The purpose of this paper is to assess sexual behaviours which place heroin sniffers (HSs) at high risk for HIV infection. A stratified network-based sample was used to recruit HSs who had no history of injection drug use was recruited from the streets of South Florida, USA. HSs displayed a high HIV seroprevalence rate of 12.1%; women (18.1%) were more likely than men (8.7%) to test positive for HIV. Both men and women HSs engaged in considerable high risk sex behaviour, including high risk sex-exchange behaviour. The use of crack cocaine was associated with increased sex exchange behaviour among women. The need for intervention programs targeted toward HSs is discussed.

The prevalence of HIV and associated risk behaviors were assessed among three groups of heroin users: long term injection drug users (LTIDUs), new injection drug users (NIDUs), and heroin sniffers (HSs) with no history of injection. HIV seroprevalence was similar among NIDUs (13.3%) and HSs (12.7%). LTIDUs had almost twice as high a level of HIV infection (24.7%). After including drug use and sex behavior variables in logistic regression models, both drug and sexual risk factors remained in the models. Attributable risk percent (APR) from injection for HIV infection among injection drug users was estimated to be 55.7% for LTIDUs and 5.8% for NIDUs. High-risk sex behavior plays an important role in the prevalence of HIV among drug users and accounts for nearly all the infection among NIDUs. Both injection and sexual risk behaviors need to be stressed in HIV prevention and intervention programs aimed at drug users.

The primary objective of this paper is to investigate the relationship between sustained illicit drug use and the utilization of primary preventive health care. Data from 1254 African-American, Hispanic/Latino, and non-Hispanic/Latino white men and women collected in 1996-1997 were analyzed to determine independent risk factors for the utilization of primary preventive health care that was not received as a result of seeking treatment for a specific health condition. When several demographic, health, and drug use variables were assessed in a logistic regression model, gender, ethnicity, health insurance status, drug use, and alcohol use were independently associated with primary preventive care. Women, Hispanic/Latinos, and persons who had health insurance were more likely to have received primary preventive health care while injection drug users, other sustained drug users, and "heavy" alcohol users were less likely to have used primary preventive health care services in the past year.

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Introduction: Although the literature on self-medication among Latino migrant workers (LMWs) is sparse, a few existing studies indicate that this practice is common in this community. The purpose of this paper is to estimate health status, access to health care, and patterns of self-medication practices of a cohort of LMWs in South Florida.Methods: A stratified network-based sample was utilized to recruit 278 LMWs in the Homestead area. After screening for eligibility, participants were administered a structured questionnaire that collected data on their health status, access to health care services, and self-medication practices. A convenience sample of 24 LMWs, who participated in the parent study were invited back to participate in 3 focus groups to look more in depth into self-medication practices in the LMW community.Results: Study findings indicate that LMWs are affected by a vast array of health problems yet lack access to health care services. Participants already engaged in self-medication practices in the countries of origin and, upon their arrival in the US, these practices continue and, in many cases, increase.Conclusion: Long-held traditions and lack of access to the formal health care system in the US contribute to the high prevalence of self-medication among LMWs. Self-medication practices such as the use of prescription medications without a prescription and lay injection are high risk practices that can have harmful consequences. Prevention interventions that address self-medication in the LMW community are likely to be most effective if they are culturally adapted to the community and facilitate access to health care services.