Indian Journal of Social Psychiatry (Jan 2020)
Assessment of sexual behavior among patients seeking treatment for opioid dependence and their knowledge and attitude about high-risk sexual behavior: A cross-sectional observational study
Abstract
Aims: The primary aim of the current study was to assess the sexual history and behavior among treatment-naïve male patients of heroin dependence presenting to outpatient services; their knowledge and attitude about high-risk sexual behavior; and their sexual quality of life. Methods: A cross-sectional exploratory study was done on treatment-naïve patients of heroin dependence, recruited by purposive sampling method. They were assessed using a semi-structured pro forma that explored sociodemographic and clinical details, including details on injecting behavior, sexual history and behavior, perceived impact of heroin on sexual functioning, and knowledge and attitude toward high-risk sexual behavior; Human Immunodeficiency Virus (HIV) Knowledge Questionnaire-18; and Sexual Quality of Life Questionnaire-Male. Results: Fifty-three married patients with a diagnosis of opioid dependence were included in the study. The mean age of the sample was 31.4 years, with a mean age of heroin initiation being 22.5 years and 39.6% having a history of injecting drug use. About 40% of the sample reported to have engaged in sex with a commercial sex worker or a casual partner, of which many reported that such encounters were unprotected. Almost all of the participants reported sex under intoxication in the last month. Prolonging of the duration of erection and ejaculation was reported by a large majority of participants, while many reported heroin intake to increase libido and sexual pleasure. HIV and sexual quality of life were generally poor. Injecting drug use was associated with significantly greater number of partners, having history of casual partner sex, unprotected sex with casual partner, and poorer sexual quality of life. Conclusion: Risky sexual behaviors are common (including few having coercion/assault) among patients with opioid dependence syndrome. Knowledge regarding high-risk sexual behavior and HIV is poor, which should be a focus of treatment strategies. Injecting drug use is associated with more risky sex and poorer sexual quality of life.
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