رفتارهای پر خطر جنسی در یک زمینه سوء مصرف مواد: روش گروه متمرکز

Clinical studies show that heavy and dependant substance users engage with high frequency in high-risk sexual behaviors. To better understand the dynamics of unsafe sexual practices among alcoholics or non-intravenous drug users (IDUs), a series of focus group discussions was conducted with 26 single, sexually active men and women in treatment for substance abuse. Results show that unsafe sexual practices in this subgroup may be explained by three factors: (1) intoxication, (2) negative perceptions of condoms, and (3) cognitive distortions. Furthermore, men's negative perceptions of condoms and women's concerns about not opposing men by fear of being rejected seem to be synergetic to bringing about the negative outcome. Implications for clinical practices are discussed.

A significant proportion of individuals diagnosed with substance disorders engage in casual sexual encounters and/or have multiple sexual partners while failing to use condoms. This behavior puts them at an increased risk of HIV infection Avins et al., 1994, Fitterling et al., 1993, Keighan & Nadeau, 1994, Scheidt & Windle, 1995, Stiffman et al., 1992 and Windle, 1989. Alcohol abuse and non-intravenous drug use are considered as contributing factors in the failure to use condoms Leigh, 1990a, Plant, 1990, Santé Québec, 1992, Stall, 1988 and Stall et al., 1986, but very little information is available on the unsafe sexual practices of addicted patients who are not intravenous drug users (IDUs).

In this clinical sample, large amounts of substances are the main variable at play in unprotected heterosexual intercourse. The interaction between men's negative perception of condoms and women's concern about not opposing men through fear of being rejected appears to be synergetic when referring to the relevance of promoting safer sexual practices within a male–female interactionist approach. Finally, in future research as well as in the treatment settings, there is a need to take into account that addicted patients, more so than people from the general population, may use several defense mechanisms to protect themselves against the threat of AIDS.