Appendix B: Excluded Studies (Grouped by Reason for Exclusion)

Appendix B: Excluded studies (grouped by reason for exclusion)

No extractable sexual risk outcome data

Campbell, A. N. C., S. Tross, et al. Female condom skill and attitude: results from a NIDA Clinical Trials Network gender-specific HIV risk reduction study. AIDS EDUCATION & PREVENTION 2011; 23(4): 329-340.

Gollub, E. L., K. M. Morrow, et al. Three city feasibility study of a body empowerment and HIV prevention intervention among women with drug use histories: Women FIT." Journal of Women's Health 2010; 19(9): 1705-1713.

Latka MH, Hagan H, Kapadia F, et al. A randomized intervention trial to reduce the lending of used injection equipment among injection drug users infected with hepatitis C. American Journal of Public Health 2008; 98: 853-861.

Mausbach BT, Semple SJ, Strathdee SA, et al. Efficacy of a behavioral intervention for increasing safer sex behaviors in HIV-negative, heterosexual methamphetamine users: Results from the fast-lane study. Annals of Behavioral Medicine 2007; 34:263.-274.

Morgenstern J, Bux J, Parsons J, et al. Randomized Trial to Reduce Club Drug Use and HIV Risk Behaviors Among Men Who Have Sex With Men. Journal of Consulting.and Clinical Psychology 2009; 77: 645.-656.

Otiashvili, D., I. Kirtadze, et al. Drug use and HIV risk outcomes in opioid-injecting men in the Republic of Georgia: Behavioral treatment+naltrexone compared to usual care. Drug & Alcohol Dependence 2012; 120(1-3): 14-21.

Tross S, Campbell AN, Cohen LR, et al. Effectiveness of HIV/STD sexual risk reduction groups for women in substance abuse treatment programs: results of NIDA Clinical Trials Network Trial. Journal of Acquired Immune Deficiency Syndromes 2008; 48:581-589

Greater than 50% did not receive enhanced intervention as assigned

Hershberger SL, Wood MM, Fisher DG. A cognitive-behavioral intervention to reduce HIV risk behaviors in crack and injection drug users. AIDS & Behavior 2003; 7:229-243.

Risk behaviour measure used includes both sexual and injection risk

Chawarski, M., W. Zhou, et al. Behavioral drug and HIV risk reduction counseling (BDRC) in MMT programs in Wuhan, China: A pilot randomized clinical trial. Drug and Alcohol Dependence 2011; 115(3): 237-239.

No stratified analyses for drug users in substance abuse populations

Mansergh, G., B. A. Koblin, et al. An intervention to reduce HIV risk behavior of substance-using men who have sex with men: a two-group randomized trial with a nonrandomized third group. PLoS medicine 2010; 7(8): e1000329.

Rotheram-Borus MJ, Desmond K, Comulada WS, et al. Reducing risky sexual behavior and substance use among currently and formerly homeless adults living with HIV. American Journal of Public Health 2009; 99:1100.-7.

Weir BW, O'Brien K, Bard RS, et al. Reducing HIV and partner violence risk among women with criminal justice system involvement: a randomized controlled trial of two motivational interviewing-based interventions. AIDS and Behavior 2009; 13:509-522.

Not all participants currently using drugs within past 3 months

Castor, D., D. J. Pilowsky, et al. Sexual risk reduction among non-injection drug users: report of a randomized controlled trial. AIDS Care 2010; 22(1): 62-70.

Intervention is not focused only on sexual risk behavior but also on a number of other factors (e.g. medication adherence, access to medical care)

Purcell DW, Latka MH, Metsch LR, et al. Results from a randomized controlled trial of a peer-mentoring intervention to reduce HIV transmission and increase access to care and adherence to HIV medications among HIV-seropositive injection drug users. Journal of Acquired Immune Deficiency Syndromes 2007; 46 (Suppl 2): S35-S47.

Did not meet age criteria

Garfein RS, Golub ET, Greenberg AE, et al.A peer-education intervention to reduce injection risk behaviors for HIV and hepatitis C virus infection in young injection drug users. AIDS 2007; 21:1923-1932.

Magura S, Kang S, Shapiro JL. Outcomes of intensive AIDS education for male adolescent drug users in jail. Journal of Adolescent Health1994;15:457–63.

