Abstract
Previous evidence links substance use disorders (SUD) to STI/HIV risk and suggests that comorbid psychiatric disorders increase the probability to engage in sexual risk behaviors. This study had two aims: (1) to identify subgroups based on sexual risk behavior using a person-centered approach in a sample of substance users and (2) to measure the association of psychiatric and SUD with subgroup membership. We assessed 402 male adults with SUD, reporting sexual intercourse in the previous 12 months using the HIV-Risk Behavior Scale and the Mini International Neuropsychiatric Interview. Latent class analysis was performed to determine multidimensional patterns of sexual risk behaviors and multinomial logistic regression was utilized to associate classes with disorders. The three-class model showed the best fit, and the classes were labeled: Relationship-Based (31.34% of the sample), Condom-Based (39.55%), and Multiple Risks (29.10%). Controlling for age and marital status, major depressive disorders, antisocial personality disorder, and any psychiatric disorder were associated with the Multiple Risks class. Results stress the importance of developing a personalized assessment and counseling for sexual risk behaviors in individuals with SUD, particularly when they endorse criteria for comorbid psychiatric disorders. Future studies should focus on evaluating differential response to preventive interventions.
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Acknowledgements
A special acknowledgment for their institutional support in this study: National Institute on Drug Abuse—Clinical Trials Network (NIDA-CTN), Consejo Nacional Contra las Adicciones (CONADIC-México), Instituto para la Atención y Prevención de las Adicciones en la Ciudad de México Instituto Mexiquense Contra las Adicciones, Consejo Estatal Contra las Adicciones de Puebla, Consejo Estatal Contra las Adicciones de Hidalgo, Consejo Estatal Contra las Adicciones de Querétaro. We also wish to thank David Sheehan M.D. for allowing the use of the Spanish-language adaptation of the 5th version of the Mini International Neuropsychiatric Interview.
Funding
This publication stems from the project “Development of a Clinical Trial Network on Addiction and Mental Health in Mexico” funded by a grant from the US Department of State (Grant No. SINLEC11GR0015-A001). The US Department of State had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. LVG received funding from the National Council of Science and Technology (CONACYT) to write this article via scholarship no. 383294. RMN received funding grant no. 262500 from CONACYT-FOSISS.
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All protocol procedures, informed consent forms, assessment forms, and patient recruitment materials were approved by the Research on Ethics Committee of the National Institute of Psychiatry “Ramón de la Fuente Muñiz” and are in accordance with the 1964 Declaration of Helsinki and its later amendments. For all participants who endorsed criteria for any psychotic, manic episode, or suicide behavior, the research team informed the site director and local health authorities in charge to ensure patients received specialized treatment.
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Villalobos-Gallegos, L., Medina-Mora, M.E., Benjet, C. et al. Multidimensional Patterns of Sexual Risk Behavior and Psychiatric Disorders in Men with Substance Use Disorders. Arch Sex Behav 48, 599–607 (2019). https://doi.org/10.1007/s10508-018-1227-2
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DOI: https://doi.org/10.1007/s10508-018-1227-2