Impact of drug treatment on subsequent sexual risk behavior in a multisite cohort of drug-using women: A report from the Women's Interagency HIV Study
Received 9 November 2004; received in revised form 10 July 2005; accepted 23 August 2005.
Abstract
Background
The evidence that drug treatment programs are associated with changes in sexual behavior and, thus, have prevention benefits beyond addiction is inconclusive. We examined whether entry into drug treatment was associated with subsequent alterations in sexual behavior among a group of drug-using women.
Methods
Data were collected semiannually via structured interviews over 8 years. Generalized estimating equations evaluated the relationship between self-reported drug treatment at each visit and sexual abstinence and consistent condom use in the subsequent 6-month period.
Results
In this sample (N = 1,658; mean age, 37.3 years; 57.5% African American; 80.3% HIV positive; 49.6% crack/cocaine users), 40% reported being in a variety of drug treatment programs. Those undergoing drug treatment (vs. those not) were less likely to become sexually active (adjusted odds ratio [AOR], 0.83; 95% confidence interval [CI], 0.76–0.91); this association was unchanged when the frequency of attendance and number of different drug treatment programs were evaluated. Drug treatment was not associated with subsequent consistent condom, regardless of frequency of attendance, but involvement in at least three treatment programs was (AOR, 1.40; 95% CI, 1.00–1.97).
Conclusions
Additional efforts are needed to integrate effective sexual risk reduction programs into drug treatment settings; expanding access to different types of drug treatment modalities may be indicated.
hDepartments of Medicine and Epidemiology, San Francisco School of Medicine, University of California, San Francisco, CA, USA
Corresponding author. Center for Urban Epidemiological Studies, New York Academy of Medicine, New York, NY 10029, USA. Tel.: +1 212 822 7284; fax: +1 212 822 6220