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01-08-2018

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

Authors: Jennifer L. Brown, Michael D. Eriksen, Nicole K. Gause, Gene H. Brody, Jessica M. Sales

Published in: Prevention Science | Issue 6/2018

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.

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).

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

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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Title: 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
Authors: Jennifer L. Brown
Michael D. Eriksen
Nicole K. Gause
Gene H. Brody
Jessica M. Sales
Publication date: 01-08-2018
Publisher: Springer US
Published in: Prevention Science / Issue 6/2018
Print ISSN: 1389-4986
Electronic ISSN: 1573-6695
DOI: https://doi.org/10.1007/s11121-018-0913-6

At a glance: The STEP trials

Springer Medicine

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

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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