Injecting, Sexual Risk Behaviors and HIV Infection in Young Cocaine and Heroin Users in Spain

Abstract

Aim: To evaluate differences between young cocaine users and heroin users (HUs) regarding the prevalence of sexual and injection risk behavior, and HIV, HCV and HBV infection. Methods: Two community cohorts were recruited in Madrid, Barcelona and Seville; 720 cocaine users, of whom 586 had never used heroin (CUs), and 991 HUs were interviewed. Dried blood spot samples were tested. Results: CUs were less marginalized socially than HUs. Only 0.9% had ever injected versus 64.3%; none had ever injected with borrowed syringes versus 25%; 2.2% had an injecting steady partner in the last 12 months versus 24.9%; 4.8% had ever traded sex versus 16.0%. However, 31.0 versus 12.7% had unprotected sex with more than two occasional partners in the last 12 months; 45.0 versus 21.9% had sniffed through tubes used by more than 10 persons. Only 32.3% knew their HIV status versus 80.3%; 0.4 versus 18.1% were HIV positive; 0.9 versus 51.9% were HCV positive, and 1.5 versus 17.0% were HBV positive. Conclusions: The intense cocaine epidemic has hitherto had little impact on either HIV, HBV or HCV in Spain. However, surveillance should be intensified given the high percentage of CUs having unprotected sex with occasional partners.

Sexually Transmitted Infections and Sexual Practices among Injecting Drug Users in Harm Reduction Centers in Catalonia

“…Despite the low prevalence of STIs observed in this group of IDUs, the respondents reported a high prevalence of sexual risk practices that is similar to that observed in several previous surveys [7] , and among the general population [10] ; therefore, the risk of transmission of HIV and other STIs remains high [8,9,15] . Consistent with other studies, we found a high prevalence of unprotected sex between HIV-serodiscordant stable partners; this underlines the marked possibility of sexual transmission in this group [23] .…”

“…In contrast, the change in the prevalence of regular condom use has not been as considerable over the years, especially with stable sexual partners (from 26.3% in 1993 to 32% in 2006). The low condom use observed among IDUs in Catalonia is consistent with that reported in other national [7] and international studies [8,9] . Although the use of condoms among IDUs is similar to that observed in the general population [10] , the higher HIV prevalence observed among this group means that a higher risk of HIV transmission exists.…”

Cocaine-Related Health Emergencies in Europe: A Review of Sources of Information, Trends and Implications for Service Development

“…Regular cocaine use, independently of the route of administration, is also associated with accidents and with the transmission of infectious diseases (through unprotected sex) [7]. Recent concerns have also been raised regarding the association between cocaine use and violent crimes in the night-time economy [8].…”

Cocaine – Characteristics and addiction

“…Używanie kokainy zwiększa również ryzyko urazów w wyniku wypadków i zakażenia chorobami zakaźny-mi, w tym przenoszonymi drogą płciową [43]. W grupie użytkowników kokainy stwierdza się również wysoki wskaźnik współwystępowania innych uzależnień i zaburzeń psychicznych.…”