Tross Susan, Feaster Daniel J, Thorens Gabriel, Duan Rui, Gomez Zoilyn, Pavlicova Martina, Hu Mei Chen, Kyle Tiffany, Erickson Sarah, Spector Anya, Haynes Louise, Metsch Lisa R
New York State Psychiatric Institute (S.T., M.C.H., A.S.), Columbia University Medical Center, New York, USA; Department of Biostatistics (D.J.F., R.D., Z.G.), Miller School of Medicine, University of Miami, Miami, Florida, USA; Department of Mental Health and Psychiatry (G.T.), University Hospital of Geneva, Geneva, Switzerland; Department of Biostatistics (M.P.), Mailman School of Public Health, Columbia University Medical Center, New York, USA; Center for Drug-Free Living (T.K.), Orlando, Florida, USA; Department of Psychology (S.E.), University of New Mexico, Albuquerque, New Mexico; Medical University of South Carolina (L.H.), Charleston, South Carolina, USA; and Department of Sociomedical Sciences (L.R.M.), Mailman School of Public Health, Columbia University Medical Center, New York, USA.
J Addict Med. 2015 Nov-Dec;9(6):457-63. doi: 10.1097/ADM.0000000000000162.
The NIDA Clinical Trials Network trial of rapid HIV testing/counseling in 1281 patients was a unique opportunity to examine relationships among substance use, depressive symptoms, and sex risk behavior.
Past 6-month substance use; substance use severity (Drug Abuse Screening Test - 10); depressive symptoms (Quick Inventory of Depressive Symptomatology); and three types of sex risk behavior (unprotected sex occasions [USOs] with primary partners; USOs with nonprimary partners; and USOs while high/drunk) were assessed. Zero-inflated negative binomial analyses provided: probability and rate of sex risk behavior (in risk behavior subsample).
Levels of sexual risk behavior were high, while variable across the three types of sex risk behaviors. Among the patients, 50.4% had engaged in USOs with primary partners, 42% in sex while drunk or high, and 23.8% in USOs with nonprimary partners. Similar factors were significantly associated with all three types of sex risk behaviors. For all types, problem drinking, cocaine use, and substance use severity had an exacerbating effect. Older age was associated with lower risk behavior; other relationship categories (eg, married, separated/divorced, cohabitating) were associated with greater risk behavior than was single status. Depressive symptoms were associated with decreased likelihood of USOs with a primary partner.
Sexual risk behavior is common among individuals in outpatient substance abuse treatment. Results highlight problem drinking (eg, up to three-fold) and cocaine (eg, up to twice) in increasing sex risk behavior. They demonstrate the utility of distinguishing between partner types and presence/absence of alcohol/drugs during sex. Findings argue for the need to integrate sex risk reduction into drug treatment.
美国国家药物滥用研究所临床试验网络对1281名患者进行的快速艾滋病毒检测/咨询试验，是一个检验物质使用、抑郁症状和性风险行为之间关系的独特机会。
评估过去6个月的物质使用情况；物质使用严重程度（药物滥用筛查测试-10）；抑郁症状（抑郁症状快速清单）；以及三种性风险行为类型（与主要伴侣的无保护性行为次数[USOs]；与非主要伴侣的USOs；以及在吸毒/醉酒时的USOs）。零膨胀负二项式分析提供了：性风险行为的概率和发生率（在风险行为子样本中）。
性风险行为水平较高，且在三种性风险行为类型中存在差异。在患者中，50.4%的人与主要伴侣发生过USOs，42%的人在吸毒或醉酒时发生过性行为，23.8%的人与非主要伴侣发生过USOs。相似的因素与所有三种性风险行为均显著相关。对于所有类型，问题饮酒、可卡因使用和物质使用严重程度都有加剧作用。年龄较大与较低的风险行为相关；其他关系类别（如已婚、分居/离婚、同居）与单身状态相比，与更高的风险行为相关。抑郁症状与与主要伴侣发生USOs的可能性降低有关。
性风险行为在门诊物质滥用治疗患者中很常见。结果突出了问题饮酒（如高达三倍）和可卡因（如高达两倍）对增加性风险行为的影响。它们证明了区分伴侣类型以及性行为期间是否存在酒精/药物的效用。研究结果表明有必要将降低性风险纳入药物治疗。
