Abstract
Growing evidence suggests that drug and alcohol use are fueling the heterosexual transmission of HIV among African Americans. This study aims to examine the relative contribution of drug and alcohol use of male and female partners to risks of heterosexual transmission of HIV among 535 African American HIV serodiscordant couples (N = 1,070 participants) who participated in an HIV prevention trial. Associations found between use of drugs and alcohol by one or both partners and sexual risk indicators varied by type of substance and whether male or female partner or both partners reported use. The findings suggest multiple ways in which substance use of male and female partners may be contributing to the heterosexual transmission of HIV and other STDs among African Americans and underscore the need for HIV prevention strategies to address dyadic patterns of substance use that lead to sexual risks.
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References
CDC. Racial/Ethnic disparities in diagnoses of HIV/AIDS—33 States, 2001–2005. MMWR. 2007;56(09):189–193.
Adimora AA, Schoenbach VJ, Martinson FE, et al. Heterosexually transmitted HIV infection among African Americans in North Carolina. J Acquir Immune Defic Syndr. 2006;41(5):616–23.
Bowen A, Williams M, Dearing E, Timpson S, Ross M. Male heterosexual crack smokers with multiple sex partners: between- and within-person predictors of condom use intention. Health Educ Res. 2006;21(4):549–59.
Raj A, Reed E, Santana MC, et al. The associations of binge alcohol use with HIV/STI risk and diagnosis among heterosexual African American men. Drug Alcohol Depend. 2009;101(1–2):101–6.
Wingood GM, DiClemente RJ. Partner influences and gender-related factors associated with noncondom use among young adult African American women. Am J Community Psychol. 1998;26(1):29–51.
Adimora AA, Schoenbach VJ, Martinson FE, Donaldson KH, Stancil TR, Fullilove RE. Concurrent partnerships among rural African Americans with recently reported heterosexually transmitted HIV infection. J Acquir Immune Defic Syndr. 2003;34(4):423–9.
Theall KP, Clark RA, Powell A, Smith H, Kissinger P. Alcohol consumption, ART usage and high-risk sex among women infected with HIV. AIDS Behav. 2007;11(2):205–15.
Schonnesson LN, Atkinson J, Williams ML, Bowen A, Ross MW, Timpson SC. A cluster analysis of drug use and sexual HIV risks and their correlates in a sample of African-American crack cocaine smokers with HIV infection. Drug Alcohol Depend. 2008;97(1–2):44–53.
Edlin BR, Irwin KL, Faruque S, et al. Intersecting epidemics–crack cocaine use and HIV infection among inner-city young adults. Multicenter Crack Cocaine and HIV Infection Study Team. N Engl J Med. 1994;331(21):1422–7.
Buchanan D, Tooze JA, Shaw S, Kinzly M, Heimer R, Singer M. Demographic, HIV risk behavior, and health status characteristics of “crack” cocaine injectors compared to other injection drug users in three New England cities. Drug Alcohol Depend. 2006;81(3):221–9.
Logan TK, Cole J, Leukefeld C. Women, sex, and HIV: social and contextual factors, meta-analysis of published interventions, and implications for practice and research. Psychol Bull. 2002;128(6):851–85.
Miller M, Liao Y, Gomez AM, Gaydos CA, D’Mellow D. Factors associated with the prevalence and incidence of Trichomonas vaginalis infection among African American women in New York city who use drugs. J Infect Dis. 2008;197(4):503–9.
Plitt SS, Garfein RS, Gaydos CA, Strathdee SA, Sherman SG, Taha TE. Prevalence and correlates of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis infections, and bacterial vaginosis among a cohort of young injection drug users in Baltimore, Maryland. Sex Transm Dis. 2005;32(7):446–53.
Burt RD, Thiede H, Barash ET, Sabin K. Recent condom use by arrested injection drug users in King County, Washington, USA. Int J Drug Policy. 2006;17(3):222–9.
