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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

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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.

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Notes

  1. This analytic approach is equivalent to estimating a two-way generalized linear mixed model with a constant and independent random effect. Possible serial correlation within participants was accounted for by estimating clustered Huber-White sandwich estimators for each participant independently as suggested by Stock and Watson (2008).

  2. Female and older participants were only slightly less likely to engage in a risky sexual behavior, although neither difference were statistically relevant.

  3. Akaike Information Criterion (1977) indicated a superior fit of the above effects interacted with both a linear and quadratic term of weeks since intervention as compared to a strictly linear effect.

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Funding

This research was supported by R03DA037786 from the National Institute on Drug Abuse to Jennifer L. Brown.

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Authors and Affiliations

  1. Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Suite 104, Cincinnati, OH, 45229, USA

    Jennifer L. Brown

  2. Department of Finance & Real Estate, University of Cincinnati, Cincinnati, OH, USA

    Michael D. Eriksen

  3. Department of Psychology, University of Cincinnati, Cincinnati, OH, USA

    Nicole K. Gause

  4. Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Gene H. Brody & Jessica M. Sales

  5. Center for AIDS Research, Emory University, Atlanta, GA, USA

    Gene H. Brody & Jessica M. Sales

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  1. Jennifer L. Brown
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Correspondence to Jennifer L. Brown.

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The authors declare that they have no conflict of interest.

Research Involving Human Participants and/or Animals

All procedures performed in studies involving human subjects were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained in all of the original clinical trials included in this secondary data analysis.

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Brown, J.L., Eriksen, M.D., Gause, N.K. et al. 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. Prev Sci 19, 761–771 (2018). https://doi.org/10.1007/s11121-018-0913-6

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