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Aim and Background: In the recent years, the percentage of people diagnosed with acquired immune deficiency syndrome (AIDS) through sexual relations has grown dramatically. Since AIDS infection is associated with risky behaviors, to prevent illness, understanding the reasons for the growth of high-risk behaviors is essential. The aim of this study was to predict risky sexual behaviors related to human immunodeficiency virus (HIV) based on difficulties in emotion regulation in substance users. Methods and Materials: This study was descriptive-correlational. Statistical population included substance users referred to addiction treatment and rehabilitation centers in Shiraz, Iran, that 200 of them were selected by convenient sampling. The criterion variable was risky sexual behavior and the predictor variable was difficulties in emotion regulation which were assessed by HIV Risk-taking Behavior Scale (HRBS) and Difficulties in Emotion Regulation Scale (DERS), respectively. Data were analyzed using stepwise multiple regression. Findings:  All dimensions of difficulties in emotion regulation had a significant positive relationship with risky sexual behaviors (P < 0.01). Among other subscales of difficulties in emotional regulation, non-acceptance and limited access to effective strategies of emotion regulation were predictors of risky sexual behaviors. Conclusions: It can be concluded that difficulties in emotional regulation can predict risky sexual behavior in substance users and can lead to more vulnerability to such behaviors. This result will be useful in designing interventions to reduce risky sexual behavior.

Keywords: Risk behavior, Sexual behavior, Emotions, Human immunodeficiency virus, Substance abuse

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