Online Program

Gender difference in HIV sexual risk behavior among substance use program patients in US

Monday, November 4, 2013

Yue Pan, MS, Department of Public Health Sciences, University of Miami, Miami, FL
Daniel Feaster, PhD, Department of Public Health Sciences, University of Miami, Miami, FL
Weize Wang, MA, Department of Epidemiology, Robert Stempel College of Public Health & Social Work at Florida International University, Miami, FL
Rui Duan, MPH, Department of Epidemiology and Public Health, University of Miami, Miami, FL
Zoilyn L Gomez, MPH, Department of Epidemiology and Public Health, University of Miami, Miami, FL
Ke-Sheng Wang, PhD, Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN
Tiffany L Kyle, PhD, The Center for Drug Free Living, The Center for Drug Free Living, Orlando, FL
Susan Tross, PHD, Department of Psychiatry, Columbia University, New York, NY
Lisa R. Metsch, PhD, Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
Although sexual risk behavior among drug users is highly associated with HIV transmission, gender-specific patterns in sexual risk have previously received less systematic study among this particular population. This study examined gender differences in a variety of sexual risk behaviors, such as multiple partners, type of partner (primary or non-primary), site of penetration (vaginal or anal), protection (condom use or no condom use), substance use prior to sex and partners' HIV status (HIV-positive, negative, and unknown). Participants were 777 male and 504 female clients from 12 US community-based substance use disorder treatment programs participating in the National Drug Abuse Treatment Clinical Trials Network protocol CTN0032. Chi-sq test and negative binomial regression via generalized estimating equations (GEE) model were used in the statistical analysis. Results showed that female clients reported more unprotected sex with their primary partner (OR=1.27, 95%CI 1.01-1.59, p=0.04), unprotected sex while using drugs or alcohol (OR=1.41, 95%CI 1.03-1.92, p=0.03), unprotected sex with HIV-positive partners (OR=4.55, 95%CI 1.15-16.67, p=0.03) and partners with unknown serostatus (OR=2.13, 95%CI 1.47-3.13, p<0.0001) than male clients, adjusted for time, ethnicity, age, education, marital status, income and if ever in jail. Male clients reported significantly more anal sex (OR=1.66, 95%CI 1.13-2.43, p=0.01) than did female clients. Men also reported more unprotected sex with their non-primary partners (OR=1.89, 95%CI 1.19-2.99, p=0.01) when only adjusted for time. No significant gender differences were identified in number of sexual partners, vaginal sex or sex with HIV-negative partners. Gender specific intervention approaches may be indicated and are discussed.

Learning Areas:

Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Social and behavioral sciences

Learning Objectives:
Describe sexual risk profiles of men and women in substance abuse treatment. Identify differences in sexual risk profiles and identify differential targets for gender-specific interventions.

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

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I performed and initiated the analysis and have been part of data analysis team on the larger protocol and quality assurance. Further, I have a background in working with sexual risk behavior among substances use clients.
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: 3299.0: HIV and substance use