Substance Use, Childhood Sexual Abuse, and Sexual Risk Behavior among Women in Methadone Treatment

• Published in: The American journal of drug and alcohol abuse Vol. 35; no. 5; pp. 305 - 310
• Main Authors: Cohen, Lisa R., Tross, Susan, Pavlicova, Martina, Hu, Mei-Chen, Campbell, Aimee N., Nunes, Edward V.
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 01.01.2009; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Adult; Child; Child abuse & neglect; Child Abuse, Sexual - psychology; Child Sexual Abuse; Childhood; Childhood sexual abuse; Cocaine; Disease prevention; Drug Abuse; Drug use; Female; Females; Humans; Methadone; Methadone - therapeutic use; Narcotic Antagonists - therapeutic use; Opiates; Patient Selection; Risk; Risk Factors; Risk-Taking; Safe sexual practices; Severity of Illness Index; Sex crimes; Sexual behavior; Sexual Behavior - psychology; Substance Abuse; Substance abuse treatment; Substance-Related Disorders - drug therapy; Substance-Related Disorders - psychology; Surveys and Questionnaires; Women
• ISSN: 0095-2990; 1097-9891
• DOI: 10.1080/00952990903060127

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.