Laura M. Bogart, PhD¹, Alexander H. Kral, PhD², Rachel L. Anderson, BA³, Andrea Scott², Neil Flynn, MD, MPH³, Mary Lou Gilbert, JD, MA⁴, and Ricky N. Bluthenthal, PhD⁴. (1) RAND Health, RAND Corportation, 1700 Main Street P.O. Box 2138, Santa Monica, CA 90407-2138, 310-393-0411 x7109, lbogart@rand.org, (2) Urban Health Studies, UCSF, 3180 18th St. Suite 302, Campus box 1304, San Francisco, CA 94110, (3) Infectious Diseases, UC Davis, 4150 V St., Suite 500, Sacramento, CA 95817, (4) RAND Health, RAND, 1700 Main Street P.O. Box 2138, Santa Monica, CA 90407-2138

Background: Research indicates that injection drug users (IDUs) are at high risk for HIV from their sexual behavior. However, little research attention has been directed to understanding the predictors of IDUs’ sexual risk.

Methods: We examined the levels and correlates of consistent condom use among 1,445 IDUs (68% male; 53% White, 19% Black, 20% Latino) recruited from 24 syringe exchange programs (SEPs) in California. Logistic regressions were used to predict any unprotected vaginal/anal intercourse in the past six months for men and women separately, controlling for confounding variables.

Results: A large majority (80%) of sexually-active respondents (n = 1,043) reported unprotected intercourse. For men, being HIV-positive (AOR=4.7, 95%CI=2.0,11.2) and having multiple partners (AOR=1.7, 95%CI=1.1,2.7) were associated with using condoms consistently, and having a steady sexual partner (AOR=0.3, 95%CI=0.2,0.5), sharing syringes (AOR=0.6, 95%CI=0.4,0.9), and injecting amphetamines (AOR=0.4, 95%CI=0.3,0.7) were related to having unprotected intercourse (all p<.05). For women, being paid for sex in the past 6 months (AOR=4.8, 95%CI=2.0,11.1) increased the likelihood of consistent condom use, whereas sharing syringes (AOR=0.2, 95%CI=0.1,0.5) and having a steady sexual partner (AOR=0.3, 95%CI=0.2,0.7) decreased the likelihood (all p<.01).

Conclusions: Despite participation in SEP programs, most IDUs continued to engage in risk behaviors. Interventions focused on reducing substance use, as well as increasing condom use within steady partnerships, may be most successful in reaching IDUs at sexual risk for HIV.

Learning Objectives: At the conclusion of the session, participants will be able to

• Identify correlates of sexual risk behavior among IDUs
• Discuss the implications of IDU’s sexual risk behavior for HIV prevention efforts

Keywords: Injecting Drug Use, Sexual Risk Behavior

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.