Transcript Open poster - CTN Dissemination Library

Gender differences of heterosexual anal sex among men
and women in substance abuse treatment
Donald A. Calsyn, Ph.D.1,2, Mary A. Hatch-Maillette, Ph.D.1,2, Christina S. Meade, Ph.D. 3, Susan Tross, Ph.D.4, Aimee N. C. Campbell, Ph.D.4
1Alcohol
& Drug Abuse Institute, 2Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, 3Duke University, Durham, NC, 4 Columbia University College of Physicians & Surgeons, New York, NY
Background
Substance abusers are at risk for HIV and other STIs.
Anal intercourse (AI) is riskier than vaginal intercourse.
Studies of AI have focused primarily on men who have sex with
men (MSM). However, recent national surveys indicate that the total
acts of AI occur more frequently among heterosexuals than among
MSM.
Little has been reported about heterosexual anal intercourse (HAI)
among men and women substance abusers.
Results – HAI Frequency
Compared to the general population (National
More men (32.8%) than women (27.1%) engage
in HAI (Χ2=3.7, p = .47, Figure 1).
HAI with casual partners more likely in men
(Figure 2).
receptive partner.
and casual partners and who engaged in HAI, men
(56.9%) were more likely than women to engage in
HAI with both main and casual partners (17.6%,
Χ2=14.0, p < .001).
Compare the prevalence of HAI among men and women
in substance abuse treatment to data from nationally
representative sample of U.S. adults.
recent bisexual
behavior, and being
younger and white,
were significantly
associated with HAI.
Among male and female substance users:
Of men (n=65) and women (n=37) with both main
Results – Logistic Regression
For men and women,
Survey of Sexual Health and Behavior ), more male
and female substance abusers engaged in HAI (see
Figure 1).
HAI is riskier for women than men because they are always the
Specific Aims
Figure 1
Figure 2
Table 1
Logistic regression summary identifying variables
associated with heterosexual anal intercourse (n=945).
For men, number of
sex partners was also
associated with HAI.
More bisexual men (52.2%) and women (46.7%)
reported HAI in the prior 90 days than heterosexualonly men (32.0%, Χ2=4.07, p=.04) and women
(25.5%, Χ2=6.33, p = .01).
Conclusions
Compare rates of HAI with main and casual partners
More men and women in substance abuse treatment practice
among men and women substance abusers in treatment
HAI than in the general population.
Identify variables associated with HAI among substance
abusers.
Methods
Participants were men (n=539) and women
(n=421) enrolled in the NIDA Clinical Trials
Network (CTN) “Real Men Are Safe” and “Safe
Sex Skill Building for Women” trials who
reported heterosexual activity at baseline.
A logistic regression model with HAI as the
DV included variables related to high risk sex,
and participant sex as an interaction term.
No differences in
 Percent of total sexual intercourse events that were HAI (Median=16.67 men
vs. 13.04 women).
Men engage in HAI more with casual partners than do women.
Condom use for HAI is infrequent.
 Percent who engaged in HAI with their main sexual partner. (Figure 2).
 Younger age, bisexual behavior, being White and having more
 Percent of men (4.3%) and women (6.8%) reporting bisexual activity in the
prior 90 days.
sex partners (men) were associated with engaging in HAI.
Figure 3
Results – Condom Use
Men more likely than women to use
condoms for HAI with main partners (21.9%
vs. 9%, Χ2=5.60, p = .02, Figure 3).
No gender difference in condom use for
HAI with casual partners (Figure 3).
An increased focus on HAI in HIV prevention efforts with men
and women in substance abuse treatment is warranted.
Acknowledgements
This study was supported by National Institute on Drug Abuse (NIDA) grants
U10 DA13714 (Dennis Donovan , PI), U10 DA 13035 (Edward Nunes, PI), U10 DA
013727 (Kathleen Brady, PI).
The authors wish to thank Paul Crits-Christoph, Ph.D., University of
Pennsylvania and Robert Gallop, Ph.D., West Chester University, for their
assistance in combining the datasets from CTN protocols 0018/0019.
No conflict of interests to report.