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Relationship Power and Sexual Risk among Women in Community-Based Substance Abuse Treatment

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Abstract

Relationship power has been highlighted as a major factor influencing women’s safer sex practices. Little research, however, has specifically examined relationship power in drug-involved women, a population with increased risk for HIV transmission. Using baseline data from a National Institute on Drug Abuse Clinical Trials Network multisite trial of a women’s HIV prevention intervention in community-based drug treatment programs, this paper examined the association between sexual relationship power and unprotected vaginal or anal sex. The Sexual Relationship Power Scale, a measure of relationship control and decision-making dominance, was used to assess the association between power and unprotected sex in relationships with primary male partners. It was hypothesized that increased relationship power would be associated with decreased unprotected sexual occasions, after controlling for relevant empirical and theoretical covariates. Findings show a more complex picture of the association between power and sexual risk in this population, with a main effect in the hypothesized direction for decision-making dominance but not for relationship control. Possible explanations for these findings are discussed, and future research directions for examining power constructs and developing interventions targeting relationship power among drug-involved women are suggested.

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Acknowledgments

This study was supported by grants from the National Institute on Drug Abuse: Clinical Trials Network U10 DA13035 (Edward V. Nunes) and K24 DA022412 (Edward V. Nunes). We would like to thank the study participants and staff from the 12 community treatment programs and eight regional research and training centers.

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Authors and Affiliations

  1. Substance Abuse Division, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 120, Room 3732, New York, NY, 10032, USA

    Aimee N. C. Campbell & Edward V. Nunes

  2. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York, NY, USA

    Susan Tross

  3. Department of Psychiatry, Columbia University, New York, NY, USA

    Susan Tross & Edward V. Nunes

  4. Department of Social and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA

    Shari L. Dworkin

  5. Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA

    Mei-Chen Hu

  6. Division of Mental Health Services and Policy Research, New York State Psychiatric Institute, New York, NY, USA

    Jennifer Manuel

  7. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA

    Martina Pavlicova

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  1. Aimee N. C. Campbell
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  2. Susan Tross
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  3. Shari L. Dworkin
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  4. Mei-Chen Hu
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  5. Jennifer Manuel
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  6. Martina Pavlicova
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  7. Edward V. Nunes
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Correspondence to Aimee N. C. Campbell.

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Campbell, A.N.C., Tross, S., Dworkin, S.L. et al. Relationship Power and Sexual Risk among Women in Community-Based Substance Abuse Treatment. J Urban Health 86, 951–964 (2009). https://doi.org/10.1007/s11524-009-9405-0

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