Reducing sex under the influence for substance abuse treatment patients.

In the context of substance abuse treatment, sex under the influence of drugs or alcohol is seen as a risk behavior for HIV/STI transmission. However, few studies of HIV prevention efforts report the impact of the interventions on this risk behavior. At study enrollment all men in CTN Safe Sex for Men protocol (CTN-0018), a gender-specific HIV prevention intervention (Real Men Are Safe [REMAS]), were administered a structured self report questionnaire using ACASI methodology focusing on involvement in sexual risk behaviors in the prior 90 days. Included in this assessment were detailed questions about the most recent sexual event, including whether the participant was under the influence of drugs or alcohol. This assessment was repeated at 3 and 6 months following the intervention. Data were analyzed using a mixed-effects logistic regression model in which engaging in sex under the influence at the most recent sexual event was the dependent measure. Independent measures were time (baseline, 3 months, 6 months), intervention (five session gender specific, single session HIV education), and partner riskiness (high, low). Included in this report were all men randomized and for whom there were 3 and/or 6 month outcome data (n=397). There is a significant time by partner risk effect (t=-3.06, p<.01). Combining sex and drugs happen less frequently at the two follow up assessments compared to the baseline assessment for men with high risk partners, but there was not an intervention effect. Further studies are needed to identify interventions that would help reduce this risk further for men attending treatment.

Related protocols: CTN-0018