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Abstracts / Drug and Alcohol Dependence 171 (2017) e2–e226
cocaine use” classes have been in substance treatment (p < 0.01). Significantly greater proportions of the “moderate” and “serious” arrest classes have been in substance treatment (p < 0.01). Conclusions: Our results suggest substance treatment may present opportunities for increasing engagement in HIV care for PLWH with serious substance use disorders who are involved with the criminal justice system. Financial support: U10DA13720. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.519 US trends in past-year marijuana use and perceived risk of regular use, 2002–2013, by race/ethnicity Dvora Shmulewitz ∗ , Qiana Brown, Reanne Rahim-Juwel, Silvia S. Martins, Melanie M. Wall, Pia M. Mauro, Hannah Carliner, Aaron L. Sarvet, Deborah Hasin Columbia University, New York, NY, United States Aims: Little is known about racial/ethnic differences in time trends in adult marijuana use and perceived risk of use. This study investigated such trends in past-year marijuana use and perceived risk from 2002 to 2013, testing for differences by race/ethnicity. Methods: Non-Hispanic Black, White, and Hispanic adults aged 18+ (N = 414,798) from the 2002 to 2013 US National Surveys on Drug Use and Health were analyzed for trends from 2002 to 2013 in past-year marijuana use and perceived great risk of regular marijuana use with logistic regression, unadjusted and adjusted for sociodemographics (gender, race, age, education, income, marital status). Interaction tests determined if rates of change differed by race, followed by race-stratified regressions. Results: From 2002 to 2013, marijuana use increased significantly overall and in all race groups (unadjusted and adjusted). Prevalence of use overall was higher among Blacks, followed by Whites, then Hispanics. Rates of change differed significantly by race (interaction p = .027); Hispanics showed the largest increase over time. Between 2002 and 2013, an additional 4.1 million Whites, 1.1 million Blacks, and 1.9 million Hispanics became past-year users. Perceived great risk of regular use decreased significantly in all race groups (unadjusted and adjusted). Compared to 2002, 23.3 million fewer Whites, Blacks, and Hispanics perceived regular use as a great risk in 2013. Overall, Blacks and Whites were less likely than Hispanics to perceive great risk. Rates of change did not differ by race (interaction p = .345). Conclusions: Trends in marijuana use over time vary by race/ethnicity, with Blacks at highest risk of use throughout. The greater increase over time in Hispanic marijuana use is also a public health concern, as the U.S. Hispanic population is rapidly increasing. The relationship between perceived risk and likelihood of use merits further attention, as does whether consequences of marijuana use differ by race/ethnic group. Financial support: NIH grants T32DA031099, R01DA037866 and R01DA034244, New York State Psychiatric Institute. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.520
Modeling a theory-based approach to examine the influence of neurocognitive impairment on HIV risk reduction behaviors among drug users in treatment Roman Shrestha 1,2,∗ , Tania B. Huedo-Medina 2,3 , Michael Copenhaver 2,3 1 Department of Community Medicine & Health Care, University of Connecticut Health Center, Farmington, CT, United States 2 Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, CT, United States 3 Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
Aims: Although it is well established that people who use drugs (PWUDs) are characterized by significant neurocognitive impairment (NCI), there has been no examination of how NCI may impede one’s ability to accrue the expected HIV prevention benefits stemming from an otherwise efficacious intervention. This paper incorporated a theoretical IMB model of health behavior change to examine the potential influence of NCI on HIV prevention outcomes as significantly moderating the mediation defined in the original model. Methods: 304 HIV-negative opioid-dependent individuals enrolled in a community-based methadone maintenance treatment and reporting drug- and/or sex-related HIV risk behaviors were included. The IMB model-based measures of NCI (nciIMB models) were developed and fitted for drug- and sex-related HIV risk reduction variables separately. Using structural equation modelling in MPlus, the moderated mediation effect was tested for each domain. Results: The findings showed that enhancement of HIV risk reduction information and motivation positively influences HIV behavioral skills, which in turn, predicted better HIV prevention outcomes (i.e., consistent condom use and clean needle use). Furthermore, the translation of HIV risk reduction knowledge and motivation into HIV preventive behaviors via HIV risk reduction behavioral skills was significantly weakened as a function of NCI severity. Conclusions: The findings make an important contribution to our understanding of the applicability of theoretically-grounded models of HIV prevention behavior for persons who may be characterized by higher levels of NCI. This provides support for the utility of the nciIMB framework of HIV risk reduction to inform future interventions targeting high risk PWUDs in drug treatment. Financial support: NIDA Grants: R01-DA022122; K02DA033139. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.521 Interim buprenorphine treatment for reducing illicit opioid use during treatment delays Stacey C. Sigmon 1,∗ , Taylor A. Ochalek 2 , Bryce Hruska 1 , Sarah Hughes Heil 1 , Stephen Higgins 1 , Gail Rose 1 , Brent A. Moore 3 1 Psychiatry, The University of Vermont, Burlington, VT, United States 2 Psychology, University of Vermont, Burlington, VT, United States 3 Psychiatry, Yale University School of Medicine, New Haven, CT, United States
Aims: Despite the effectiveness of agonist maintenance for opioid dependence, patients can remain on waitlists for months before