Gender differences among HIV-positive methadone maintenance patients enrolled in a medication adherence trial.

This study examined baseline gender differences among HIV-positive methadone maintenance outpatients currently prescribed antiretroviral medications. Participants were enrolled in a larger clinical trial, which included a 4-week observation period using electronic monitors to track medication adherence. Contrary to previous literature, no significant differences were detected between men (n = 42) and women (n = 36) on medication adherence or depression. Both groups showed remarkably poor adherence during baseline (M = 56% of doses taken on time), high overall prevalence of depression (47%) and illicit cocaine use (47%). Women reported significantly more medication side effects (M = 21.4 vs. 14.9), higher severity of ASI psychiatric problems (M = 0.50 vs. 0.40), and lower SF-36 health-related quality of life in physical (M = 42.1 vs. 63.3) and emotional functioning (M = 26.9 vs. 58.9) than men. Women tested positive for opioids at higher rates than men (53% vs. 29%, respectively), whereas men were more likely to be positive for benzodiazepines than women (26% vs. 6%, respectively). Findings suggest that gender differences between male and female methadone maintenance patients have relevance to treatment providers. Extensive assessment, specialized medical care and mental health services may be warranted in the treatment of HIV-positive female drug abusers.

Characteristics and outcomes of three models of community residential care for abuse patients.

Three models of transitional residential community care for substance abuse patients are defined on the basis of the differential provision of health and treatment services: a psychosocial model, a supportive rehabilitation model, and an intensive treatment model. Facilities that provided a high level of on-site health and treatment services were categorized as following an intensive treatment model; these facilities had the strongest emphasis on medical, dual diagnosis, and family treatment orientations. These facilities also had clearer policies and provided their residents more opportunities to participate in setting policies; however, staff were not more accepting of patient impairment or problem behavior. Patients in facilities with intensive treatment programs obtained more outpatient mental health after care. In each of the three types of facilities, a longer length of care was associated with a lower readmission rate; patients who dropped out of psychosocial model facilities had especially high readmission rates. Overall, the findings identify substantial variations among community residential facilities for substance abuse patients, but show relatively little matching of patients' needs with facility services and programs.

Direct experience with a cancer self-exam: effects on cognitions and behavior.

We tested and expanded Fazio's hypothesis that direct experience enhances attitude-behavior consistency (Fazio & Zanna, 1981) to identify effects of experience on the relation of behavior to subjective norm and intention. We also monitored the endurance of the experience effect over time. In order to manipulate experience, we instructed male college students in the United States to perform the testicle self-exam (TSE) a prescribed number of times during an initial week. We compared attitude, subjective norm, intention, and self-reported behavior across experience condition and three postmanipulation times. Direct experience increased later reported TSE behavior and tended to increase attitude and intention. It also enhanced consistency of attitude, subjective norm, and intention with early reported behavior as well as intention with later reported behavior.