Skip to main content

Advertisement

Log in

Sexual Risk Among African Americans in Substance Use Treatment: Secondary Analysis of Two Clinical Trials

  • Original Paper
  • Published:
Sexuality & Culture Aims and scope Submit manuscript

Abstract

African Americans who use substances experience a particular risk for HIV. Negative attitudes towards condoms are a strong predictor of risk and can serve as barriers to safe sex. They also vary by gender. In a secondary analysis of data from two National Drug Abuse Treatment Clinical Trials Network trials collecting data from 2004 to 2006, the relationship between gender, unprotected sex, and condom barriers among 203 African Americans in substance use treatment was examined. Results indicated that no gender differences were present in unprotected sex. Men reported more motivational barriers to condom use and were more likely to believe that condoms would impede sexual experience (the latter not statistically significant). For both genders, the perception that condoms might negatively impact sexual experience was associated with unprotected sex. Gender did not moderate the relationship between condom barriers and unprotected sex. These findings suggest the need for gender and race-specific prevention strategies that focus on motivation and address pleasure-based concerns regarding condoms. Substance use treatment facilities are well-positioned to support interventions to target these issues.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Abraham, A. J., Andrews, C. M., Grogan, C. M., D’Aunno, T., Humphreys, K. N., Pollack, H. A., & Friedmann, P. D. (2017). The affordable care act transformation of substance use disorder treatment. American Journal of Public Health, 107(1), 31–32.

    Article  Google Scholar 

  • Adimora, A. A., Schoenbach, V. J., & Floris-Moore, M. A. (2009). Ending the epidemic of heterosexual HIV transmission among African Americans. American Journal of Preventive Medicine, 37, 468–471.

    Article  Google Scholar 

  • Burlew, A. K., Copeland, V. C., Ahuama-Jonas, C., & Calsyn, D. A. (2013). Does cultural adaptation have a role in substance abuse treatment? Social Work in Public Health, 28(3–4), 440–460.

    Article  Google Scholar 

  • Calsyn, D. A., Campbell, A. N., Tross, S., & Hatch-Maillette, M. A. (2011). Is monogamy or committed relationship status a marker for low sexual risk among men in substance abuse treatment? Clinical and methodological considerations. The American Journal of Drug and Alcohol Abuse, 37(5), 294–300.

    Article  Google Scholar 

  • Calsyn, D. A., Hatch-Maillette, M., Tross, S., Doyle, S. R., Crits-Christoph, P., Song, Y. S., Harrer, J. M., Lalos, G., & Berns, S. B. (2009). Motivational and skills training HIV/sexually transmitted infection sexual risk reduction groups for men. Journal of Substance Abuse Treatment, 37(2), 138–150.

    Article  Google Scholar 

  • Calsyn, D. A., Peavy, M., Wells, E. A., Campbell, A. N., Hatch-Maillette, M. A., Greenfield, S. F., & Tross, S.  (2013). Differences between men and women in condom use, attitudes, and skills in substance abuse treatment seekers. The American Journal on Addictions, 22(2), 150–157.

    Article  Google Scholar 

  • Calsyn, D. A., Wells, E. A., Saxon, A. J., Jackson, R., & Heiman, J. R. (2001). Sexual activity under the influence of drugs is common among methadone clients. In Problems of Drug Dependence 1999. Harris LS, ed. NIH Pub. No. 00-4773. Rockville, MD: National Institute on Drug Abuse, 2000; 315.

  • Centers for Disease Control and Prevention (CDC). (2018a). Estimated HIV incidence and prevalence in the United States, 2010–2015. HIV Surveillance Supplemental Report 2018. Retrieved from http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html.

  • Centers for Disease Control and Prevention (CDC). (2018b). HIV and substance use in the United States. Retrieved from https://www.cdc.gov/hiv/risk/substanceuse.html.

  • Centers for Disease Control and Prevention (CDC). (2020). HIV Testing. Retrieved from https://www.cdc.gov/hiv/testing/index.html.

  • Charnigo, R., Crosby, R. A., & Troutman, A. (2010). Psychosocial constructs associated with condom use among high-risk African American men newly diagnosed with a sexually transmitted disease. Annals of Behavioral Medicine, 39, 303–310.

    Article  Google Scholar 

  • Copen, C. E. (2017). Condom use during sexual intercourse among women and men aged 15–44 in the United States: 2011–2015 National Survey of Family Growth. National Health Statistics Reports, 105, 1–18.

    Google Scholar 

  • Crosby, R., Shrier, L. A., Charnigo, R., Sanders, S. A., Graham, C. A., Milhausen, R., et al. (2013). Negative perceptions about condom use in a clinic population: Comparisons by gender, race and age. International Journal of STD and AIDS, 24, 100–105.

    Article  Google Scholar 

  • Doyle, S. R., Calsyn, D. A., & Ball, S. A. (2009). Factor structure of the condoms barriers scale with a sample of men at high risk for HIV. Assessment, 16, 3–15.

    Article  Google Scholar 

  • Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling [White paper]. Retrieved from http://www.afhayes.com/public/process2012.pdf.

  • Laurecin, C. T., Christensen, D. M., & Taylor, E. D. (2008). HIV/AIDS and the African-American community: a state of emergency. Journal of the National Medical Association, 100, 35–43.

    Article  Google Scholar 

  • Lawrence, J. S. S., Chapdelaine, A. P., Devieux, J. G., O’Bannon, R. E., Brasfield, T. L., & Eldridge, G. D. (1999). Measuring perceived barriers to condom use: Psychometric evaluation of the Condom Barriers Scale. Assessment, 6, 391–404.

