Date of Award


Degree Type


Degree Name

Master of Science (MS)



First Advisor

Jane Stafford


Substance abusing populations are at an increased risk for disease transmission and have higher rates of psychological comorbidity compared to the general population (e.g., Centers for Disease Control and Prevention [CDC], 2012a; Chaudhury & Singh, 2009; Des Jarlais, Semaan, & Arasteh, 2011; Goodwin & Stein, 2013). Numerous studies have implicated the interaction of psychological distress and risky sexual behaviors in the increased risk of disease transmission, however, several studies have not found this association. It has been suggested that there may be curvilinear relationship between psychological distress and risky sexual behaviors but this theory has yet to be tested. The present study sought to examine whether a curvilinear relationship among these factors was present among an opioid dependent population. Further, the associations between polysubstance abuse and psychological distress, as well as between injection drug use, psychological distress, and risky sexual behaviors were examined. One hundred thirteen opioid-dependent individuals from an outpatient opiate treatment program (OTP) were surveyed regarding their drug use, sexual behaviors, depression, anxiety, and stress. Results did not support a curvilinear or linear model for the relationship between psychological distress and risky sexual behaviors. Further, a relationship between polysubstance abuse and psychological distress was not found to be significant. However, injection use was found to be associated with anxiety among participants. The importance of future research examining other factors related to increased disease transmission among a drug-using population is emphasized, as reasons for increased transmission are likely due to several complex and interrelated factors.