Contingency management (CM) reduces drug use, but its effect on HIV/AIDS risk behaviors is not known. Researchers analyzed data from 3 randomized controlled studies of the effect of CM added to methadone maintenance (MM) treatment in persons who had cocaine abuse or dependence to measure its impact on HIV/AIDS risk behaviors. Participants in each of the combined studies (N=165) received either standard MM treatment or MM treatment with CM for 3 months.

• Compared with the standard MM treatment groups, patients in the CM groups had
• lower overall scores on the HIV Risk Behavior Scale (HRBS) at 12-week and 6-month follow-up.
• less injection drug use at 12-week and 6-month follow-up.
• fewer drug-positive urine samples.
• No significant differences were demonstrated on the HRBS sexual behavior subscores.
• Longer term abstinence was a substantial mediating factor.

Comments by Michael Boyle, MA
These results show than an additional benefit of CM is a reduction in HIV risk behaviors. Although many providers dismiss the use of CM as too expensive, a case could be made that it increases attendance at group sessions and retains existing patients in treatment, thus lowering administrative costs and improving care and outcomes. Also, payors could provide new funding for drug treatment based on these results.