title: The impact of substance use, sexual trauma, and intimate partner violence on sexual risk intervention outcomes in couples: a randomized trial.
abstract: BACKGROUND
  Few HIV prevention interventions focus on sexual risk reduction as mutual process determined by couple members, though risk behaviors are inter-dependent.
  
  
  OBJECTIVE
  This trial examined the impact of substance use, history of sexual trauma, and intimate partner violence on sexual risk associated with participation in a risk reduction intervention.
  
  
  METHODS
  HIV seroconcordant and serodiscordant multicultural couples in Miami, Florida (n = 216) were randomized to group (n = 112) or individual (n = 104) couple-based interventions.
  
  
  RESULTS
  Group intervention participants increased condom use in couples in which women had a history of sexual trauma [F(2,221) = 3.39, p = 0.036] and by partners of alcohol users. History of sexual trauma was a determinant of conflict resolution, predicting negative communication and intimate partner violence.
  
  
  CONCLUSIONS
  Results emphasize the need for group sexual risk reduction interventions targeting sexual trauma, partner violence, and substance use among HIV seroconcordant and serodiscordant couples.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Avenue, Miami, FL 33136, USA. djones@med.miami.edu
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Jones
authors.forename: Deborah
authors.initials: D
authors.lastname: Kashy
authors.forename: Olga M
authors.initials: OM
authors.lastname: Villar-Loubet
authors.forename: Ryan
authors.initials: R
authors.lastname: Cook
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Weiss
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005431:Florida; D015658:HIV Infections / Q000517:prevention & control*; D006679:HIV Seropositivity / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D021841:Safe Sex / Q000523:psychology; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners / Q000523:psychology*; D013179:Spouse Abuse / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology*; D011795:Surveys and Questionnaires; D014754:Violence / Q000517:prevention & control