Flom PL, Friedman SR, Kottiri BJ, et al. Stigmatized drug use, sexual partner concurrency, and other sex risk network and behavior characteristics of 18- to 24-year-old youth in a high-risk neighborhood. Sex Transm Dis. 2001;28(10):598–607.
Latka MH, Metsch LR, Mizuno Y, et al. Unprotected sex among HIV-positive injection drug-using women and their serodiscordant male partners: role of personal and partnership influences. J Acquir Immune Defic Syndr. 2006;42(2):222–8.
Castilla J, Barrio G, Belza MJ, de la Fuente L. Drug and alcohol consumption and sexual risk behaviour among young adults: results from a national survey. Drug Alcohol Depend. 1999;56(1):47–53.
Bailey SL, Camlin CS, Ennett ST. Substance use and risky sexual behavior among homeless and runaway youth. J Adolesc Health. 1998;23(6):378–88.
Boyer CB, Sebro NS, Wibbelsman C, Shafer MA. Acquisition of sexually transmitted infections in adolescents attending an urban, general HMO teen clinic. J Adolesc Health. 2006;39(2):287–90.
Liau A, Diclemente RJ, Wingood GM, et al. Associations between biologically confirmed marijuana use and laboratory-confirmed sexually transmitted diseases among African American adolescent females. Sex Transm Dis. 2002;29(7):387–90.
NIMH Multisite HIV/STD Prevention Trial for African American Couples Group. Special issue. J Acquir Immune Defic Syndr. 2008;49(Suppl 1):S1–74.
NIMH Multisite HIV/STD Prevention Trial for African American Couples Group. Risky sexual behavior and correlates of STD prevalence among African American HIV serodiscordant couples. AIDS Behav.
Bellamy SL, NIMH Multisite HIV/STD Prevention Trial for African American Couples Study Group. A dynamic block-randomization algorithm for group-randomized clinical trials when the composition of blocking factors is not known in advance. Contemp Clin Trials. 2005;26(4):469–79. doi:10.1016/j.cct.2005.02.005.
Ewing JA. Detecting alcoholism. The CAGE questionnaire. JAMA. 1984;252(14):1905–7.
Peters RH, Greenbaum PE, Steinberg ML, et al. Effectiveness of screening instruments in detecting substance use disorders among prisoners. J Subst Abuse Treat. 2000;18(4):349–58.
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The NIMH Multisite HIV/STD Prevention Trial for African American Couples Study Group
Steering Committee
Nabila El-Bassel, DSW (PI) - Columbia
Gina Wingood, ScD, MPH (PI) - Emory
Gail E. Wyatt, PhD (PI) - UCLA
John B. Jemmott, III, PhD (PI) - Penn
Willo Pequegnat, PhD - NIMH
J. Richard Landis, PhD (PI) - DCC
Co-Investigators
Scarlett Bellamy, ScD - DCC
Louisa Gilbert, PhD Candidate - Columbia
Robert H. Remien, PhD - Columbia
Susan Witte, PhD - Columbia
Elwin Wu, PhD - Columbia
Ralph DiClemente, PhD - Emory
Hector Myers, PhD - UCLA
Loretta Sweet Jemmott, PhD, RN, FAAN - Penn
David Metzger, PhD - Penn
Data Coordinating Center (DCC - Penn)
Shawn Ballard, MS
Trina Brown
Quincy Greene
Christopher Helker, RN, MSPH
Nancy Robinson, PhD
Lynne Allen-Taylor, PhD
Dina Appleby, MS
Evelyn Crowley, PhD
Project Directors
Angela Ankoma MSSW, MPH - Columbia
Deidre Ashton, MSSW - Columbia
Dawn A. Goddard, MSS - Columbia
