High-Risk Sexual Behavior Among Drug Users

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Abstract
Objectives: The purpose of this study was to develop a typology of drug users based on alcohol use variables and then determine the utility of this typology for predicting high-risk sexual behavior, controlling for the personality traits of sensation seeking and risk proneness. Methods: A sample of 283 out-of-treatment drug users in Anchorage, Alaska, were interviewed regarding their alcohol and drug use, sexual behavior, sensation seeking, and risk proneness. The sample was 66% male; 44% white, 26% black, and 24% Native American; had a median age of 36 years; and a median monthly income of $500 to $999. Results: Cluster analyses of alcohol variables showed the presence of two clusters, one of which is characterized by relatively high alcohol consumption and early age of first alcohol use. This alcohol typology was significantly related to several sexual risk behaviors, including having sex with multiple partners without consistent condom use (χ2(1) = 10.47,p< .01), having sex with an injection drug user (IDU) without consistent condom use (χ2(1) = 4.87,p< .05), number of sex partners (t(281) = −2.16,p< .05), STD history (χ2(1) = 7.86,p< .01), and having traded sex for drugs or money recently (χ2(1) = 6.91,p< .01) or in one's lifetime (χ2(1) = 9.20,p< .01). All but one of these associations remained significant after controlling for sensation seeking and risk proneness. Conclusions: Among this sample of out-of-treatment drug users, a typology based on patterns of alcohol use was found to be associated with several measures of high-risk sexual behavior. Drug users who were classified as high risk on the basis of their lifetime and current alcohol use patterns were found to be significantly more likely than low-risk drug users to have engaged in risky sexual behavior. Risk proneness does not appear to account for this pattern of associations.