The study's goal was to identify ethnic differences in HIV risk behaviors among cocaine-using women receiving methadone maintenance for opioid dependence, and further to evaluate the efficacy of contingency management (CM) for cocaine use disorders in reducing HIV risk behaviors.

Included in the study were 47 African-American women, 47 Hispanic women, and 29 white women. The subjects were randomized either to standard methadone treatment or to standard methadone treatment plus a CM intervention. The women completed the HIV Risk Behavior Scale (HRBS), indicating frequency of drug use and sexual behaviors across the lifetime, in the month before baseline, and in the three months following clinical trial participation. The researchers evaluated ethnic group differences and the effect of CM on HIV risk behaviors between baseline and follow-up.

On the HRBS, white women reported significantly higher lifetime rates of risky drug use and sexual behaviors than did African-American women, though neither group differed significantly from Hispanic women. The researchers noted no ethnic group differences in HIV risk behaviors in the month prior to baseline. At follow-up, African-American participants reported fewer high-risk drug use behaviors than white or Hispanic women, while Hispanic women reported more high-risk sexual behaviors than the other two groups of women. Regardless of ethnicity, CM was associated with reduction in high-risk drug use behaviors; however, CM did not affect high-risk sexual behaviors.

"White women receiving methadone maintenance engage in more lifetime HIV risk behaviors than African-American women," the authors concluded. "CM for cocaine use reduces risky drug use behaviors, but certain ethnic groups may benefit from additional targeted HIV prevention efforts."

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