Abuse, addiction, and depression as pathways to sexual risk in women and men with a history of substance abuse

Purpose: In this paper, we develop and test a model for predicting sexual r isk for HIV and other STDs. Methods: Researchers interviewed 528 women and men with a history of substance abuse about their past experiences of physi cal and sexual abuse, symptoms, and sexual risk behavior (number of partner s, trading sex for drugs or money, unprotected intercourse, and sexual orie ntation). The model explores direct and indirect associations of physical a buse and sexual abuse with sexual risk. Results: Depression and severity of problems with drugs and alcohol were expected to mediate associations betw een abuse and sexual risk. However, analyses did not substantiate any indir ect effects. Being female, more severe drug problems and, among men, past s exual abuse were significant predictors of sexual risk. Conclusion: Prevent ion interventions would do well to address not only drug addiction, but als o past sexual abuse in men and depression in women. (C) 2001 Elsevier Scien ce Inc. All rights reserved.