***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Contingency management ( CM ) rapidly reduces cocaine use , but its effects subside after treatment . Cognitive-behavioral therapy ( CBT ) produces reductions months after treatment . Combined , the 2 might be complementary . One hundred ninety-three cocaine-using methadone-maintained out patients were r and omly assigned to 12 weeks of group therapy ( CBT or a control condition ) and voucher availability ( CM contingent on cocaine-negative urine or noncontingent ) . Follow-ups occurred 3 , 6 , and 12 months posttreatment . Primary outcome was cocaine-negative urine ( urinalysis 3 times/week during treatment and once at each follow-up ) . During treatment , initial effects of CM were dampened by CBT . Posttreatment , there were signs of additive benefits , significant in 3- versus 12-month contrasts . Former CBT participants were also more likely to acknowledge cocaine use and its effects and to report employment A r and omized trial was conducted to test the effectiveness of couple-based HIV counseling and testing ( CB-HIV-CT ) and  women-only relationship-focused HIV counseling and testing ( WRF-HIV-CT ) in reducing HIV risk compared to the National Institute on Drug Abuse HIV-CT st and ard intervention . Substance using HIV-negative women and their primary heterosexual partner ( N = 330 couples ) were r and omized to 1 of the 3 interventions . Follow-up assessment s measuring HIV risk behaviors and other relevant variables were conducted at 3- and 9-months postintervention . Repeated measures generalized linear mixed model analysis was used to assess treatment effects . A significant reduction in HIV risk was observed over the 9-month assessment in the CB-HIV-CT group compared to that of the control group ( b = −0.51 , t[527 ] = −3.20 , P = 0.002 ) and compared to that of the WRF-HIV-CT group ( b = −0.34 , t[527 ] = −2.07 , P = 0.04 ) , but no significant difference was observed between WRF-HIV-CT and controls ( b = −0.17 , t[527 ] = −1.09 , P = 0.28 ) . A brief couple-based HIV counseling and testing intervention design ed to address both drug-related and sexual risk behaviors among substance using women and their primary male partners was shown to be more effective at reducing overall HIV risk compared to a st and ard HIV-CT intervention in an urban setting Background : There is a lack of effective behavioral interventions for HIV-positive injection drug users ( IDUs ) . We sought to evaluate the efficacy of an intervention to reduce sexual and injection transmission risk behaviors and to increase utilization of medical care and adherence to HIV medications among this population . Methods : HIV-positive IDUs ( n = 966 ) recruited in 4 US cities were r and omly assigned to a 10-session peer mentoring intervention or to an 8-session video discussion intervention ( control condition ) . Participants completed audio computer-assisted self-interviews and had their blood drawn to measure CD4 cell count and viral load at baseline and at 3-month ( no blood ) , 6-month , and 12-month follow-ups . Results : Overall retention rates for r and omized participants were 87 % , 83 % , and 85 % at 3 , 6 , and 12 months , respectively . Participants in both conditions reported significant reductions from baseline in injection and sexual transmission risk behaviors , but there were no significant differences between conditions . Participants in both conditions reported no change in medical care and adherence , and there were no significant differences between conditions . Conclusions : Both interventions led to decreases in risk behaviors but no changes in medical outcomes . The characteristics of the trial that may have contributed to these results are examined , and directions for future research are identified OBJECTIVES We evaluated the efficacy of a peer-mentoring behavioral intervention design ed to reduce risky distributive injection practice s ( e.g. , syringe lending , unsafe drug preparation ) among injection drug users with hepatitis C virus ( HCV ) infection . METHODS A r and omized trial with a time-equivalent attention-control group was conducted among 418 HCV-positive injection drug users aged 18 to 35 years in 3 US cities . Participants reported their injection-related behaviors at baseline and at 3- and 6-month follow-ups . RESULTS Compared with the control group , intervention-group participants were less likely to report distributive risk behaviors at 3 months ( odds ratio [OR]=0.46 ; 95 % confidence interval [CI]=0.27 , 0.79 ) and 6 months ( OR=0.51 ; 95 % CI=0.31 , 0.83 ) , a 26 % relative risk reduction , but were no more likely to cite their HCV-positive status as a reason for refraining from syringe lending . Effects were strongest among intervention-group participants who had known their HCV-positive status for at least 6 months . Peer mentoring and self-efficacy were significantly increased among intervention-group participants , and intervention effects were mediated through improved self-efficacy . CONCLUSIONS This behavioral intervention reduced unsafe injection practice s that may propagate HCV among injection drug users Background We evaluated brief combination interventions to simultaneously reduce sexual and injection risks among female sex workers who inject drugs ( FSW-IDUs ) in Tijuana and Ciudad Juarez , Mexico during 2008–2010 , when harm reduction coverage was exp and ing rapidly in Tijuana , but less so in Juarez . Methods FSW-IDUs ≥18 years reporting sharing injection equipment and unprotected sex with clients within the last month participated in a r and omized factorial trial comparing four brief , single-session conditions combining either an interactive or didactic version of a sexual risk intervention to promote safer sex in the context of drug use , and an injection risk intervention to reduce sharing of needles/injection paraphernalia . Women underwent quarterly interviews and testing for HIV , syphilis , gonorrhea , Chlamydia and Trichomonas , blinding interviewers and assessors to assignment . Poisson regression with robust variance estimation and repeated measures ordinal logistic regression examined effects on combined HIV/STI incidence and receptive needle sharing frequency . Findings Of 584 initially HIV-negative FSW-IDUs , retention was ≥90 % . After 12 months , HIV/STI incidence decreased > 50 % in the interactive vs. didactic sex intervention ( Tijuana : AdjRR:0.38,95 % CI:0.16–0.89 ; Juarez : AdjRR:0.44,95 % CI:0.19–0.99 ) . In Juarez , women receiving interactive vs. didactic injection risk interventions decreased receptive needle-sharing by 85 % vs. 71 % , respectively ( p = 0.04 ) ; in Tijuana , receptive needle sharing declined by 95 % , but was similar in active versus didactic groups . Tijuana women reported significant increases in access to syringes and condoms , but Juarez women did not . Interpretation After 12 months in both cities , the interactive sexual risk intervention significantly reduced HIV/STI incidence . Exp and ing free access to sterile syringes coupled with brief , didactic education on safer injection was necessary and sufficient for achieving robust , sustained injection risk reductions in Tijuana . In the absence of exp and ing syringe access in Juarez , the injection risk intervention achieved significant , albeit more modest reductions , suggesting that community-level interventions incorporating harm reduction are more powerful than individual-level interventions . Trial Registration clinical trials.gov Active injection drug users ( IDUs ) who are also hazardous alcohol users are at particularly high risk for HIV transmission due to sharing of injection equipment . We recruited AUDIT-positive injectors from the Providence , RI needle exchange program for a r and omized clinical trial testing the effect of a brief motivational intervention ( MI ) on frequency of injection-related HIV risk behavior ( IRRB ) . HIV drug risk behavior was measured as the number of days on which subjects reported sharing works using the 30-day Timeline Followback Method . Overall , 109 subjects reported a mean reduction of IRRB days of 9.1 days from baseline to 6-month follow-up ( p < .001 ) . When compared to controls , there was a trend in reduction of IRRB days to zero at follow-up for MI subject ( OR = 2.1 ; 95 % CI = 0.9 - 4.5 ) , and strongly significant reductions in IRRB days across a range of alternative improvement thresholds . Results from this study demonstrate that MI reduces drug-related HIV risk behaviors among active IDUs . As a brief intervention , MI may be a useful adjunct to existing services intended to reduce harm BACKGROUND This study estimates the past year prevalence of and factors associated with  sex trading  ( offering sex for money , drugs or something else ) among 1796 men and women presenting to 342 drug misuse treatment agencies in Engl and , and identifies service development and delivery implication s. METHODS Secondary analysis of baseline data from a prospect i ve cohort was conducted . Short Form-12 