Tamu Daniel, MPH - Emory
Tina Henderson, PhD - UCLA
Inna Rivkin, PhD - UCLA
Cynthia M. Green, MA - Penn
Facilitators
Jeffery Brently, MSW - Columbia
Rebecca D. Cheraquit, MSSW - Columbia
Deborah Gray - Columbia
Linda Hakim - Columbia
Bright Sarfo - Columbia
Kijana Saunders - Columbia
Dawn Simmons, MSW - Columbia
Keisha Wilson, MSW - Columbia
Nikia D. Braxton, MPH - Emory
Christina Camp, PhD - Emory
Anita Conner, MPH - Emory
Jevon Gibson - Emory
Alvin Harmon, PhD - Emory
Teaniese Latham, MPH - Emory
Tiffany Pennick-Walters, MPH - Emory
Kenneth Rucker - Emory
Shammara Steinback, MPH - Emory
Phillip Williams - Emory
Richard Williams, PhD - Emory
Shauni Williams - Emory
Kevin Chancy, PsyD - UCLA
Frank Levels - UCLA
Nathaniel Thomas, PhD - UCLA
Reginald Bennett, MS - Penn
Shirley Bryson, MSW - Penn
Salema Curtis, MPH - Penn
Michelle Jones, MS - Penn
Phyllis Jones, MSW - Penn
Malachi Moore, MS - Penn
Charles Patterson, MA - Penn
Marcia Penn, MS - Penn
Alicia Samuel, M.Ed. - Penn
Randy Shine, MPH - Penn
Ralph Stevenson, MA - Penn
Robert Tate, M.Ed. - Penn
Michael Taylor, MSW - Penn
Charlotte Wroton, MS - Penn
Recruiters
Derryck Griffith - Columbia
Pearl Johnson - Columbia
Lisa Matthews - MPH, EdD Candidate - Columbia
Rhonda Mendoza - Columbia
Allan Winkle - Columbia
Jill Daugherty, MPH - Emory
Deja Er, MPH - Emory
Linda Felix, MAT - Emory
Meklit Hailemeskal, MPH - Emory
Toya Howard - Emory
Tamika Hoyte, MPH - Emory
Jamie Smith, MPH - Emory
Lisa Smith, MPH - Emory
Les DeMorst - UCLA
Rotrease Regan, RN, MPH - UCLA
Elsa Rogers - UCLA
Karen Carter - Penn
Calvin Collier, BS - Penn
Mikia Croom, BS - Penn
Dionna Samuel, MS - Penn
Joseph Sosa, BS - Penn
Brian Taylor, BS - Penn
Supervisors
Tamara S. Bryan, PhD - Columbia
LaShun Robinson-Simpson, PhD - Emory
Christina Camp, PhD - Emory
Tamra Loeb, PhD - UCLA
John Williams MD - UCLA
Lynette Gueits, MPH - Penn
Laboratory
Cynthia Bayer, MS, CRNP - Penn
Angela Caliendo, MD, PhD - Emory
Shalonda Freeman, PhD - Emory
Jessica Ingersoll - Emory
Lisa Maslankowski, MD - Penn
Debra McGee-Smith, NP - UCLA
Patrice Moorer, MS - Emory
Michelle Mott, MSN, FNP-C - Emory
Bennie Woodard, MPH - Emory
Data Collectors
Claudette Bannerman - Columbia
Warren Blake - Columbia
Tiffany Bratts MPH - Columbia
Olivia Copeland, Ed.D - Columbia
Daisy De Jesus-Sosa - UCLA
Adefunke Faly, MPH - Emory
Meklit Hailemeskal, MPH - Emory
Tamika Hoyte, MPH - Emory
Janet Hsu, BS - Penn
Heather Irobunda - Columbia
Shakaria Johnson, MPH - Emory
Frandy Napoleon - Columbia
Karen Williams - UCLA
Sonya Combs, MS - Penn
Mathew MacDonald, BS - Penn
Lolita Roy MSSW - Columbia
Dalena White, MBA - Penn
Pandora Woods, BS - Penn
Crystal Wyatt - Penn
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The NIMH Multisite HIV/STD Prevention Trial for African American Couples Group. The Contribution of Male and Female Partners’ Substance Use to Sexual Risks and STDs Among African American HIV Serodiscordant Couples. AIDS Behav 14, 1045–1054 (2010). https://doi.org/10.1007/s10461-010-9695-y
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DOI: https://doi.org/10.1007/s10461-010-9695-y