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Behavioral Treatment for SUD Also Reduces Sexual Risk Behaviors

January 7, 2018
Brown, JL, et al.
Brown JL, et al. Impact of Behavioral Drug Abuse Treatment on Sexual Risk Behaviors: An Integrative Data Analysis of Eight Trials Conducted Within the National Drug Abuse Treatment Clinical Trials Network. Prevention Science 2018 (in press). [doi: 10.1007/s11121-018-0913-6]
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  • Individuals with substance use disorders (SUDs) are at increased risk for acquisition and transmission of HIV, due in part to specific drug use behaviors, such as injection drug use and needle sharing.
  • Substance use disorders are also associated with high-risk sexual behaviors, like inconsistent condom use and multiple or concurrent sexual partners.
  • Behavioral interventions for the treatment of SUDs, used alone or in conjunction with medication-assisted treatment (e.g., methadone or buprenorphine), offer the potential to reduce both substance use and HIV risk behaviors among at-risk populations, however the extent of that potential is still largely unknown.

This study examined the impact of behavioral substance use disorder treatments on sexual risk behaviors using an integrative data analysis approach (simultaneous analysis of multiple data sets) across eight trials conducted within the NIDA Clinical Trials Network: CTN-0004, 0005, 0006, 0007, 0009, 0013, 0015, and 0021.

Participants (N=1305) from the 8 randomized controlled trials who were sexually active at baseline were included in the pooled dataset. 48.7% were female, 64.1% self-identified as a racial/ethnic minority, and the mean age was 34.9.

Statistical analysis estimated the probability of risky sexual behavior (i.e., inconsistent condom use and/or >1 sexual partner in past 30 days) post-intervention with an indicator variable (1 for post-intervention), study condition (control, intervention), and their interaction as predictors.

Approximately 84.2% of participants reported risky sexual behaviors at baseline. Post-intervention, however, participants of both the control and the intervention conditions were 18.5% and 17.3% less likely to report risk sexual behavior, respectively. This effect lasted 8 weeks for the control group and 9 for the intervention group, though risky sexual behavior did subsequently increase.

Conclusions: The 8 CTN trials employed different types of behavioral interventions, suggesting the effectiveness of behavioral drug abuse treatment generally to reduce sexual risk behaviors. Identifying HIV risk reduction interventions that work well when integrated with existing resource-limited substance use disorder treatment programs would help bolster further reductions in sexual risk behavior engagement.

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