measured mental and physical wellbeing , psychiatric diagnoses were self-reported and the circumstances , motivation and readiness tool assessed readiness for/pressure to enter treatment . Logistic regression models determined associations with sex trading separately by sex . Inverse probability population weights were calculated , utilising demographics from the National Drug Treatment Monitoring System and agency specific data collection windows . RESULTS The estimated prevalence rate of sex trading in the past 12 months was 5.1 % ( 15.0 % for women and 2.1 % for men ) . For women , adjusted models identified crack use ( aOR 1.83 , 95 % CI 1.22 - 2.74 , p=0.004 ) , previous treatment ( aOR 3.00 , 95 % CI 1.31 - 6.86 , p=0.010 ) and greater readiness for treatment ( aOR 1.12 , 95 % CI 1.01 - 1.24 , p=0.027 ) as independently associated with sex trading . For men , lower mental wellbeing ( aOR 0.97 , 95 % CI 0.94 - 0.99 , p=0.030 ) was independently associated and marginal effects were identified for syringe sharing ( aOR 2.89 , 95 % CI 0.94 - 8.86 , p=0.064 ) and unprotected sex ( aOR 2.23 , 95 % CI 0.95 - 5.26 , p=0.065 ) . CONCLUSIONS Sex trading among drug misusers is associated with additional health risks and specific treatment needs . Given the scale of the problem it is important that treatment providers have the competencies to adequately address the issue and provide accessible and appropriate services Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVES We compared the effects of 2 interventions on alcohol use , use of a new syringe at last injection , and condom use at last sexual encounter in a community sample of injection drug users . METHODS Between 2003 and 2006 , 851 out-of-treatment injection drug users were recruited in Raleigh , NC , and Durham , NC , through street outreach and were r and omly assigned to either a 6-session educational intervention or a 6-session motivational intervention . Intervention effects were examined at 6 and 12 months after enrollment . RESULTS In multiple logistic regression analyses adjusted for baseline alcohol use and HCV status , participants assigned to the motivational intervention were significantly less likely than were participants in the educational intervention to be drinking at the 6-month follow-up ( odds ratio = 0.67 ; 95 % confidence interval = 0.46 , 0.97 ) . There were no significant between-group differences in use of a new syringe at last injection or condom use at last sexual encounter at either follow-up . CONCLUSIONS Reducing alcohol use among persons with HCV may slow disease progression and provide important health benefits . Additional strategies are needed for slowing HCV disease progression until more effective HCV treatments are available This study r and omized 90 HIV-seropositive , methadone-maintained injection drug users ( IDUs ) to an HIV Harm Reduction Program ( HHRP+ ) or to an active control that included harm reduction components recommended by the National AIDS Demonstration Research Project . The treatment phase lasted 6 months , with follow-ups at 6 and 9 months after treatment entry . Patients in both treatments showed reductions in risk behaviors . However , patients assigned to HHRP+ were less likely to use illicit opiates and were more likely to adhere to antiretroviral medications during treatment ; at follow-up , they had lower addiction severity scores and were less likely to have engaged in high risk behavior . Findings suggest that enhancing methadone maintenance with an intervention targeting HIV-seropositive IDUs increases both harm reduction and health promotion behaviors AIMS Social norms are a key source of influence on health behaviors . This study examined changes in social norms and relationships between HIV injection risk behaviors and social norms among injection drug users ( IDUs ) involved in an experimental intervention . DESIGN R and omized clinical trial . SETTING An HIV Prevention Trials Network study , Philadelphia , USA . PARTICIPANTS IDUs , called indexes , and their social network members , who were drug or sex partners , were recruited for an HIV prevention intervention and followed for up to 30 months ( n = 6 
    Output:
    
Such interventions could be included with other harm reduction approaches to prevent BBV transmission among PWID.ResumenEl tratamiento de sustitución de opiáceos y los programas de intercambio de jeringuillas han disminuido la transmisión de virus transmitidos por sangre ( VTS ) entre los usuarios de drogas inyectadas ( UDI ) .