testing weekly. Results showed that treatment enrollment reduced sexual-risk behaviors at month 1, though a longer treatment duration provided no further reductions in risky behaviors. Women reported higher levels of sexual risk throughout the observation period, and the use of cocaine diminished risk-reduction benefits. These findings demonstrate that participation in methadone maintenance reduces sexual-risk behaviors in syringe exchange registrants. Efforts to help more patients reduce cocaine use, and to help women address gender-specific psychosocial vulnerabilities, may further reduce risky behaviors during the treatment episode.