Behavioral Drug and HIV Risk Reduction Counseling in Methadone Patients in China

This project is a supplement to a parent grant, Drug Counseling and Abstinence-Contingent
Take-Home Buprenorphine in Malaysia. The specific aims of the parent grant include
evaluating whether the relatively minimal counseling and other services provided with
standard buprenorphine maintenance treatment (Standard BUP) is sufficient or whether one or
a combination of two enhanced behavioral treatments--behavioral drug and HIV risk reduction
counseling (BDRC) or abstinence-contingent take-home buprenorphine (ACB)—improve its
efficacy (Specific Aim 1) and are cost-effective, with regard to the direct economic costs
of providing the treatments (Specific Aim 2) and also to provide training and mentoring in
drug abuse treatment and HIV prevention research to clinical researchers and clinical
training for health professionals in Malaysia (Specific Aim 4). BDRC utilizes short-term
behavioral contracts to promote abstinence and reduce drug- and sex-related HIV risk
behaviors and can be provided by nurses and medical assistants available in medical settings
in developing countries.

The specific aims of the proposed study are consistent with the specific aims of the parent
grant and include evaluating in a pilot, randomized clinical trial in a methadone treatment
program in Wuhan, China, the feasibility and potential efficacy for reducing illicit drug
use and HIV risk behaviors of BDRC when combined with standard methadone treatment services
(Standard Methadone) compared to Standard Methadone only (Specific Aim 1 of the proposed
study). Additional Specific Aims of the proposed study include developing estimates of the
treatment costs and cost-effectiveness of Standard Methadone and BDRC (Specific Aim 2 of the
proposes study), and providing training and mentoring in drug abuse treatment and HIV
prevention research to clinical researchers an clinical training for health professionals in
China (Specific Aim 3 of the proposed study).

Specific aims of the China project:

1. Conduct a preliminary evaluation of the feasibility, acceptability, and preliminary
efficacy for increasing treatment retention and reducing drug use and HIV risk
behaviors of Behavioral Drug and HIV Risk Reduction Counseling (BDRC) when combined
with Standard Methadone, in comparison to Standard Methadone, among opiate dependent
treatment seeking volunteers admitted to the Wuhan Methadone Clinic.

2. Develop estimates of the costs and cost-effectiveness of Standard Methadone and BDRC.

3. Train and provide ongoing clinical supervision to a core group of 10 drug counseling
staff and provide additional mentoring in drug abuse and HIV risk reduction research to
investigators in China.