Palepu Anita, Raj Anita, Horton Nicholas J, Tibbetts Nicole, Meli Seville, Samet Jeffrey H
Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
J Subst Abuse Treat. 2005 Jan;28(1):3-9. doi: 10.1016/j.jsat.2004.09.002.
We examined the association of substance abuse treatment with sexual and drug use risk behaviors among 349 HIV-infected persons with a history of alcohol problems using a standardized questionnaire regarding sexual and drug use risk behaviors, demographics, substance use, and use of substance abuse treatment. We defined substance abuse treatment services as any of the following in the past 6 months: 12 weeks in a half-way house or residential facility; 12 visits to a substance abuse counselor or mental health professional; day treatment for at least 30 days; or participation in any methadone maintenance program. Our three outcome variables of high-risk behavior were the Risk Assessment Battery sex-risk and drug-risk scores and high-risk sex behavior which included any of the following: inconsistent condom use; having more than one sexual partner; and exchanging sex for money or drugs. Although sexual risk was high (51%) in our HIV-infected cohort, engagement in substance abuse treatment was not independently associated with lower frequency of any of our measures of high- risk behaviors. Although the opportunity exists to address HIV risk behaviors in the setting of substance abuse treatment, effective institutionalization of this challenging behavior change effort has not yet been realized.
我们使用一份关于性和药物使用风险行为、人口统计学、物质使用及物质滥用治疗利用情况的标准化问卷，对349名有酒精问题病史的HIV感染者进行了研究，以探讨物质滥用治疗与性及药物使用风险行为之间的关联。我们将物质滥用治疗服务定义为在过去6个月内出现以下任何一种情况：在中途之家或住院治疗机构接受12周治疗；拜访物质滥用顾问或心理健康专业人员12次；日间治疗至少30天；或参加任何美沙酮维持治疗项目。我们的三个高风险行为结果变量分别是风险评估量表的性风险和药物风险得分以及高风险性行为，高风险性行为包括以下任何一种情况：避孕套使用不一致；有多个性伴侣；以及以性换钱或换毒品。尽管在我们的HIV感染队列中性风险很高（51%），但参与物质滥用治疗与我们任何一项高风险行为指标的较低频率并无独立关联。尽管在物质滥用治疗背景下有机会解决HIV风险行为问题，但这种具有挑战性的行为改变努力尚未有效制度化。
