Skip to main content
Log in

Predictors of HIV Sexual Risk Behaviors in a Community Sample of Injection Drug-Using Men and Women

  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Injection risk practices and unprotected sex between injection drug users (IDUs) and their sexual partners are responsible for a high proportion of AIDS cases and new HIV infections in the United States. The purpose of this study was to investigate the links between drug use behaviors and psychosocial factors with high-risk sexual behaviors among male and female IDUs. Understanding the determinants of sexual risk practices among drug users can lead to the development of more effective programs to prevent sexual HIV and STD transmission. This study enrolled a community sample of 101 IDUs (males = 65, females = 36), primarily African American and unemployed, who injected drugs and had unprotected sex in the past 3 months. The sample was categorized into highest sexual risk (multiple partners and intercourse without condoms) and lower sexual risk subgroups. Univariate analyses showed that IDUs at highest sexual risk had lower sexual risk reduction self-efficacy (p = .01) and were more likely to be African American (p = .02). Drug users at highest sexual risk also used noninjected cocaine and crack more frequently (p = .05), were less likely to inject heroin (p = .04), and tended to more often inject cocaine (p = .05). IDUs at highest sexual risk also tended to more often use crack and methamphetamines. Logistic regression analyses showed that injecting cocaine or crack, sexual risk reduction self-efficacy, and race were independent predictors of sexual risk behavior levels. Sexual risk reduction programs for this population are needed, with HIV prevention programs tailored to specific IDU risk reduction needs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Bandura, A. (1986). Social foundations of thought and actions: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  • Belanger, D., Godin, G., Alary, M., and Bernard, P. M. (2002). Factors explaining the intention to use condoms among injecting drug users participating in a needle exchange program Journal of Applied Social Psychology, 32, 1047–1063.

    Google Scholar 

  • Bowen, A. M., and Trotter, R. (1995). HIV risk in intravenous drug users and crack cocaine smokers: Predicting stage of change for condom use. Journal of Consulting and Clinical Psychology, 63, 238–248.

    Google Scholar 

  • Bryan, A. D., Fisher, J. D., Fisher, W. A., and Murray, D. M. (2000). Understanding condom use among heroin addicts in methadone maintenance using the information–motivation–behavioral skills model. Substance Use and Misuse, 35, 451–471.

    Google Scholar 

  • Catania, J. A., Kegeles, S. M., and Coates, T. J. (1990). Towards an understanding of risk behavior: An AIDS risk reduction model (ARRM). Health Education Quarterly, 17, 53–72.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2000). Drug-associated HIV transmission continues in the United States. CDC fact sheet. Available at http://www.cdc.gov.nchstp.hiv_aids/pubs/facts.idu.htm

  • Dinwiddie, S. H. (1997). Characteristics of injection drug users derived from a large family study of alcoholism. Comprehensive Psychiatry, 38, 218–229.

    Google Scholar 

  • Donoghoe, M. C. (1992). Sex, HIV and the injecting drug user. British Journal of Addiction, 87, 405–416.

    Google Scholar 

  • Falck, R. W., Wang, J., Carlson, R. G., and Siegal, H. A. (1997). Factors influencing condom use among heterosexual users of injection drugs and crack cocaine. Sexually Transmitted Diseases, 24, 204–210.

    Google Scholar 

  • Fishbein, M., and Ajzen, I. (1975). Beliefs, attitudes, intentions, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.

    Google Scholar 

  • Fisher, J. D., and Fisher, W. A. (1992). Changing AIDS risk behavior. Psychology Bulletin, 3, 455–474.

    Google Scholar 

  • Frischer, M., Haw, S., Bloor, M., Goldberg, D., Green, S., McKeganey, N., and Covell, R. (1993). Modeling the behavior and attributes of injecting drug users: A new approach to identifying HIV risk practices. International Journal of the Addictions, 28, 129–152.

    Google Scholar 

  • Gorman, E. M., and Carroll, R. T. (2000). Substance abuse and HIV: Considerations with regard to methamphetamines and other recreational drugs for nursing practice and research. Journal of the Association of Nurses in AIDS Care, 11, 51–62.

    Google Scholar 

  • Hankin, C., Gendron, S., Tran, T., Lamping, D., and Lapointe, N. (1997). Sexuality in Montreal women living with HIV. AIDS Care, 9, 261–271.

    Google Scholar 

  • Helal, H., Momas, I., Pretet, S., Marsal, L., and Poinsard, R. (1995). HIV prevalence and risk behavior among intravenous drug users attending HIV counseling and testing centers in Paris. Addiction, 90, 1627–1663.

    Google Scholar 

  • Iguchi, M. Y., and Bux, D. A. (1997). Reduced probability of HIV infection among crack cocaine–using injection drug users. American Journal of Public Health, 87, 1008–1012.

    Google Scholar 

  • Kelly, J. A. (1995). Changing HIV risk behavior: Practical strategies. New York: Guilford.

    Google Scholar 

  • Kral, A. H., Bluthenthal, R. N., Lorvick, J., Gee, L., Bacchetti, P., and Edlin, B. R. (2001). Sexual transmission of HIV-1 among injection drug users in San Francisco, USA: Risk-factor analysis. Lancet, 357, 1397–1401.

    Google Scholar 

  • Kwiatkowski, C. F., Stober, D. R., Booth, R. E., and Zhang, Y. (1999). Predictors of increased condom use following HIV intervention with heterosexually active drug users. Drug and Alcohol Dependence, 54, 57–62.

    Google Scholar 

  • Longshore, D., Annon, J., and Anglin, M. D. (1998). Long-term trends in self-reported HIV risk behavior: Injection drug users in Los Angeles, 1987 through 1995. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 18, 64–72.

    Google Scholar 

  • Molitor, F., Ruiz, J. D., Flynn, N., Mikanda, J. N., Sun, R. K., and Anderson, R. (1999). Methamphetamine use and sexual and injection risk behaviors among out-of-treatment injection drug users. American Journal of Drug and Alcohol Abuse, 25, 475–493.

    Google Scholar 

  • Stephens, R. C., Simpson, D. D., Coyle, S. L., and McCoy, C. B. (1993). Comparative effectiveness of NADR interventions. In B. Brown and G. Beschner (Eds.), Handbook on risk of AIDS: Injection drug users and sexual partners (pp. 9-25). Wesport, CT: Greenwood.

    Google Scholar 

  • Strathdee, S. A., Galai, N., Safaiean, M., Celentano, D. D., Vlahov, D., Johnson, L., and Nelson, K. E. (2001). Sex differences in risk factors for HIV seroconversion among injection drug users: A 10-year perspective. Archives of Internal Medicine, 161, 1281–1288.

    Google Scholar 

  • Weissman, G., and Brown, V. (1995). Drug-using women and HIV: Risk-reduction and prevention issues. In A. O'Leary and L. S. Jemmot (Eds.), Women at risk: Issues in the primary prevention of AIDS (pp. 175-190). New York: Plenum.

    Google Scholar 

  • Wisconsin Division of Public Health. (2000). Wisconsin HIV/AIDS quarterly surveillance summary: Cases reported 1982 through June 30, 2000 (Wisconsin AIDS/HIV update, Summer 2000). Madison, WI: Author.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anton M. Somlai.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Somlai, A.M., Kelly, J.A., McAuliffe, T.L. et al. Predictors of HIV Sexual Risk Behaviors in a Community Sample of Injection Drug-Using Men and Women. AIDS Behav 7, 383–393 (2003). https://doi.org/10.1023/B:AIBE.0000004730.62934.ed

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/B:AIBE.0000004730.62934.ed

Navigation