title: Substance use, mental health problems, and behavior at risk for HIV: evidence from CJDATS.
abstract: This study examined the relationships between substance abuse, mental health problems and HIV risk behavior in offenders discharged from prison and referred to substance abuse treatment programs. Data from 34 sites (n = 1,358) in a federally-funded cooperative agreement, the Criminal Justice Drug Abuse Treatment Studies (CJDATS), were analyzed. Among parolees referred to substance abuse treatment, self reports for the six-month period before the arrest resulting in their incarceration revealed frequent problems with both substance use and mental health. HIV risk behavior was operationalized as either (a) unsafe injection drug use, e.g., sharing needles and/or sharing injection equipment, or (b) unsafe sex, e.g., sex without a condom. The findings were that (1) unsafe injection drug use was associated with unsafe sex and vice versa, (2) unsafe sex behavior was related to frequency of drug use, and (3) unsafe sex behavior was related to frequency of alcohol use. In these samples, mental health problems did not have a significant effect on risk behavior, controlling for other variables. Future research should probe this "nonfinding" using standardized diagnostic and symptom measures to provide greater detail on the mental health problems (e.g., age of onset, frequency, and severity of the problem).
authors.affiliation: Center for the Integration of Research & Practice (CIRP), National Development & Research Institutes, Inc. (NDRI), New York, NY 10010, USA. pearson@ndri.org
authors.forename: Frank S
authors.initials: FS
authors.lastname: Pearson
authors.forename: Charles M
authors.initials: CM
authors.lastname: Cleland
authors.forename: Michael
authors.initials: M
authors.lastname: Chaple
authors.forename: Zachary
authors.initials: Z
authors.lastname: Hamilton
authors.forename: Michael L
authors.initials: ML
authors.lastname: Prendergast
authors.forename: Josiah D
authors.initials: JD
authors.lastname: Rich
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology; D003625:Data Collection; D017831:Diagnosis, Dual (Psychiatry) / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology; D016485:Needle Sharing / Q000523:psychology; D011329:Prisoners / Q000523:psychology*; D012017:Referral and Consultation; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000523:psychology; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology* / Q000628:therapy; D014481:United States; D047568:Unsafe Sex / Q000523:psychology*