Patton Rikki, Blow Frederic C, Bohnert Amy S B, Bonar Erin E, Barry Kristen L, Walton Maureen A
The Substance Abuse Research Center, University of Michigan.
Department of Psychiatry, University of Michigan.
Psychol Addict Behav. 2014 Jun;28(2):625-30. doi: 10.1037/a0035417.
Men and women involved in transactional sex (TS) report increased rates of HIV risk behaviors and substance use problems as compared with the general population. When people engaged in TS seek health care, they may be more likely to utilize the emergency department (ED) rather than primary care services. Our goal was to examine the prevalence and correlates of TS involvement among an ED sample of men and women. Adults ages 18-60 were recruited from an urban ED, as part of a larger randomized control trial. Participants (n = 4,575; 3,045 women, 1,530 men) self-administered a screening survey that assessed past 3-month substance use (including alcohol, marijuana, illicit drugs, and prescription drugs) and HIV risk behaviors, including TS (i.e., being paid in exchange of a sexual behavior), inconsistent condom use, multiple partners, and anal sex. Of the sample, 13.3% (n = 610) reported TS within the past 3 months (64.4% were female). Bivariate analysis showed TS was significantly positively associated with alcohol use severity, marijuana use, and both illicit and prescription drug use, and multiple HIV risk behaviors. These variables (except marijuana) remained significantly positively associated with TS in a binary logistic regression analysis. The prevalence of recent TS involvement among both male and female ED patients is substantial. These individuals were more likely to report higher levels of alcohol/drug use and HIV risk behaviors. The ED may be a prime location to engage both men and women who are involved in TS in behavioral interventions for substance use and sexual risk reduction.
与普通人群相比，参与交易性行为（TS）的男性和女性报告的艾滋病毒风险行为和物质使用问题发生率更高。当参与交易性行为的人寻求医疗保健时，他们可能更倾向于使用急诊科（ED）而非初级保健服务。我们的目标是调查急诊科男性和女性样本中参与交易性行为的患病率及其相关因素。作为一项更大规模随机对照试验的一部分，从一家城市急诊科招募了18至60岁的成年人。参与者（n = 4575；3045名女性，1530名男性）自行填写了一份筛查调查问卷，该问卷评估了过去3个月的物质使用情况（包括酒精、大麻、非法药物和处方药）以及艾滋病毒风险行为，包括交易性行为（即以性行为换取金钱）、不坚持使用避孕套、多个性伴侣和肛交。在样本中，13.3%（n = 610）报告在过去3个月内有过交易性行为（64.4%为女性）。双变量分析显示，交易性行为与酒精使用严重程度、大麻使用、非法药物和处方药使用以及多种艾滋病毒风险行为显著正相关。在二元逻辑回归分析中，这些变量（大麻除外）与交易性行为仍显著正相关。急诊科男性和女性患者中近期参与交易性行为的患病率相当高。这些人更有可能报告更高水平的酒精/药物使用和艾滋病毒风险行为。急诊科可能是对参与交易性行为的男性和女性进行减少物质使用和性风险行为干预的主要场所。
