title: Substance use and STI acquisition: Secondary analysis from the AWARE study.
abstract: Sexually transmitted infections (STIs) are significant public health and financial burdens in the United States. This manuscript examines the relationship between substance use and prevalent and incident STIs in HIV-negative adult patients at STI clinics.
  
  
  
  A secondary analysis of Project AWARE was performed based on 5012 patients from 9 STI clinics. STIs were assessed by laboratory assay and substance use by self-report. Patterns of substance use were assessed using latent class analysis. The relationship of latent class to STI rates was investigated using Poisson regression by population groups at high risk for STIs defined by participant's and partner's gender.
  
  
  
  Drug use patterns differed by risk group and substance use was related to STI rates with the relationships varying by risk behavior group. Substance use treatment participation was associated with increased STI rates.
  
  
  
  Substance use focused interventions may be useful in STI clinics to reduce morbidity associated with substance use. Conversely, gender-specific sexual health interventions may be useful in substance use treatment.
authors.affiliation: University of Miami Miller School of Medicine, Department of Public Health Sciences, 1120 NW 14th St., Miami, FL 33136, USA. Electronic address: dfeaster@med.miami.edu.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Feaster
authors.affiliation: Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, Miami Research Center, 1120 NW 14th St., Miami, FL 33136, USA. Electronic address: cp2695@columbia.edu.
authors.forename: Carrigan L
authors.initials: CL
authors.lastname: Parish
authors.affiliation: Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, Miami Research Center, 1120 NW 14th St., Miami, FL 33136, USA. Electronic address: lkg2129@columbia.edu.
authors.forename: Lauren
authors.initials: L
authors.lastname: Gooden
authors.affiliation: San Francisco Department of Public Health, HIV Prevention Section, 25 Van Ness Avenue, San Francisco, CA 94102, USA. Electronic address: Tim.Matheson@sfdph.org.
authors.forename: Tim
authors.initials: T
authors.lastname: Matheson
authors.affiliation: Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, Miami Research Center, 1120 NW 14th St., Miami, FL 33136, USA. Electronic address: pc2594@columbia.edu.
authors.forename: Pedro C
authors.initials: PC
authors.lastname: Castellon
authors.affiliation: University of Miami Miller School of Medicine, Department of Public Health Sciences, 1120 NW 14th St., Miami, FL 33136, USA. Electronic address: rduan@med.miami.edu.
authors.forename: Rui
authors.initials: R
authors.lastname: Duan
authors.affiliation: University of Miami Miller School of Medicine, Department of Public Health Sciences, 1120 NW 14th St., Miami, FL 33136, USA. Electronic address: panyue@med.miami.edu.
authors.forename: Yue
authors.initials: Y
authors.lastname: Pan
authors.affiliation: Medical University of South Carolina, Addiction Sciences Division, 67 President Street, Charleston, SC 29425, USA. Electronic address: hayneslf@musc.edu.
authors.forename: Louise F
authors.initials: LF
authors.lastname: Haynes
authors.affiliation: Weill Cornell Medical College, Department of Healthcare Policy and Research, 425 East 61st St., New York, NY, USA. Electronic address: brs2006@med.cornell.edu.
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Schackman
authors.affiliation: California State University, Long Beach, Department of Health Sciences, Center for Health Care Innovation, 5500 Atherton St., Long Beach, CA, USA. Electronic address: kmalotte@csulb.edu.
authors.forename: C Kevin
authors.initials: CK
authors.lastname: Malotte
authors.affiliation: National Institute of Health, National Institute on Drug Abuse, 6000 Executive Boulevard, Rockville, MD 20852, USA. Electronic address: mandlerr@nida.nih.gov.
authors.forename: Raul N
authors.initials: RN
authors.lastname: Mandler
authors.affiliation: San Francisco Department of Public Health, HIV Prevention Section, 25 Van Ness Avenue, San Francisco, CA 94102, USA. Electronic address: grant.colfax@sfdph.org.
authors.forename: Grant N
authors.initials: GN
authors.lastname: Colfax
authors.affiliation: Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722 W 168th St., 9th Floor, New York, NY 10032, USA. Electronic address: lm2892@columbia.edu.
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Metsch
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D011897:Random Allocation; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D014481:United States
keywords: Gender differences; Sexually transmitted infections; Substance use; Substance use treatment