Crack Cocaine Smoking and Oral Sores in Three Inner-City Neighborhoods

Abstract

Crack cocaine causes blisters, sores, and cuts on the lips and in the mouths of persons who smoke it, and such sores may facilitate the oral transmission of HIV. We recruited young adults aged 18-29 years, who either were current regular crack smokers, or who had never smoked crack, from inner city neighborhoods in New York, Miami, and San Francisco. Participants were interviewed for HIV risk behaviors and history of recent oral sores and were tested for HIV, syphilis, and herpes simplex virus (HSV) antibodies. Among the 2,323 participants recruited, 1,404 (60%) were crack smokers. Crack smokers (10.0%) were more likely than nonsmokers (4.5%) to report having had oral sores in the past 30 days [prevalence odds ratio (POR) 2.4, 95% confidence interval (CI) 1.7-3.4]. Sores were also more prevalent among those who had ever injected drugs (14.3%) than among those who had not (6.7%; POR 2.3, 95% CI 1.7-3.4), and among those with HIV infection (14.3%) than among those without it (8.0%; POR 1.9, 95% CI 1.3-2.8). Among the 429 participants who reported receptive oral sex, those who reported oral sores were more likely than those who did not to have HIV infection, after other HIV risk factors were controlled for (adjusted POR 1.9, 95% CI 1.0-3.6). Our results confirm that crack smokers have a high prevalence of oral sores and provides evidence that these sores, although infrequently, may facilitate oral transmission of HIV.

HIV/AIDS risk among female sex workers who use crack in Southern Brazil

“…27 Crack cocaine causes blisters, sores, and cuts on the lips and inside the mouth of those who smoke it, and such sores may facilitate the oral transmission of HIV. 6,18 Therefore, the high frequency of pipe sharing found among participants might increase theirs vulnerability to HIV. Educational prevention strategies promoting safer crack smoking behaviors are clearly needed.…”

The Risk Avoidance Partnership: Training Active Drug Users as Peer Health Advocates

“…For example, diffusion in the 1980s and early 1990s of the "new" practice of bleaching used syringes to reduce the spread of HIV required some antecedent congruence of the practice with existing conditions and drug injection conventions (e.g., using water to unclog the syringe), dissemination and encouragement by trustworthy "change agents" (such as community-based outreach workers), and acceptance by key "opinion leaders" or influential peers before a notable portion of the population adopted the practice (Friedman et al, 1994;Rogers, 1995;Watters, 1987;Wiebel, 1993). In addition to standard prevention messages and materials, RAP incorporated intervention components not previously used locally, such as harm reduction slogans (Latkin, 1998b;Latkin & Knowlton, 2002;Latkin et al, 2003) and promotion of rubber tips for the ends of crack pipes; the latter may reduce oral transmission of communicable diseases facilitated by bleeding or ulcerated lips caused by scorching, or that are transmitted through saliva (Faruque et al, 1996;Porter & Bonilla, 1993). We anticipated that these novel intervention components would diffuse through drug-using networks as PHAs promoted harm reduction practices and attitudes among their peers.…”

Assessing risk behaviors and prevalence of sexually transmitted and blood-borne infections among female crack cocaine users in salvador - Bahia, Brazil

“…In parallel with the HIV/AIDS epidemic, crack cocaine use has increased dramatically across the world since its introduction in the USA in the 1980's, mainly in deprived neighborhoods of metropolitan areas [4][5][6][7][8][9].…”