Risk behaviors for HIV in sexual partnerships of San Francisco injection drug users

Yea Hung Chen, Willi McFarland, Henry Fisher Raymond

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

While injection drug users (IDU) in the USA are known to form sexual partnerships with IDU as well as non-IDU, scientific research is lacking regarding risk behaviors for HIV transmission within these partnerships. Such information could aid HIV-prevention efforts among IDU and could also explain the relatively low prevalence of HIV among non-IDU heterosexuals in US cities such as San Francisco. Using data from a cross-sectional sample of San Francisco IDU we estimated (1) the prevalence of IDU-IDU and IDU-non-IDU sexual partnerships, (2) the frequency of serodiscordant unprotected intercourse in IDU-IDU and IDU-non-IDU sexual partnerships, and (3) the frequency of concurrence of sexual risk and injection-related risk within IDU-IDU sexual partnerships. An estimated 68% of sexually active San Francisco IDU is in IDU-IDU partnerships. Our analysis suggests that compared to IDU-non-IDU partnerships, IDU-IDU partnerships include a greater rate of episodes of serodiscordant unprotected intercourse (incidence rate ratio: 10.2; 95% confidence interval: 2.1-50.7). In fact, our data suggest that 92% of serodiscordant sexual episodes involving IDU are attributable to IDU-IDU pairings. Unprotected intercourse and needle sharing occur concurrently in an estimated 29% of IDU-IDU partnerships. Our data suggest that HIV-transmission risk is higher within IDU-IDU partnerships than it is within IDU-non-IDU partnerships. This disparity could explain the relatively low prevalence of HIV among non-IDU heterosexuals in San Francisco. We recommend that HIV-prevention efforts among IDU continue to address sexual risk behaviors for HIV transmission in addition to injection-related risk behaviors, with emphasis on IDU-IDU partnerships.

Original languageEnglish (US)
Pages (from-to)554-558
Number of pages5
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume26
Issue number5
DOIs
StatePublished - May 4 2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health

Keywords

  • HIV transmission
  • injection drug use
  • needle sharing
  • serodiscordance
  • sexual partnerships
  • unprotected intercourse

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