Comparison of two measures of HIV sexual risk behavior in women in outpatient drug treatment programs.
In the U.S., women who use drugs are at heightened susceptibility to HIV/STD heterosexual transmission. Drug treatment is a critical juncture at which to provide HIV/STD risk assessment, testing, risk reduction interventions, and linkage to treatment, as needed. To effectively implement interventions in busy drug treatment programs, it is important to have a rapid and accurate measure of sexual risk. This study compared 2 dichotomous ratings of unprotected sex among women in substance abuse treatment who participated in NIDA Clinical Trials Network study CTN-0019, “Reducing HIV/STD Risk Behaviors: A Research Study for Women in Drug Abuse Treatment”: (1) any unprotected vaginal/anal sex occasions in the last 3 months, versus (2) unprotected vaginal/anal sex at last sexual occasion (LSO). The two measures were derived from the Sexual Experiences and Risk Behavior Assessment Schedule (SERBAS). Sexually active women from 12 methadone maintenance or psychosocial outpatient programs who had a main (n = 363) or other male partner(s) (n = 117) were assessed at baseline for unprotected sex in the last 3 months and at LSO. These 2 measures were compared for congruence.
Analyses found that participants who reported unprotected sex at LSO consistently reported at least 1 unprotected sex occasion in the last 3 months: 99.1% for main male partner sex and 93.8% for other male partner sex. Participants who reported using a condom at LSO, however, were less consistent in terms of their behavior over the past 3 months: only 30.3% also reported protected sex at all sex occasions in the last 3 months with main male partner, with 67.6% reporting the same for other male partner(s).
Conclusions: This study suggests that use of one question about condom protected sex at LSO is a good indicator of the presence of sexual risk behavior during the past 3 months. If participants report unprotected sex at LSO, they are likely to have had at least one other unprotected encounter in the prior 3 months. Those reporting condom use at LSO may or may not have consistently used condoms over the prior 3 months; follow-up questions with this group will be necessary to adequately gauge risk.
Related protocols: CTN-0019