title: Impact of drug treatment on subsequent sexual risk behavior in a multisite cohort of drug-using women: a report from the Women's Interagency HIV Study.
abstract: BACKGROUND
  The evidence that drug treatment programs are associated with changes in sexual behavior and, thus, have prevention benefits beyond addiction is inconclusive. We examined whether entry into drug treatment was associated with subsequent alterations in sexual behavior among a group of drug-using women.
  
  
  METHODS
  Data were collected semiannually via structured interviews over 8 years. Generalized estimating equations evaluated the relationship between self-reported drug treatment at each visit and sexual abstinence and consistent condom use in the subsequent 6-month period.
  
  
  RESULTS
  In this sample (N = 1,658; mean age, 37.3 years; 57.5% African American; 80.3% HIV positive; 49.6% crack/cocaine users), 40% reported being in a variety of drug treatment programs. Those undergoing drug treatment (vs. those not) were less likely to become sexually active (adjusted odds ratio [AOR], 0.83; 95% confidence interval [CI], 0.76-0.91); this association was unchanged when the frequency of attendance and number of different drug treatment programs were evaluated. Drug treatment was not associated with subsequent consistent condom, regardless of frequency of attendance, but involvement in at least three treatment programs was (AOR, 1.40; 95% CI, 1.00-1.97).
  
  
  CONCLUSIONS
  Additional efforts are needed to integrate effective sexual risk reduction programs into drug treatment settings; expanding access to different types of drug treatment modalities may be indicated.
authors.affiliation: Center for Urban Epidemiological Studies, New York Academy of Medicine, New York, NY 10029, USA. mlatka@nyam.org
authors.forename: Mary H
authors.initials: MH
authors.lastname: Latka
authors.forename: Tracey E
authors.initials: TE
authors.lastname: Wilson
authors.forename: Judith A
authors.initials: JA
authors.lastname: Cook
authors.forename: Melanie C
authors.initials: MC
authors.lastname: Bacon
authors.forename: Jean L
authors.initials: JL
authors.lastname: Richardson
authors.forename: Nancy
authors.initials: N
authors.lastname: Sohler
authors.forename: Mardge H
authors.initials: MH
authors.lastname: Cohen
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Greenblatt
authors.forename: Evie
authors.initials: E
authors.lastname: Andreopoulis
authors.forename: David
authors.initials: D
authors.lastname: Vlahov
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D015331:Cohort Studies; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D012736:Sex Education / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000523:psychology; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D047568:Unsafe Sex / Q000706:statistics & numerical data*