142nd APHA Annual Meeting and Exposition

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306864
Relationship between housing status and HIV sexual risk behaviors among people in substance use disorder treatment

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 1:00 PM - 1:15 PM

Yue Pan, MS , Department of Epidemiology and Public Health Science, University of Miami, Miami, FL
Daniel Feaster, PhD , Department of Epidemiology and Public Health, 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
Tiffany L Kyle, PhD , The Center for Drug Free Living, The Center for Drug Free Living, Orlando, FL
Lisa R. Metsch, PhD , Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
Background: HIV risk behaviors such as drug use and unprotected sex are prevalent among people in substance use disorder treatment. Further, unstable housing is associated with higher rates of substance use.

Objective: We examined the associations between housing status, drug use and sexual risk behaviors among 1281 participants from 12 US community-based substance use disorder treatment programs.  In addition, drug use was examined as a potential mediator of the relationship between housing status and sexual risk behaviors.

Methods: Chi-square, univariable and multivariable logistic regression models were used in this planned secondary analysis of data from CTN-0032, a trial conducted within the National Drug Abuse Treatment Clinical Trials Network. Path analysis was used to test the associations and mediation. 

Results: Individuals living in other’s residence (lover, friend, or rented room within a house/apartment) were more likely to report having multiple sex partners (OR=1.49, 95%CI= 1.04-2.12, p=0.03), unprotected sex acts with non-primary partners (OR=1.47, 95%CI= 1.10-1.97, p=0.01) and HIV unknown serostatus partners (OR=1.33, 95% CI=1.00-1.77, p=0.04) than people living in a place they owned or rented themselves. Homeless individuals were less likely to report unprotected vaginal sex (OR=0.57, 95%CI= 0.34-0.96, p=0.03) and sex with drug use (OR=0.54, 95%CI= 0.30-0.97, p=0.04) than people living in their own residence. Alcohol, cocaine and injection drug use were found to mediate the path between housing status and sex risk behaviors.

Conclusions: Housing status should be taken into consideration when assessing HIV risk and attempting to reduce the risk behaviors of people in substance use disorder treatment.

Learning Areas:

Administer health education strategies, interventions and programs
Epidemiology
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 and substance use profiles of clients in substance abuse treatment among different housing status. Identify mediation of drug use between housing status and sexual risk behaviors.

Keyword(s): HIV Risk Behavior, Homelessness

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.