Non-Injection and Injection Drug Use and STI/HIV Risk in the United States: The Degree to which Sexual Risk Behaviors Versus Sex with an STI-Infected Partner Account for Infection Transmission among Drug Users

Abstract

We used the National Longitudinal Study of Adolescent Health (N=14,322) to measure associations between non-injection crack-cocaine and injection drug use and sexually transmitted infection including HIV (STI/HIV) risk among young adults in the United States and to identify factors that mediate the relationship between drug use and infection. Respondents were categorized as injection drug users, non-injection crack-cocaine users, or non-users of crack-cocaine or injection drugs. Non-injection crack-cocaine use remained an independent correlate of STI (adjusted prevalence ratio (APR): 1.63, 95% confidence interval (CI): 1.10–2.42) and sexual risk behaviors including multiple partnerships and inconsistent condom use. Injection drug use was strongly associated with STI (APR: 2.66, 95% CI: 1.18–5.99); this association appeared to be mediated by sex with STI-infected partners rather than by sexual risk behaviors. The results underscore the importance of sexual risk reduction among all drug users including IDUs, who face high sexual as well as parenteral transmission risk.

Effectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: A comprehensive narrative overview of English-language studies

“…In addition, several other severe physical and mental health problems are common in crack users, rendering these a high-risk population for individual and public health. For example, numerous studies have identified crack use as an independent risk factor -whether through direct drug use-related, or indirect risk (e.g., sex-related) risk behaviors -of several chronic infectious diseases (CIDs), including HCV, HIV, Tuberculosis, and rates for these CIDs are commonly higher among crack users compared to other illicit drug users (Booth, Kwiatkowski, & Chitwood, 2000;DeBeck et al, 2009;Edlin et al, 1994;Fischer et al, 2006;Howard, Klein, Schoenbaum, & Gourevitch, 2002;Khan et al, 2013;Nyamathi et al, 2002;Tortu, Neaigus, McMahon, & Hagen, 2001). Crack users indicate disproportionately elevated rates of psychiatric problems, including depression, anxiety and personality disorders, and suicide attempts (Conway, Compton, Stinson, & Grant, 2006;Ford et al, 2009;Kessler, Chiu, Demier, & Walters, 2005;Torchalla, Strehlau, Li, & Krausz, 2011).…”

Hepatites B, C E Sífilis: Prevalência E Características Associadas À Coinfecção Entre Soropositivos

“…O estado civil e a exposição a drogas apresentou significativa associação ao diagnóstico de sífilis, e o percentual (11%) de indivíduos casados que se coinfectaram pode induzir ao raciocínio equivocado de que pessoas com esse tipo de vínculo afetivo tenham menos chances de contrair IST. O consumo de álcool e drogas estão entre os principais determinantes para a transmissão de agentes infecciosos, sendo reflexo da adoção de práticas de risco, como multiplicidade de parceiros sexuais, prática de prostituição e uso incorreto ou inexistente de preservativo (26)(27) .…”

Rapid Routine HIV Testing for Psychiatric Inpatients

“…In addition to these welldocumented risk factors, a review of patients' charts revealed 33.1% of our study population had a history of drug abuse and 7.4% had a history of sex abuse. While the association between injection drug use, needle sharing and contraction of blood born pathogens is direct, use of non-injection drugs is associated with heightened risk for HIV contraction via risky sex behavior; those who use non-injection drugs have diminished inhibitions, are often more sexually active, involved in prostitution, have lower condom use and more commonly engage in anal sex [32]. A history of sex abuse is also substantially more common in patients with SMI, and is associated with an increase in high-risk sexual activity and further sexual assault [11,33].…”