Sexually Transmitted Diseases

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Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0b013e318272c497
Original Study

Unprotected Sex Among HIV-Positive Treatment-Seeking Opioid-Dependent Adults in China: A Cross-Sectional Study

Zhang, Zhenghong MD, MS; Wu, Zunyou MD, PhD; Poundstone, Katharine E. MHS; Yin, Wenyuan MD, MS; Pang, Lin MD, MS; Rou, Keming BS; Luo, Wei MD, PhD; Cao, Xiaobin MD, PhD; Wang, Changhe MD, PhD; China’s National Working Group on Methadone Maintenance Treatment

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Background: We set out to identify factors associated with unprotected sex among HIV-positive patients on methadone maintenance therapy (MMT) in China.

Methods: We conducted a cross-sectional study in 60 MMT clinics in Yunnan, Sichuan, Guizhou, Guangxi, and Xinjiang provinces, China, with a total of 2742 participants.

Results: The median age of participants was 35 years (range, 19–63 years), and 78.3% were male. More than half (1471/2742; 53.6%) were married, 6.4% (176/2742) had a regular sex partner, and 3.5% (95/2742) had 1 or more occasional sex partners. Among married participants, 64.6% (950/1471) had a spouse who was HIV negative or of unknown HIV status. Among them, 62.8% (597/950) reported sex in the past 30 days, and 31.0% (185/597) reported unprotected sex in the past 30 days. Multivariate logistic regression identified 3 factors associated with an increased risk of unprotected sex: receiving MMT in Guangxi (odds ratio [OR], 3.72 [2.05–6.75]; P < 0.001) or Xinjiang (OR, 2.23 [1.33–3.73]; P < 0.01), having a spouse that is a current or former drug user (OR, 1.80 [1.12–2.90]; P < 0.05), and having dropped out of MMT in the past 6 months (OR, 3.05 [1.63–5.71]; P < 0.001); it also identified 2 factors associated with a decreased risk of unprotected sex: being male (OR, 0.46 [0.26–0.79]; P < 0.01) and being aware of one’s own HIV serostatus (OR, 0.16 [0.10–0.27]; P < 0.001).

Conclusions: Many HIV-positive opioid-dependent individuals attending MMT continue to engage in high-risk sexual behaviors. Future efforts should focus on increasing awareness of HIV serostatus, retaining patients in MMT, and addressing the specific needs of female patients on MMT.

© Copyright 2012 American Sexually Transmitted Diseases Association


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