289631
Patterns of substance use and engagement in sexual risk behavior among HIV positive adults over 50
Tyrel Starks, PhD,
Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY
Brett Millar, BA,
Center for HIV/AIDS Educational Studies and Training (CHEST) and Health Psychology and Clinical Sciences Doctoral Program, Hunter College and the Graduate Center of the City University of New York (CUNY), New York, NY
Zak Hill-Whilton, BA,
Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY
Jeffrey T. Parsons, PhD,
Department of Psychology and the Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College and the Graduate Center of the City University of New York (CUNY), New York, NY
Background: The CDC estimated that by 2015 more than half of those living with HIV will be age 50 and older, a population that has not garnered substantial attention in past HIV research. The limited available research has shown significantly higher rates of alcohol and substance use among this population than their general age cohort. Additional research has also pointed to a link between substance use and higher sexual risk behavior among older adults with HIV. METHOD: HIV-positive men and women over age 50 from the New York City area (n=540) were surveyed via telephone. The survey included demographic information; self-reported immunologic functioning; and behavioral data related to recent (past 30 days) HIV medication adherence, unprotected intercourse (UI), protected intercourse (PI), and drug and alcohol use. RESULTS: Four patterns of substance use emerged: Primary marijuana use; Primary crack use; primary alcohol use; and poly-substance use (elevated rates of all substances assessed). Regression analyses suggested that UI with a main partner was positively associated with UI with a casual partner. Those with primary alcohol use and those with poly-substance use reported increased engagement in sexual activity; however, substance use was not associated with UI vs. PI. DISCUSSION: These results suggest two primary concerns. First, the concurrence of UI with main and casual partners represents a risk for within-partner STI transmission. Second, if abstinence from drugs is associated with sexual abstinence, then sexual concerns may be important barriers to reducing substance use or maintaining abstinence.
Learning Areas:
Public health or related research
Social and behavioral sciences
Learning Objectives:
Describe the patterns of substance use most commonly observed in this sample of HIV positive older adults.
Explain the associations between patterns of substance use and sexual risk taking, with particular emphasis on factors associated with HIV medication adherence and sexual orientation.
Keyword(s): Sexual Risk Behavior, Substance Abuse
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I have served as a biostatistician and co-investigator on multiple federally funded projects focused on the intersection of substance use, sexual risk behavior and HIV prevention and treatment. I have also served as a clinician providing and supervising substance abuse and medication adherence interventions with the target population.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
