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One Question About Condom Use May be Enough to Accurately Measure Sexual Risk for Women

May 1, 2016
Thorens, G. et al.
Thorens, G., et al. Comparison of Two Measures of HIV Sexual Risk Behavior in Women in Outpatient Drug Treatment Programs. J Addict Med 2015; 9 (6): 454-456
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  • In the U.S., women who use drugs are at heightened susceptibility to heterosexually-transmitted HIV, HCV, and other STDs. 
  • 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 two ratings of unprotected sex among women in substance use disorder treatment who participated in the 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
2. Unprotected vaginal/anal sex at last sexual occasion (LSO)

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.

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 the single question about condom-protected sex at last sexual encounter is a good indicator of the presence of sex risk behavior during the past 3 months. If participants report unprotected sex at LSO, it is likely they 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 would then be needed to adequately gauge risk.

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