Psychosocial predictors of AIDS risk behavior in methadone patients

Abstract

This is a longitudinal prospective study examining the role of psychosocial variables in relation to AIDS-related risk behavior among methadone maintenance outpatients. The psychosocial variables studied include: AIDS-knowledge, perceptions of invulnerability to AIDS and other health problems, functional and structural social support, assertiveness, social influence, depression, personal experience with illness, knowing people with AIDS/ARC, being tested for antibodies to the Human Immunodeficiency Virus, severity of addiction, and perceived control.;Self-report data were obtained from 130 patients in two New York City methadone clinics, one in the North Bronx, one in the South Bronx. Follow-up testing was conducted with 113 subjects from the original sample, three to six months later. Hypotheses were tested pertaining to psychosocial variables. The outcome indices of risk behavior were divided into: drug-related, sexual-related and (combined) total measures.;Results showed that some psychosocial variables were inversely related to AIDS-risk behavior, others were directly related to it, and some had no relationship to it.;Prospective analyses showed that the following variables predicted lower subsequent AIDS-related risk behavior: having been tested for antibodies to Human Immunodeficiency Virus, and (perceived) belonging support.;Concurrent analyses showed an inverse relationship with AIDS-related risk behavior for the following measures: (perceived) self-esteem support, assertiveness in situations involving possible AIDS-transmission risk, structural social support, perceived invulnerability to AIDS/ARC (relative to others), and having had a sexually transmitted disease.;In prospective analyses the following variables predicted higher levels of AIDS-related risk behavior: (perceived) tangible support, number of people known with AIDS/ARC, and having a drug-using spouse.;Concurrent analyses showed a direct relationship with AIDS-related risk behavior for the following measures: depression, risk behavior in one's close social network, having a drug-using spouse, the total number of previous illnesses related to sexual and drug behaviors, the number of people known with AIDS/ARC, (perceived) belonging support, and severity of addiction.;The importance of conceptualizing different dimensions of risk behavior (e.g., drug-risk versus sexual-risk) is explained. Methodological problems are discussed, and recommendations for future research are provided.