    Article  Google Scholar 

  • Lefkowitz, E. S., Shearer, C. L., Gillen, M. M., & Espinosa-Hernandez, G. (2014). How gendered attitudes relate to women’s and men’s sexual behaviors and beliefs. Sexuality and Culture, 18(4), 833–846.

    Article  Google Scholar 

  • Macaluso, M., Demand, M. J., Artz, L. M., & Hook, E. W. I. I. I. (2000). Partner type and condom use. AIDS, 14(5), 537–546.

    Article  Google Scholar 

  • McLellan, A., Cacciola, J., Kushner, H., Peters, F., Smilth, L., & Pettinati, H. (1992). The fifth edition of the Addiction Severity Index. Journal of Substance Abuse Treatment, 9, 199–213.

    Article  Google Scholar 

  • Meyer-Bahlburg, H., Ehrhardt, A., Exner, T. M., & Gruen, R. S. (1991). Sexual risk behavior assessment schedule—adult armory interview (SERBAS A-ARM). New York, NY: New York State Psychiatric Institute and Columbia University.

    Google Scholar 

  • Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). New York, NY: Guilford Press.

    Google Scholar 

  • Miranda, J., Bernal, G., Lau, A., Kohn, L., Hwang, W. C., & LaFromboise, T. (2005). State of the science on psychosocial interventions for ethnic minorities. Annual Review of Clinical Psychology, 1, 113–142.

    Article  Google Scholar 

  • Noar, S. M., Webb, E., Van Stee, S., Feist-Price, S., Crosby, R., Willoughby, J. F., & Troutman, A. (2012). Sexual partnerships, risk behaviors, and condom use among low-income heterosexual African Americans: a qualitative study. Archives of Sexual Behavior, 41, 959–970.

    Article  Google Scholar 

  • Prendergast, M. L., Urada, D., & Podus, D. (2001). Meta-analysis of HIV risk-reduction interventions within drug abuse treatment programs. Journal of Consulting and Clinical Psychology, 69, 389–405.

    Article  Google Scholar 

  • Randolph, M. E., Pinkerton, S. D., Bogart, L. M., Cecil, H., & Abramson, P. R. (2007). Sexual pleasure and condom use. Archives of Sexual Behavior, 36(6), 844–848.

    Article  Google Scholar 

  • Reece, M., Herbenick, D., Schick, V., Sanders, S. A., Dodge, B., & Fortenberry, J. D. (2010). Condom use rates in a national probability sample of males and females ages 14–94 in the United States. The Journal of Sexual Medicine, 7, 266–276.

    Article  Google Scholar 

  • Soet, J. E., Dudley, W. N., & Dilorio, C. (1999). The effects of ethnicity and perceived power on women’s sexual behavior. Psychology of Women Quarterly, 23(4), 707–723.

    Article  Google Scholar 

  • Strada, M. J., Donohue, B., & Lefforge, N. L. (2006). Examination of ethnicity in controlled treatment outcome studies involving adolescent substance abusers: a comprehensive literature review. Psychology of Addictive Behaviors, 20(1), 11–27.

    Article  Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate analysis. California State University Northridge: Harper Collins College Publishers.

    Google Scholar 

  • Tross, S., Campbell, A. N., Cohen, L. R., Calsyn, D., Pavlicova, M., Miele, G. M & Nunes, E. V. (2008). Effectiveness of HIV/STD sexual risk reduction groups for women in substance abuse treatment programs: Results of NIDA Clinical Trials Network Trial. Journal of Acquired Immune Deficiency Syndrome, 45, 581–589.

    Article  Google Scholar 

  • United Nations Programme on HIV/AIDS (UNAIDS). (2018). Fast-Track: Ending the AIDS epidemic by 2030. Retrieved from http://www.unaids.org/sites/default/files/media_asset/JC2686_WAD2014report_en.pdf.

  • U.S. Food and Drug Administration (FDA). (2019). FDA in Brief: FDA continues to encourage ongoing education about the benefits and risks associated with PrEP, including additional steps to help reduce the risk of getting HIV. Retrieved from https://www.fda.gov/news-events/fda-brief/fda-brief-fda-continues-encourage-ongoing-education-about-benefits-and-risks-associated-prep.

  • Wendt, S. J., & Solomon, L. J. (1995). Barriers to condom use among heterosexual male and female college students. Journal of American College Health, 44(3), 105–110.

    Article  Google Scholar 

  • Wilson, J., Burlew, A. K., Montgomery, L., Peteet, B., Johnson, C., & Hatch-Maillette, M. (2014). Do masculinity and perceived condom barriers predict heterosexual HIV risk behaviors among black substance abusing men? Journal of Health Disparities Research and Practice, 5, 1–23.

    Google Scholar 

  • Wingood, G. M., & DiClemente, R. J. (2000). Application of the Theory of Gender and Power to examine HIV-related exposures, risk factors, and effective interventions for women. Health Education & Behavior, 27, 539–565.

    Article  Google Scholar 

Download references

Funding

This study has no funding to report.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Caravella McCuistian.

Ethics declarations

Conflict of interest

No authors have any conflicts of interest to report.

Ethical Standards

The study was deemed by institutional IRB as non-human subjects research because it was a secondary data analysis and all identifiers were removed.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

McCuistian, C., Peteet, B.J., Burlew, A.K. et al. Sexual Risk Among African Americans in Substance Use Treatment: Secondary Analysis of Two Clinical Trials. Sexuality & Culture 24, 2065–2078 (2020). https://doi.org/10.1007/s12119-020-09737-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12119-020-09737-1

Keywords

Navigation