Counselor prompts to increase condom taking during treatment for cocaine dependence.

HIV infection is increasing among noninjecting as well as iv drug users. Of particular concern are users of cocaine and crack cocaine who are likely to trade sex for money or drugs and to have multiple sexual partners. This study investigated whether an active counselor intervention could increase the number of free condoms taken from dispensers placed in counselors offices in a cocaine abuse treatment program in Philadelphia Pennsylvania (US). A multiple baseline design across 2 teams of counselors with reversals was utilized. During the initial 5-week baseline period when condoms were displayed on the counselors desks but no prompts were given an average of 0.34 and 0.25 condoms were taken per visit per team. During weeks 6-13 when counseling Team 1 utilized prompting and encouraged condom taking this average increased to 3.17/visit. When Team 2 implemented the intervention (weeks 13-20) an average of 2.78 condoms/visit were taken. When both teams stopped the intervention the number of condoms taken fell close to baseline levels. Resumption of the intervention increased use but not to the previous high level. Over the entire 28-week study period clients took an average of 0.43 condoms/visit during baseline conditions and 2.45/visit during counselor prompting conditions. The 6-fold increase in condom uptake associated with active encouragement suggests the feasibility of this strategy for cocaine treatment programs. However the participating counselors voiced irritation with the mandatory sometimes intrusive intervention. The availability of free condoms in the clinic waiting area or day room represents an alternative strategy documented to increase the taking of condoms.