University of Connecticut School of Medicine, Calhoun Cardiology Center, 263 Farmington Avenue, Farmington, CT 06030, United States.
University of Connecticut School of Medicine, Calhoun Cardiology Center, 263 Farmington Avenue, Farmington, CT 06030, United States.
J Subst Abuse Treat. 2017 Dec;83:10-14. doi: 10.1016/j.jsat.2017.09.016. Epub 2017 Sep 30.
People who inject drugs (PWID) are at increased risk of HIV infection. Although methadone maintenance therapy can help lower this risk, many methadone patients continue to engage in HIV risk behaviors, especially patients who use cocaine and alcohol. The purpose of the current study was to investigate relations between alcohol use disorders and HIV risk behavior in 239 cocaine-dependent methadone patients participating in a randomized controlled trial of a behavioral intervention to promote cocaine abstinence. Past 3-month HIV Risk-taking Behavior Scale (HRBS) scores were compared between cocaine-dependent methadone patients who met DSM-IV-TR diagnostic criteria for alcohol abuse or dependence and those who did not meet these criteria. No significant differences in HRBS drug subscale scores were observed between participants with and without alcohol use disorders, indicating risky drug use was similar between groups. However, alcohol use disorder was significantly associated with HRBS sex subscale scores (t=2.59, p=0.01), indicating participants with alcohol use disorders were more likely to engage in risky sexual behavior. Item-level analyses of the sex-related HRBS questions showed participants with alcohol use disorders were significantly more likely than participants without alcohol use disorders to have unprotected sex, engage in transactional (paid) sex, and have anal sex. Interventions are needed to reduce risky sexual behavior and attenuate the spread of HIV in this high-risk population.
注射毒品的人（PWID）感染 HIV 的风险增加。虽然美沙酮维持治疗可以帮助降低这种风险，但许多美沙酮患者仍继续从事 HIV 风险行为，尤其是那些同时使用可卡因和酒精的患者。本研究的目的是调查在参加一项促进可卡因戒除的行为干预随机对照试验的 239 名可卡因依赖的美沙酮患者中，酒精使用障碍与 HIV 风险行为之间的关系。将符合 DSM-IV-TR 酒精滥用或依赖诊断标准和不符合这些标准的可卡因依赖美沙酮患者的过去 3 个月 HIV 风险行为量表（HRBS）评分进行比较。在药物子量表评分方面，参与者之间没有观察到显著差异，表明两组之间的药物滥用风险相似。然而，酒精使用障碍与 HRBS 性相关子量表评分显著相关（t=2.59，p=0.01），表明有酒精使用障碍的参与者更有可能从事高风险性行为。对与性相关的 HRBS 问题进行的项目水平分析表明，有酒精使用障碍的参与者比没有酒精使用障碍的参与者更有可能发生无保护性行为、从事交易性（有偿）性行为和肛交。需要采取干预措施，减少高风险人群中的高风险性行为，并减缓 HIV 的传播。
