Substance use, childhood sexual abuse, and sexual risk behavior among women in methadone treatment.

摘要

BACKGROUND: Substance use and a history of childhood sexual abuse (CSA) are risk factors for unprotected sex among women, yet questions remain as to how their combined influence may differentially affect sexual risk. OBJECTIVE: The current study investigated how complex relationships among drug use and CSA may contribute to unprotected sexual occasions (USO). METHODS: A Generalized Linear Mixed Model was used to examine the interaction between current cocaine/stimulants and opioid use and CSA on number of USOs in a sample of 214 sexually active women in outpatient methadone maintenance treatment. RESULTS: For women with CSA, an increase in days of cocaine/stimulant use was associated with a significant increase in USOs. In contrast, an increase in days of opiate use was associated with a significant decrease in USOs. For the group of women who did not report CSA, there was a significant increase in USOs with increased opiate use. CONCLUSIONS: Findings indicate that CSA is related to unprotected sexual occasions depending on drug type and severity of use. SCIENTIFIC SIGNIFICANCE: Women with CSA using cocaine are at particularly high risk for having unprotected sex and should be specifically targeted for HIV prevention interventions.