Sexual Risk and HIV Infection Among Drug Users in New York City: A Pilot Study

Abstract

Measures of sexual health were assessed during 2008–2009 in a New York City sample of 102 injection and noninjection users of heroin, cocaine, or crack. There was considerable overlap and transitioning between crack smoking and injecting. Crack users were also significantly more likely to be gay, lesbian, or bisexual than other drug users. In multivariate analysis, HIV infection was independently associated with crack use and with being gay or bisexual. In New York City, HIV prevention for drug users has focused on syringe access, safe injection, and drug user treatment, but further progress in HIV control will require strategies to address sexual health among people who use drugs. The study's limitations are noted.

Keywords :

• HIV
• prevention
• substance use
• prevalence
• risk behavior
• HSV-2

THE AUTHORS

Holly Hagan, Ph.D., is a Senior Research Scientist at New York University College of Nursing and an infectious-disease epidemiologist. Dr. Hagan has been Principal Investigator for a number of studies funded by the National Institute on Drug Abuse on the etiology, prevention, and treatment of blood-borne viral infections in drug users. Her work related to hepatitis C virus (HCV) has earned her an international reputation, with her having led a series of longitudinal cohort studies of HCV seroconversion, a meta-analysis of research related to the epidemiology and prevention of HCV infection, and randomized controlled trials of interventions to reduce HCV infections and increase medical follow-up for infected drug users.

David C. Perlman, M.D., is Associate Chief, Infectious Diseases, at Beth Israel Medical Center in New York.He is also an Investigator in the Baron Edmond de Rothschild Chemical Dependency Institute and Director of the Infectious Disease Core in the Center for Drug Use and HIV Research. His research interests focus on clinical, epidemiologic, and health service aspects of tuberculosis, viral hepatitis, and other infections among HIV-infected persons and drug users in and out of drug treatment. Dr. Perlman is also a provider in Beth Israel's office-based methadone medical maintenance program. He is Professor of medicine at the AECOM. He received his medical degree from the AECOM, did his residency at the New York Hospital, and completed a fellowship in infectious diseases at the Montefiore/AECOM.

Don C. Des Jarlais, Ph.D., is Director of Research for The Baron Edmond de Rothschild Chemical Dependency Institute at Beth Israel Medical Center and Professor of epidemiology and social medicine at the Albert Einstein College of Medicine (AECOM) in New York. He is one of the leading authorities on AIDS and intravenous drug use and has published extensively on these related topics.