Predictors of condom use in women receiving court-mandated drug and alcohol treatment: implications for intervention

Abstract

Women who abuse substances are at a high-risk for contracting HIV. Condom use interventions are important in reducing HIV in high-risk populations, but current interventions have small effects. The aim of this study is to examine the relative impact of substance use, personal variables (sexual impulsivity and condom expectancies), and relationship variables (perceptions of relationship commitment and partner risk, perceptions of power within the relationship) on condom use in women in court-mandated substance abuse treatment. Information was collected from 312 sexually active women in an inpatient drug and alcohol treatment facility in the Southeastern US Participants completed questionnaires and were interviewed using the Timeline Follow-back method and provided information about sexual activity in the 30-days prior to intake, including type of sexual event, co-occurrence with substance use, condom use, and characteristics of sexual partners and the nature of the relationship. Multilevel logistic modeling revealed that perception of relationship commitment, condom outcome expectancies, and age significantly affected condom use for women in the sample. Specifically, condom use was least likely when women reported that the relationship was committed (odds ratio [OR] = 0.31, 95% confidence interval [CI]: 0.23, 0.43) or when the participant was older (OR = 0.96, 95% CI: 0.94, 0.99), and more likely when women reported more positive condom outcome expectancies (OR = 1.02, 95% CI: 1.00, 1.03). The findings suggest that perceptions of relationship commitment, regardless of perceptions of partner risk, strongly affect condom use among women court-mandated into drug and alcohol treatment. In addition, positive outcome expectancies (e.g., positive self-evaluations and perceived positive partner reactions) are associated with a greater likelihood of condom use. These findings have important implications for condom use interventions, which have failed to produce large or lasting effects within this population.

One Step at a Time: A Latent Transitional Analysis on Changes in Substance Use, Exposure to Violence, and HIV/AIDS Risk Behaviors among Female Offenders

“…The lack of difference between the intervention groups may be attributed to suboptimal utilization of the case management intervention. In addition, research by DePesa et al (2015) found that interventions to date tend to have small effects on risky sexual behaviors among female substance users.…”

“…Females in the criminal justice system, including those in drug courts, have been shown to have comorbid issues such as exposure to violence and HIV/AIDS risk behaviors including multiple sex partners and unprotected sex (Festinger, Dugosh, Kurth, & Metzger, 2016; Morse, Silverstein, Thomas, Bedel, & Cerulli, 2015; DePesa, Eldridge, Deavers, & Cassisi, 2015; Cosden, Larsen, Donahue, & Nylund-Gibson, 2015; Meyer, Cepeda, Taxman, & Altice, 2015; Messina, Calhoun, & Braithwaite, 2014; Saxena, Messina, & Grella, 2014, Torchalla, Nosen, Rostam, & Allen, 2012; Millay et al, 2009). Specifically, female offenders have been reported to have substance use related problems at a higher rate than male offenders and nearly ten times higher than non-offending women (Saxena et al, 2014).…”

Psychometric Properties and Validity of a Multi-dimensional Risk Perception Scale Developed in the Context of a Microbicide Acceptability Study

“…However, numerous studies have shown that sexual risk perception—that is, one’s views of their own risk—is associated with partner-specific factors such as partner type (e.g., mainor non-main; Mehrotra, Noar, Zimmerman, & Palmgreen, 2009). The decision to engage in or not to engage in safer sex behaviors may also be specific to a given partner or type of partner (DePesa, Eldridge, Deavers, & Cassisi, 2014). For example, many people believe that knowing or trusting a partner increases that partner’s safety (Masaro, Dahinten, Johnson, Ogilvie, & Patrick, 2008).…”