Heterosexual Anal Sex Among Men and Women in Substance Abuse Treatment: Secondary Analysis of Two Gender-Specific HIV-Prevention Trials

Abstract

Receptive anal sex has high human immunodeficiency virus (HIV) transmission risk, and heterosexual substance-abusing individuals report higher anal sex rates compared to their counterparts in the general population. This secondary analysis evaluated the effectiveness of two gender-specific, evidence-based HIV-prevention interventions (Real Men Are Safe, or REMAS, for men; Safer Sex Skill Building, or SSSB, for women) against an HIV education (HIV-Ed) control condition on decreasing unprotected heterosexual anal sex (HAS) among substance abuse treatment-seeking men (n = 171) and women (n = 105). Two variables, engagement in any HAS and engagement in unprotected HAS, were assessed at baseline and three months postintervention. Compared to the control group, women in the gender-specific intervention did not differ on rates of any HAS at follow-up but significantly decreased their rates of unprotected HAS. Men in both the gender-specific and the control interventions reported less HAS and unprotected HAS at three-month follow-up compared to baseline, with no treatment condition effect. The mechanism of action for SSSB compared to REMAS in decreasing unprotected HAS is unclear. More attention to HAS in HIV-prevention interventions for heterosexual men and women in substance abuse treatment is warranted.

Acknowledgments

The authors would like to acknowledge the significant contribution of Donald Calsyn, PhD, to this manuscript. His sudden and unexpected death during its preparation was a great loss to the field of HIV risk and substance abuse treatment. Findings reported in this manuscript were presented in part at the International AIDS Conference, Washington, DC, July 26, 2012. The authors wish to thank Paul Crits-Christoph, PhD, University of Pennsylvania, and Robert Gallop, PhD, West Chester University, for their assistance in combining the data sets from CTN protocol 0018 (Real Men Are Safe) and CTN protocol 0019 (Safer Sex Skills Building for Women).

Funding

The study was supported by National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) grants U10 DA 13714 (Dennis Donovan, PI); U10 DA 13035 (Edward Nunes and John Rotrosen, co-PIs); U10 DA 013727 (Kathleen Brady, PI); and K23 award, DA028660 (Christina Meade, PI).

Additional information

Funding

The study was supported by National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) grants U10 DA 13714 (Dennis Donovan, PI); U10 DA 13035 (Edward Nunes and John Rotrosen, co-PIs); U10 DA 013727 (Kathleen Brady, PI); and K23 award, DA028660 (Christina Meade, PI).