Marsch LA, Grabinski MJ, Bickel MJ. et al.Computer-Assisted HIV Prevention for Youth With Substance Use Disorders. Subst Use and Misuse 2011; 46(1): 46–56.

Tolou-Shams, M., C. Houck, et al. HIV prevention for juvenile drug court offenders: a randomized controlled trial focusing on affect management. Journal of Correctional Health Care 2011; 17(3): 226-232.

Compares active multi-session psychosocial interventions

Koblin, BA, Bonner S. et al. A randomized trial of enhanced HIV risk-reduction and vaccine trial education interventions among HIV-negative, high-risk women who use noninjection drugs: the UNITY study. Journal of acquired immune deficiency syndromes 2010; 53(3): 378-387.

Shoptaw S, Reback CJ, Peck JA, et al Behavioral treatment approaches for methamphetamine dependence and HIV-related sexual risk behaviors among urban gay and bisexual men. Drug and Alcohol Dependence 2005; 78:125-134.

Shoptaw S, Reback CJ, Larkins S, et al. Outcomes using two tailored behavioral treatments for substance abuse in urban gay and bisexual men. Journal of Substance Abuse Treatment 2008; 35: 285-293.

Wechsberg WM, Luseno WK, Karg RS, et al Alcohol, cannabis, and methamphetamine use and other risk behaviours among Black and Coloured South African women: A small randomized trial in the Western Cape. International.Journal of Drug Policy 2008; 19: 130-139.

Pooled analysis of three trials

Hanson T, Alessi SM, and Petry NM. Contingency management reduces drug-related human immunodeficiency virus risk behaviors in cocaine-abusing methadone patients. [References]. Addiction 2008; 103:1187-1197.

Does not meet criteria for multisession intervention

Bernstein, E., D. Ashong, et al. The Impact of a Brief Motivational Intervention on Unprotected Sex and Sex While High Among Drug-Positive Emergency Department Patients Who Receive STI/HIV VC/T and Drug Treatment Referral as Standard of Care. AIDS & Behavior 2012; 16(5): 1203-1216.

Booth, R., B. Campbell, et al. Reducing hiv-related risk behaviors among injection drug users in residential detoxification." AIDS & Behavior 2011; 15(1): 30-44.

Campbell, B. K., B. E. Fuller, et al. Facilitating outpatient treatment entry following detoxification for injection drug use: a multisite test of three interventions. Psychology of addictive behaviors 2009; 23(2): 260-270.

Surratt HL and Inciardi JA "An effective HIV risk-reduction protocol for drug-using female sex workers." Journal of prevention & intervention in the community 2010; 38(2): 118-131.

Wechsberg, W. M., E. Krupitsky, et al. Double jeopardy--drug and sex risks among Russian women who inject drugs: initial feasibility and efficacy results of a small randomized controlled trial. Substance Abuse Treatment, Prevention, & Policy 2012; 7: 1.

Williams, M., A. Bowen, et al. An assessment of brief group interventions to increase condom use by heterosexual crack smokers living with HIV infection. AIDS Care 2012; 24(2): 220-231.

No control group

Amaro, H., C. Magno-Gatmaytan, et al. Addiction treatment intervention: an uncontrolled prospective pilot study of Spiritual Self-Schema therapy with Latina women." Substance abuse 2010; 31(2): 117-125.

Copenhaver, M. M., I. C. Lee, et al. Testing an optimized community-based human immunodeficiency virus (HIV) risk reduction and antiretroviral adherence intervention for HIV-infected injection drug users. Substance abuse 2011; 32(1): 16-26.

Training outreach workers

Deren, S., S. Y. Kang, et al. Conducting peer outreach to migrants: outcomes for drug treatment patients. Journal of immigrant and minority health 2012; 14(2): 251-258.

