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

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.

• Authors: Ariel Ludwig, Laura B Monico, Jan Gryczynski, Elizabeth Lertch, Robert P Schwartz, Marc Fishman, Ross Dionne, Shannon Gwin Mitchell
• Journal: Journal of substance abuse treatment (J Subst Abuse Treat) Vol. 130 Pg. 108477 (11 2021) ISSN: 1873-6483 [Electronic] United States
• PMID: 34118711 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 Elsevier Inc. All rights reserved.

Chemical References

• Delayed-Action Preparations
• Narcotic Antagonists
• Naltrexone

Topics

• Adolescent
• Delayed-Action Preparations (therapeutic use)
• Female
• HIV Infections (drug therapy)
• Humans
• Naltrexone (therapeutic use)
• Narcotic Antagonists (therapeutic use)
• Opioid-Related Disorders (drug therapy)
• Risk-Taking
• Young Adult