TY - JOUR
T1 - Associations of Transactional Sex and Sexually Transmitted Infections Among Treatment-Seeking Individuals With Opioid Use Disorder
AU - Ellis, Matthew S.
AU - Kasper, Zachary A.
AU - Takenaka, Bryce
AU - Buttram, Mance E.
AU - Shacham, Enbal
N1 - Funding Information:
Subscribers do not participate in data collection, nor do they have access to the raw data. This work was supported by the Researched Abuse, Diversion and Addiction-Related Surveillance system, an independent nonprofit postmarketing surveillance system that is supported by subscription fees from pharmaceutical manufacturers, who use these data for pharmacovigilance activities and to meet regulatory obligations. Researched Abuse, Diversion and Addiction-Related Surveillance System is the property of Denver Health and Hospital Authority, a political subdivision of the State of Colorado. Denver Health retains exclusive ownership of all data, databases, and systems. MSE is a member of the Scientific Advisory Board for the National Drug Early Warning System. No other financial disclosures were reported. Matthew S. Ellis: Conceptualization, Investigation, Methodology, Project administration, Supervision, Visualization, Writing – original draft. Zachary A. Kasper: Formal analysis, Methodology, Software, Validation, Visualization, Writing – review and editing. Bryce Takenaka: Writing – original draft, Writing – review and editing. Mance E. Buttram: Writing – review and editing. Enbal Shacham: Conceptualization, Methodology, Writing – review and editing.
Publisher Copyright:
© 2022 American Journal of Preventive Medicine
PY - 2023/1
Y1 - 2023/1
N2 - Introduction: Coinciding with the rise in opioid use across the U.S., the rates of sexually transmitted infections have reached historically high levels, underscoring the need to understand multiple pathways of disease spread. Although prevention is often focused on injection-related behaviors, this study sought to identify the prevalence and associations of a little understood pathway, transactional sex, among individuals with opioid use disorder, including associations of transactional sex with the prevalence of sexually transmitted infection diagnoses. Methods: Data were sourced from a nationwide opioid surveillance program of treatment-seeking individuals with opioid use disorder utilizing a serial, cross-sectional survey of 4,366 new entrants to 1 of 99 substance use treatment programs for opioid use disorder in 37 states from October 2018 to June 2021. Results: A quarter of the sample (24.9%) self-reported a lifetime history of transactional sex for drugs, with rates highest for sexual (56.6%) and gender (53.8%) minority, female (33.4%), Latinx (30.4%), and Black (29.6%) subgroupings. Lifetime diagnoses of all specific sexually transmitted infections analyzed were significantly higher (p<0.001) among those reporting transactional sex, particularly syphilis (14.3% vs 4.4%) and HIV (4.0 vs 0.9%). Financial hardship, trauma, and psychiatric disorder were significantly associated with transactional sex engagement. Conclusions: Transactional sex is relatively common among patients with opioid use disorder, particularly among sexual/gender minorities, which was associated with a greater lifetime prevalence of all sexually transmitted infections assessed. Sexually transmitted infection testing remains at low levels within substance use treatment programs, occurring in just 26.3% of programs; sexual health screenings and sexually transmitted infection prevention/testing need to be prioritized and integrated into opioid use disorder patient care.
AB - Introduction: Coinciding with the rise in opioid use across the U.S., the rates of sexually transmitted infections have reached historically high levels, underscoring the need to understand multiple pathways of disease spread. Although prevention is often focused on injection-related behaviors, this study sought to identify the prevalence and associations of a little understood pathway, transactional sex, among individuals with opioid use disorder, including associations of transactional sex with the prevalence of sexually transmitted infection diagnoses. Methods: Data were sourced from a nationwide opioid surveillance program of treatment-seeking individuals with opioid use disorder utilizing a serial, cross-sectional survey of 4,366 new entrants to 1 of 99 substance use treatment programs for opioid use disorder in 37 states from October 2018 to June 2021. Results: A quarter of the sample (24.9%) self-reported a lifetime history of transactional sex for drugs, with rates highest for sexual (56.6%) and gender (53.8%) minority, female (33.4%), Latinx (30.4%), and Black (29.6%) subgroupings. Lifetime diagnoses of all specific sexually transmitted infections analyzed were significantly higher (p<0.001) among those reporting transactional sex, particularly syphilis (14.3% vs 4.4%) and HIV (4.0 vs 0.9%). Financial hardship, trauma, and psychiatric disorder were significantly associated with transactional sex engagement. Conclusions: Transactional sex is relatively common among patients with opioid use disorder, particularly among sexual/gender minorities, which was associated with a greater lifetime prevalence of all sexually transmitted infections assessed. Sexually transmitted infection testing remains at low levels within substance use treatment programs, occurring in just 26.3% of programs; sexual health screenings and sexually transmitted infection prevention/testing need to be prioritized and integrated into opioid use disorder patient care.
UR - http://www.scopus.com/inward/record.url?scp=85137293166&partnerID=8YFLogxK
U2 - 10.1016/j.amepre.2022.07.011
DO - 10.1016/j.amepre.2022.07.011
M3 - Article
C2 - 36085260
AN - SCOPUS:85137293166
SN - 0749-3797
VL - 64
SP - 17
EP - 25
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
IS - 1
ER -