Appendix C: Summary effect sizes in Semaan et al [10] and in updated meta-analysis

Table 1: Comparison of interventioneffects in Semaan et al. meta-analysis (2002) and the updated meta-analysis on US based studies (multisession interventions compared with all controls)

Semaan et al. MA [10] / Updated meta-analysis*
K / OR (95%CI) / K / OR (95% CI)
Individually-focused** / 28*** / 0.85
(0.74, 0.98) / 43 / 0.84 (0.74,0.95)
Social** / 2*** / 0.66
(0.51, 0.86) / 5 / 0.70
(0.47, 1.05)
Structural / N/A / N/A / 2 / 0.75
(0.60, 0.94)
K= number of trials OR= odds ratio CI = confidence interval MA=meta-analysis
* no statistically significant differences were found between the previous and updated meta-analysis
**limited to studies of adult PWUDs, CDC1999 was classified as a social intervention in previous MA but as a social structural intervention in updated meta-analysis
** *these ORs were calculated as part of this current MA for the purposes of comparison

Appendix D: Cumulative meta-analysis

Figure 1 Cumulative meta-analysis of studies published 1992-2011 comparing multisession interventions with standard education to reduce sexual risk behavior (OR <1 favours multisession intervention)

Appendix E Search strategy in Medline

Database: Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) <1946 to Present>

1 amphetamine-related disorders/

2 marijuana abuse/

3 cocaine-related disorders/

4 heroin addiction/

5 exp Opioid-Related Disorders/

6 substance-related disorders/

7 Substance Abuse, Intravenous/

8 ((stimulant$ or polydrug$ or drug$ or substance) adj3 abstain$).tw.

9 ((stimulant$ or polydrug$ or drug$ or substance) adj3 abstinen$).tw.

10 ((stimulant$ or polydrug$ or drug$ or substance) adj3 abus$).tw.

11 ((stimulant$ or polydrug$ or drug$ or substance) adj3 addict$).tw.

12 ((stimulant$ or polydrug$ or drug$ or substance) adj3 "excessive use").tw.

13 ((stimulant$ or polydrug$ or drug$ or substance) adj3 dependen$).tw.

14 ((stimulant$ or polydrug$ or drug$ or substance) adj3 disorder$).tw.

15 ((stimulant$ or polydrug$ or drug$ or substance) adj3 intoxicat$).tw.

16 ((stimulant$ or polydrug$ or drug$ or substance) adj3 misuse$).tw.

17 ((stimulant$ or polydrug$ or drug$ or substance) adj3 over dos$).tw.

18 ((stimulant$ or polydrug$ or drug$ or substance) adj3 overdos$).tw.

19 ((stimulant$ or polydrug$ or drug$ or substance) adj3 withdraw$).tw.

20 (drugs adj user$).tw.

21 or/1-20

22 exp Amphetamine/

23 Cannabis/

24 exp Central Nervous System Stimulants/

25 exp Cocaine/

26 Heroin/

27 exp Narcotics/

28 Naltrexone/

29 Opium/

30 (amphetamine$ or crack or dextroamphetamine$ or methamphetamine$ or speed or upper$).tw.

31 (cannabis or hashish or marihuana or marijua$).tw.

32 (cocaine or crack).tw.

33 methadone.tw.

34 (opiate$ or opioid$ or opium).tw.

35 or/22-34

36 (abstain$ or abstinen$ or abus$ or addict$ or drug use$ or excessive use$ or dependen$ or intoxicat$ or misus$ or over dos$ or overdos$ or use$ disorder$ or use$ illicit or withdraw$).mp.

37 (inject$ adj2 drug$).mp.

38 36 or 37

39 38 and 35

40 39 or 21

41 exp Adaptation, Psychological/

42 exp Behavior Therapy/

43 Case Management/

44 Cognitive Therapy/

45 Community Networks/

46 exp Counseling/

47 Family Therapy/

48 Day Care/

49 "Imagery (Psychotherapy)"/

50 Marital Therapy/

51 exp Motivation/

52 Patient Education as Topic/

53 exp Psychotherapy/

54 exp "Reinforcement (Psychology)"/

55 exp Relaxation/

56 exp Self-Help Groups/

57 Social Adjustment/

58 social support/

59 ((behavio?r$ or cogniti$) and (educat$ or intervent$ or manage$ or program$ or rehab$ or technique$ or therap$ or train$ or treat$)).tw.

60 cbt.tw.

61 (communicat$ adj5 (educat$ or intervent$ or manage$ or program$ or rehab$ or technique$ or therap$ or train$ or treat$)).tw.

62 (contingency adj5 (educat$ or intervent$ or manage$ or program$ or rehab$ or technique$ or therap$ or train$ or treat$)).tw.

63 ((cope or coping) adj5 (educat$ or interven$ or manage$ or program$ or technique$ or therap$ or train$ or treat$)).tw.

