Substance use and high risk sexual behaviors among women in psychosocial outpatient and methadone maintenance treatment programs.

The purpose of the present study was to assess the association between substance use/diagnosis and sexual risk behaviors among women enrolled in both psychosocial outpatient (PS) and methadone maintenance (MM) treatment and involved in an HIV prevention intervention study within the National Drug Abuse Treatment Clinical Trials Network (CTN-0019, “HIV/STD Risk Behaviors: A Research Study for Women in Drug Abuse Treatment”). Five-hundred and fifteen sexually active women reported on unprotected sexual occasions (USO), anal sex, sex trading, sex with drug occasions, and multiple male sex partners at the baseline assessment. Within the PS sample, cocaine use diagnosis was associated with more than twice the risk of having multiple partners, trading sex for drugs, having anal sex, or having sex with drugs; alcohol or opioid use diagnosis was associated with fewer risk behaviors. Within the MM sample, cocaine use, alcohol use and opiate use diagnoses were each associated with one to two risk behaviors. Associations between sexual risk and substance using days were less frequent in both samples.

These findings highlight the need for integration of HIV sexual prevention interventions that address the relationship between sexual risk behavior and substance use diagnoses into substance abuse treatment programs. Such interventions should target alcohol, cocaine, and opiate use and problem use, and should address the impulsivity that drives both sexual risk behavior and substance use.

Related protocols: CTN-0019