Drug and sexual HIV-risk behaviors among adolescents and young adults with opioid use disorder

Ariel Ludwig, Laura B. Monico, Jan Gryczynski, Elizabeth Lertch, Robert P. Schwartz, Marc Fishman, Ross Dionne, Shannon Gwin Mitchell

Research output: Contribution to journalArticlepeer-review

Abstract

Opioid use disorder (OUD) among adolescents and young adults (youth) is associated with drug use and sexual HIV-related risk behaviors and opioid overdose. This mixed methods analysis assesses risk behaviors among a sample of 15–21-year-olds (N = 288) who were being treated for OUD in a residential drug treatment program in Baltimore, Maryland. Participants were enrolled in a parent study in which they received either extended-release naltrexone (XR-NTX) or Treatment as Usual (TAU), consisting of outpatient counseling with or without buprenorphine, prior to discharge. At baseline, participants were administered the HIV-Risk Assessment Battery (RAB), and clinical intake records were reviewed to determine participants' history of sexual, physical, or other abuse, as well as parental and partner substance use. A sub-sample of study participants completed semi-structured qualitative interviews (N = 35) at baseline, three-, and six-month follow-up periods. This analysis identified gender (e.g., female IRR = 1.63, CI 1.10–2.42, p =.014), the experience of dependence (e.g., previous detoxification IRR = 1.08, CI 1.01–1.15, p =.033) and withdrawal (e.g., severe withdrawal symptoms IRR = 1.41, CI 1.08–1.84, p =.012), and the role of relationships (e.g., using with partner IRR = 2.45, CI 1.15–5.22, p =.021) as influencing high-risk substance use behaviors. Similarly, high-risk sex was influenced by gender (e.g., female IRR = 1.43, CI 1.28–1.59, p <.001), and the role of relationships (e.g., using with partner IRR = 0.78, CI 0.62–0.98, p =.036). These are key targets for future prevention, treatment, and intervention.

Original languageEnglish (US)
Article number108477
JournalJournal of Substance Abuse Treatment
Volume130
DOIs
StatePublished - Nov 2021
Externally publishedYes

Keywords

  • HIV risk behavior
  • Mixed methods
  • Opioid use disorder
  • Qualitative

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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