Impact of Behavioral Drug Abuse Treatment on Sexual Risk Behaviors: An Integrative Data Analysis of Eight Trials Conducted Within the National Drug Abuse Treatment Clinical Trials Network

• Authors: Jennifer L. Brown, University of Cincinnati; Michael D. Eriksen, University of Cincinnati; Nichole K. Gause, University of Cincinnati; Gene H. Brody, Emory University; Jessica Sales, Emory University
• Journal Title: Prevention Science
• Volume: Volume 19, Number 6
• Publisher: Springer Verlag (Germany) | 2018-08-01, Pages 761-771
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1007/s11121-018-0913-6
• Subjects: Health Sciences, Public Health; Psychology, Behavioral
• Keywords: Science & Technology; Life Sciences & Biomedicine; Public, Environmental & Occupational Health; Integrative data analysis; Behavioral drug treatment; Sexual risk behaviors; MOTIVATIONAL ENHANCEMENT THERAPY; TREATMENT PROGRAMS; SUBSTANCE USERS; RANDOMIZED-TRIAL; HIV; ASSOCIATIONS; IMPULSIVITY; INCENTIVES; PREDICTORS; ADULTHOOD

Abstract

The extent to which behavioral drug abuse treatments affect sexual risk behaviors is largely unknown. This study examined the impact of behavioral drug abuse treatments on sexual risk behaviors using an integrative data analysis approach across eight trials conducted within the National Drug Abuse Treatment Clinical Trials Network (CTN). Participants (N = 1305) from eight randomized controlled trials who were sexually active at baseline were included in the pooled dataset; 48.7% were female, 64.1% self-identified as a racial/ethnic minority, with M (SD) age of 34.9 (9.6). Longitudinal logistic regression estimated the probability of risky sexual behavior (i.e., inconsistent condom use and/or > 1 sexual partner in past 30 days) post-intervention with an indicator variable (1 for post-intervention), study condition (control, intervention), and their interaction as predictors; the analysis employed random effects for each trial and included relevant control variables. Time-varying differences in effects based on weeks post-intervention were incorporated using interacted linear and quadratic terms with condition status. Approximately 84.2% reported risky sexual behaviors at baseline. The control and intervention conditions were 18.5 and 17.3 percentage points less likely to report risky sexual behavior post-intervention, respectively. Results suggest decreasing rates of risky sex engagement until 8 weeks (control) or 9 weeks (intervention) post-intervention; risky sexual behavior subsequently increased. Behavioral CTN trial participation was associated with decreased sexual risk behaviors in both the intervention and control trial conditions. Participation in behavioral substance use treatment may result in secondary benefits of sexual risk behavior reductions.