Including the issue of receiving payment for sex in intervention for substance use disorder: Professionals' intentions and interventions

Background: Studies have shown that a high percentage of individuals with substance use disorder (SUD) are involved in receiving payment for sex (RPS). The stigma associated with RPS may lead to non-disclosure of RPS in drug treatment services thus preventing fully benefitting from SUD treatment. Research on RPS in the context of SUD interventions is scarce. The current study examined the extent to which social workers believe they should attend to the issue of RPS as part of the treatment of addictions and the extent of their self-reported work with RPS, as associated with comfort in discussing sexual issues in treatment (CDSIT), professional self-efficacy, attitudes towards people who engage in RPS, and attitudes towards social justice. Method: A sample of 171 social workers who had worked with individuals with SUD in addiction treatment centers completed an online questionnaire. The main analyses were only conducted on participants who completed the full questionnaire (n = 124). Results: Most social workers believe in the importance of addressing RPS issues in treatment of individuals with SUD, but mostly did not translate their beliefs into practice. Attitudes toward social justice and toward people who engage in RPS, and the interaction between self-efficacy and CDSIT were associated with the belief in the importance of addressing RPS in treatment. The main factor that contributed to the self-reported work with RPS was CDSIT. Conclusion: Policy-makers should promote specific training for professionals in the addiction field to address the issue of RPS when working with individuals with SUD, and increase levels of CDSIT.