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Sex Risk Behaviors and Substance Use Severity Among Men in SUD Treatment

January 6, 2017
Neville H., et al.
Newville H, et al. Temporal Relationship of Sex Risk Behaviors and Substance Use Severity Among Men in Substance Use Treatment.Journal of Sex Research 2017 (in press). [doi: 10.1080/00224499.2017.1321101]
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  • Rates of new HIV infections due to sexual transmission in the United States have been increasing in the last several years, comprising 94% of new cases in 2014.
  • Additionally, among people who inject drugs, sexual risk behaviors are independently associated with HIV transmission and may be a larger factor in HIV transmission than injection behavior.
  • Is it possible, given that, that changes in sex risk behaviors might coincide with changes in drug/alcohol use severity?

This study aimed to answer that question, using a population of men in substance use disorder treatment, as part of CTN-0018, a gender-specific HIV risk reduction trial. Men in methadone maintenance and outpatient drug-free treatment (N=359) completed assessments at baseline and six months later. Changes in sex risk and substance use severity were assessed using the Addiction Severity Index-Lite (ASI-Lite), controlling for treatment condition.

Analysis of the results found that:

  • Decreased alcohol severity was significantly associated with decreases in reported sex partners, while increased alcohol severity was significantly associated with increases in reported sex partners;
  • Increasing drug use severity was significantly associated with maintaining and initiating sex with a high-risk partner;
  • Decreasing alcohol use severity was significantly associated with discontinuing sex under the influence;
  • Changes in drug/alcohol use severity were not associated with changes in unprotected sex.

Conclusions: Substance use reductions may decrease HIV risk behaviors among male substance users. These findings highlight the importance of integrating interventions in SUD treatment settings that address the intersection of sex risk behaviors and substance use.

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