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Sociodemographic and Substance Use Disorder Determinants of HIV Sexual Risk Behavior in Men and Women in Outpatient Drug Treatment in the NIDA National Drug Abuse Treatment Clinical Trials Network.

Substance Use & Misuse 2017;52(7):585-865. [doi: 10.1080/10826084.2016.1264971]

Jeremy D. Kidd, MD, MPH (New York State Psychiatric Institute, GNY Node), Susan Tross, PhD (New York State Psychiatric Institute, GNY Node), Martina Pavlicova, PhD (Columbia University, GNY Node), Mei-Chen Hu, PhD (Columbia University, GNY Node), Aimee N. C. Campbell, PhD, MSW (Columbia University, GNY Node), Edward V. Nunes, MD (New York State Psychiatric Institute, GNY Node).

Sexual risk behavior is now the primary vector of HIV transmission among substance users in the United States with gender as a crucial moderator of risk behavior. This study examined gender differences in factors (age, race/ethnicity, education) that predict main-partner unprotected sexual occasions (USO) using the unique platform of two parallel NIDA Clinical Trials Network gender-specific safer sex intervention trials. Baseline assessments of male (N=430) and female (N=377) participants included demographic characteristics; past 3-month sexual activity; and a diagnostic assessment for alcohol, cocaine/stimulant, and opioid use disorders. Using mixed effects generalized linear modeling of the main outcome USO, two-way interactions of gender with age, race/ethnicity, and education were evaluated and adjusted by alcohol, cocaine/stimulant, or opioid use disorder.

When adjusted for alcohol use disorder, the interaction of education and gender was significant. For men, a high school or greater education was significantly associated with more USO compared to men with less than high school. For women, greater than high school education was significantly associated with less USO compared to women with a high school education. None of the other interactions were significant when adjusted for cocaine/stimulant or opioid use disorder.

Conclusions: This study demonstrates gender differences in the relationship of education, alcohol use disorder, and main-partner USO in individuals in substance abuse treatment. This underscores the importance of considering demographic and substance use factors in HIV sexual risk behavior and in crafting prevention messages for this population. (Article (Peer-Reviewed), PDF, English, 2017)

Keywords: Behavior therapy | Condom use | CTN platform/ancillary study | Gender differences | Gender-specific interventions | HIV/AIDS | Sexual risk behavior | Sexually transmitted diseases | Women | Substance Use & Misuse (journal)

Document No: 1262, PMID: 28426361, PMCID: PMC5710008 (available 6/1/2018).

Submitted by the CTN Dissemination Librarians (3/20/2017).

Campbell, Aimee N. C. mail
Hu, Mei-Chen
Kidd, Jeremy D. mail
Nunes, Edward V. mail
Pavlicova, Martina mail
Tross, Susan search mail
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