HIV risk in intravenous drug users and crack cocaine smokers: predicting stage of change for condom use.

This study examined the utility of the Transtheoretical Model of Change and the AIDS Risk Reduction Model for predicting condom use with not-in-treatment crack cocaine smokers and intravenous drug users. The sample included 265 participants; 99 reported having casual partners and 166 reported having main partners. All participants must have used drugs in the preceding 48 hr and received no drug treatment for at least 1 year. Participants were grouped into 3 stages of change; precontemplation, contemplation, and action. Logistic regression analyses indicated that both the benefits of change and condom assertiveness varied across the stages of change for main and casual partners, whereas the costs of change were important for predicting stage only with main partners. Age was a significant predictor of stage with casual partners, whereas ethnicity and nonherpes sexually transmitted diseases significantly predicted stage with main partners. The utility of the stages of change for choosing intervention strategies and the need for more qualitative and longitudinal research to determine additional predictors of intention to use condoms are discussed.