Cavazos-Rehg Patricia A, Spitznagel Edward L, Schootman Mario, Strickland Jaime R, Afful Stephanie E, Cottler Linda B, Bierut Laura Jean
Department of Psychiatry, Washington University in St. Louis, 660 South Euclid, St. Louis, MO 63110, USA.
AIDS Patient Care STDS. 2009 Sep;23(9):727-34. doi: 10.1089/apc.2008.0272.
Cocaine users routinely engage in high-risk sexual behaviors that place them at an elevated risk of contracting HIV and other blood-borne infections. The purpose of the present study was to compare trading sex for drugs and/or money, having 10 or more sexual partners in 1 year, and sexually transmitted diseases (STDs) of cocaine-dependent individuals in treatment for their dependence across race and gender and against participants who live in their community. Cocaine-dependent individuals (n = 459) were identified through nine publicly and privately funded inpatient and outpatient chemical dependency treatment centers in the St. Louis area during 2001-2006. Community-based participants (n = 459) were matched to cocaine-dependent participants on age, ethnicity, gender, and zip code of residence. Mean age of the sample was 36 years old, 50% were Caucasians, 50% were African American, and 47% were male. Nearly half of cocaine-dependent participants in treatment had traded sex for drugs and/or money and over one-third had more than 10 sexual partners in 1 year with a risk concentrated among African Americans even after controlling for income and educational attainment. Participants recruited from the community with some exposure to cocaine reported similar rates of high risk sexual behaviors as the cocaine dependent subjects from treatment settings. It is important for clinicians to recognize that once released from treatment, cocaine-dependent individuals may be returning to high-risk environments where sexual risk behaviors are occurring in the context of cocaine use.
可卡因使用者经常从事高风险性行为，这使他们感染艾滋病毒和其他血源性感染的风险升高。本研究的目的是比较用性交易换取毒品和/或金钱、一年内有10个或更多性伴侣以及接受戒毒治疗的可卡因依赖者的性传播疾病（STD）情况，比较对象包括不同种族和性别的可卡因依赖者以及他们所在社区的参与者。2001年至2006年期间，通过圣路易斯地区9个由公共和私人资助的住院及门诊药物依赖治疗中心，确定了459名可卡因依赖者。以社区为基础的参与者（459名）在年龄、种族、性别和居住邮政编码方面与可卡因依赖参与者进行了匹配。样本的平均年龄为36岁，50%为白种人，50%为非裔美国人，47%为男性。接受治疗的可卡因依赖参与者中，近一半曾用性交易换取毒品和/或金钱，超过三分之一在一年内有10个以上性伴侣，即使在控制了收入和教育程度后，风险仍集中在非裔美国人中。从社区招募的有一定可卡因接触史的参与者报告的高风险性行为发生率与来自治疗机构的可卡因依赖者相似。临床医生必须认识到，一旦从治疗中释放，可卡因依赖者可能会回到高风险环境中，在可卡因使用的背景下发生性风险行为。
