141st APHA Annual Meeting and Exposition

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
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Online Program

279948
Risky sexual behavior and substance use among HIV-infected and high-risk individuals after six months of patient navigation


Monday, November 4, 2013

Kathryn Macapagal, Ph.D., Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
Daniel Fridberg, Ph.D., Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Pritzker School of Medicine, Chicago, IL
Kena Arnold, B.A., Department of Psychiatry and Health Behavior, Medical College of Georgia at Georgia Regents University, Augusta, GA
Lauren Penwell-Waines, Ph.D., Department of Psychiatry and Health Behavior, Medical College of Georgia at Georgia Regents University, Augusta, GA
Abbey Valvano, Ph.D., Department of Psychiatry and Health Behavior, Medical College of Georgia at Georgia Regents University, Augusta, GA
Lara Stepleman, Ph.D., Department of Psychiatry and Health Behavior, Medical College of Georgia at Georgia Regents University, Augusta, GA
  
Background: Patient navigation is an emerging model of patient-centered intervention that has been shown to reduce barriers to care and improve medical outcomes among persons with chronic illness. This study examined sexual behavior and substance use outcomes of individuals enrolled in the Substance abuse Treatment Engagement Program (STEP), a pretreatment program consisting of patient navigation and motivational interviewing for substance-abusing persons with HIV or at high risk for HIV in the Southeastern U.S.A.

Methods: Participants were 160 sexually active, HIV-infected or high-risk men and women (M age = 40.2 years) enrolled in STEP for at least 6 months. Participants answered items regarding sexual behavior and substance use as part of interviews at intake and 6-month follow-up. Data were analyzed using t-tests and McNemar tests.

Results: The percentage of participants who had unprotected sex in the previous 30 days decreased significantly from intake to follow-up (p < .001). The number of days per month using substances decreased (p < .001), and was accompanied by a decrease in mean number of sexual encounters (p < .001), frequency of unprotected sex (p < .001), and frequency of unprotected sex with partners who used IV drugs (p < .02) or who were high (p < .01).

Conclusions: Sexual risk behavior and substance use decreased significantly after 6 months among patients enrolled in STEP. Involvement in patient navigation may have contributed directly to reductions in substance use and indirectly to improvements in behaviors that are highly correlated with substance abuse, such as risky sex.

Learning Areas:

Provision of health care to the public
Public health or related research
Social and behavioral sciences

Learning Objectives:
List changes in sexual behavior and substance use associated with participation in a patient navigation program

Keyword(s): Sexual Risk Behavior, Substance Abuse Treatment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator of a federally funded grant focusing on psychosocial correlates of sexual decision making in substance using individuals. I am completing a clinical residency in Medical Psychology and HIV/AIDS and my primary research and clinical interests are sexual health, substance abuse, HIV prevention and HIV mental health.
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.

Back to: 3298.0: HIV/AIDS and sexual health