Understanding the role of opiate dependency treatment in risky sexual behavior could help optimize interventions for people who inject drugs (PWID).
We evaluated whether long-term medication-assisted treatment (LT-MAT) of opiate dependency with buprenorphine/naloxone influenced risky sexual behavior among HIV-uninfected PWID and identified predictors of risky sexual behavior.
We used data from HPTN058, a randomized controlled trial of LT-MAT vs. short-term medication assisted treatment among PWID in China and Thailand. We evaluated associations between randomized opiate dependency treatment group and self-reported risky sexual behaviors within the past month: condomless sex with primary partner, condomless sex with non-primary partner, multiple partners and >3 sexual acts. We used generalized estimating equations to conduct intention-to-treat, as-treated, and exploratory analyses of these associations.
Of 1,250 participants included in the analysis, 92% were male, with median age of 34 years (IQR 28-39). At baseline, referring to the past month, 36% of participants reported condomless sex with primary partner, 4% reported condomless sex with non-primary partner, 6% reported multiple sex partners, and 30% reported >3 sexual acts. Risky sexual behaviors did not differ significantly between treatment groups at any point. Significant predictors (p<0.05) of condomless sex with non-primary partner were history of incarceration and non-injection drug use. Number of needle-sharing partners, non-injection drug use and higher income were predictors for multiple sexual partners.
LT-MAT did not significantly modify risky sexual behavior amongst HIV uninfected PWIDs. Interventions that reduce sexual risk should target PWIDs with history of incarceration, alcohol use and needle sharing.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.