64 (counsel?ing or counsel?or$ or ((clientcentred or client centred) adj5 (communicat$ or educat$ or intervention$ or management$ or treatment$ or program$ or relation$ or support$ or therap$ or train$))).tw.

65 (educat$ adj5 (film$ or intervention$ or lecture$ or program$ or therap$ or treat$)).tw.

66 (family adj (based or cent$ or focused or focused)).tw.

67 (family adj3 (communicat$ or educat$ or intervention$ or manage$ or treat$ or program$ or relation$ or support$ or therap$ or train$)).tw.

68 (conjoint adj therap$).tw.

69 (parent adj child$ adj3 treatment$).tw.

70 ((father or mother or parent) adj (child adj3 (intervention$ or therap$ or treatment$))).tw.

71 (family-based or family-responsive or family-relation$).tw.

72 ((inter personal or interpersonal) adj5 (educat$ or intervent$ or manage$ or program$)).tw.

73 ((marital or marriage) adj5 (educat$ or intervent$ or manage$ or program$ or rehab$ or technique$ or therap$ or train$ or treat$)).tw.

74 ((milieu or situational or socio?environmental or socio environmental or network) adj5 (educat$ or intervent$ or manage$ or program$ or rehab$ or technique$ or therap$ or train$ or treat$)).tw.

75 (motivation$ adj5 (educat$ or enhance$ or interview$ or manage$ or program$ or intervention$ or technique$ or therap$ or train$ or treat$)).tw.

76 (psycho$ adj (communicat$ or educat$ or intervention$ or manage$ or treatment$ or program$ or rehab$ or relation$ or support$ or technique$ or therap$ or train$)).tw.

77 (psycho analy$ or psychoanaly$).tw.

78 (psycho dynamic$ or psychodynamic$).tw.

79 (psycho educat$ or psychoeducat$).tw.

80 (psychological adj5 (educat$ or intervent$ or manage$ or program$ or rehab$ or technique$ or therap$ or train$ or treat$)).tw.

81 (psycho-social$ or psychosocial$).tw.

82 psychotherap$.tw.

83 (reinforcer$ or reinforcement).tw.

84 relapse prevent$.tw.

85 (relax$ or controlled breathing).tw.

86 (self control and (educat$ or intervent$ or manage$ or program$ or technique$ or therap$ or treat$)).tw.

87 ((selfhelp or self help$ or self control) adj3 (communicat$ or educat$ or intervention$ or management$ or technique$ or treatment$ or program$ or relation$ or support$ or therap$ or train$)).tw.

88 (skill$ adj3 train$).tw.

89 (social adj2 (adapt$ or adjust$)).tw.

90 (social skill$ adj5 (educat$ or intervent$ or manage$ or program$ or technique$ or therap$ or train$ or treat$)).tw.

91 (stress adj5 (educat$ or intervent$ or manage$ or program$ or technique$ or therap$ or train$ or treat$)).tw.

92 ((anger or parent$) adj3 manage$).tw.

93 (supportive adj5 expressive).tw.

94 ((psych$ or social$) adj5 (educat$ or intervent$ or manage$ or program$ or technique$ or therap$ or train$ or treat$)).tw.

95 or/41-94

96 exp HIV/

97 hiv.tw.

98 human immunodeficiency virus.tw.

99 human immunedeficiency virus.tw.

100 acquired immunodeficiency syndrome.tw.

101 acquired immunedeficiency syndrome.tw.

102 hepatitis A/

103 hepatitis B/

104 hepatitis C/

105 exp Sexually Transmitted Diseases/

106 sexual behav$.tw.

107 (sexual risk or sexual risk behav$ or unsafe sex$ or unsafe intercourse).tw.

108 (unprotected sex$ or unprotected vaginal sex or unprotected anal sex or unprotected vaginal intercourse or unprotected anal intercourse).tw.

109 condom$.tw.

110 or/96-109

111 40 and 95 and 110

112 randomized controlled trial.pt.

113 controlled clinical trial.pt.

114 randomized.ab.

115 PLACEBO.ab.

116 clinical trials as topic.sh.

117 randomly.ab.

118 trial.ti.

119 112 or 113 or 114 or 115 or 116 or 117 or 118

120 exp animals/ not humans.sh.

121 119 not 120

122 111 and 121

123 limit 122 to yr="1998 -Current"