Risky sexual behavior in Veterans seeking substance use and mental health treatment

Veterans in the United States are at an elevated risk for substance use and risky sexual behaviors, either of which may function as coping responses to trauma exposure. The current study examined risky sexual behaviors in a sample of Veterans seeking therapy to reduce substance use behaviors and mental health symptoms as part of a larger randomized controlled trial. Self-report measures assessed substance use behaviors, PTSD, and risky sexual behaviors. Veterans (N = 834) were mostly male (93.4 %) and White (71.6 %) with an average age of 48.25 years. In the past 30 days, 50.5 % of Veterans had sex and 57.3 % of Veterans reported at least one day of heavy drinking. Among Veterans who had a regular sexual partner, 84.9 % did not always use a condom, whereas 77.1 % of Veterans who had a casual partner did not always use a condom. Of Veterans who endorsed sex in the past month, 49 % had a sexual encounter while intoxicated from alcohol and/or drugs, an outcome that was significantly associated with heavy drinking via multiple regression analysis. Nevertheless, other forms of risky sexual behavior (i.e., number of sexual partners and condom use) were not significantly associated with heavy drinking. Further, risky sexual behaviors were not directly associated with PTSD symptoms. Findings suggest that despite the high prevalence of risky sexual behaviors, these behaviors among this sample of treatment-seeking Veterans may be explained by other unexplored factors. Future research is necessary to explore alternative explanations for these behaviors to inform interventions.