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.
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.
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.
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.
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.
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.
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.
Donoghoe, M. C. (1992). Sex, HIV and the injecting drug user. British Journal of Addiction, 87, 405–416.
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.
Fishbein, M., and Ajzen, I. (1975). Beliefs, attitudes, intentions, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.
Fisher, J. D., and Fisher, W. A. (1992). Changing AIDS risk behavior. Psychology Bulletin, 3, 455–474.
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.
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.
Hankin, C., Gendron, S., Tran, T., Lamping, D., and Lapointe, N. (1997). Sexuality in Montreal women living with HIV. AIDS Care, 9, 261–271.
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.
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.
Kelly, J. A. (1995). Changing HIV risk behavior: Practical strategies. New York: Guilford.
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.
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.
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.
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.
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.
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.
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.
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.
Author information
Authors and Affiliations
Corresponding author
Rights 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
Issue Date:
DOI: https://doi.org/10.1023/B:AIBE.0000004730.62934.ed