title: Are decreases in drug use risk associated with reductions in HIV sex risk behaviors among adults in an urban hospital primary care setting?
abstract: Drug use is associated with increased sexual risk behaviors. We examined whether decreases in drug use risk are associated with reduction in HIV-related sex risk behaviors among adults. Data was from a cohort of participants (n = 574) identified by drug use screening in a randomized trial of brief intervention for drug use in an urban primary care setting. Inverse probability of treatment weighted (IPTW) logistic regression models were used to examine the relationship between decreases in drug use risk and sex-related HIV risk behavior reduction from study entry to six months. Weights were derived from propensity score modeling of decreases in drug use risk as a function of potential confounders. Thirty seven percent of the study participants (213/574) reported a decrease in drug use risk, and 7% (33/505) reported decreased sex-related HIV risk behavior at the six-month follow-up point. We did not detect a difference in reduction of risky sexual behaviors for those who decreased drug use risk (unadjusted: OR 1.32, 95% CI 0.65-2.70; adjusted OR [AOR] 1.12, 95% CI 0.54-2.36). Adults who screened positive for high drug use risk had greater odds of reducing sex risk behavior in unadjusted analyses OR 3.71, 95% CI 1.81-7.60; but the results were not significant after adjusting for confounding AOR 2.50, 95% CI 0.85-7.30). In this primary care population, reductions in HIV sex risk behaviors have complex etiologies and reductions in drug use risk do not appear to be an independent predictor of them.
authors: Department of Public Health, College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, United States.
authors: Angela Wangari
authors: AW
authors: Walter
authors: Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States; Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States.
authors: Debbie M
authors: DM
authors: Cheng
authors: Data Coordinating Center, Boston University School of Public Health, Boston, MA, United States.
authors: Christine A
authors: CA
authors: Lloyd-Travaglini
authors: Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States; Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States.
authors: Jeffrey H
authors: JH
authors: Samet
authors: Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States.
authors: Judith
authors: J
authors: Bernstein
authors: Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States; Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States.
authors: Richard
authors: R
authors: Saitz
keywords: Drug use; HIV/AIDS; Sex risk behavior; Unprotected sex