The effects of gender on response to prolonged exposure therapy for posttraumatic stress disorder among adults receiving medications for opioid use disorder.

OBJECTIVE: Women and men differ in their experience of trauma and development of posttraumatic stress disorder (PTSD). Meta-analyses on exposure therapy for PTSD have demonstrated equivalent or larger effects for women versus men. This study evaluated whether these results extend to adults with co-occurring opioid use disorder (OUD). METHOD: = 27 per condition) to MOUD treatment as usual (TAU), prolonged exposure therapy (PE), or PE plus financial incentives contingent upon PE attendance (PE+). Baseline characteristics were compared between women and men, and gender was tested as a moderator of treatment condition differences in PE attendance and changes in PTSD symptoms using multilevel growth curve modeling. There were graded decreases (TAU < PE < PE+) in measures of PTSD symptoms with a lack of evidence of differential response by gender. CONCLUSIONS: Both women and men receiving MOUD benefitted from PE therapy. Among individuals receiving MOUD, financial incentives may improve attendance to this efficacious but often poorly attended PTSD treatment and lead to better clinical outcomes regardless of gender. (PsycInfo Database Record (c) 2026 APA, all rights reserved).