A Comparison of Male and Female Intravenous Drug Users' Risk Behaviors for HIV Infection

Abstract

Despite the central role played by female intravenous drug users (IVDUs) in the worsening AIDS statistics of states in the northeastern United States, the relative paucity of research into the HIV risk behaviors--particularly risky needle practices--of female drug injections has left significant gaps in researchers' understanding of how and to what extent such women may differ in their risks from their better-studied male counterparts. This study, derived from a sample of 769 out-of-treatment IVDUs residing in an area (Paterson, New Jersey) characterized by high levels of AIDS and HIV infection among drug users, attempts to address this lacuna in the research literature by comparing the drug usage, AIDS knowledge, and needle and sexual behaviors of male and female IVDUs that place them at risk for HIV infection. In this sample, gender was found to be unrelated to HIV serostatus, injection frequency and injected drug of choice, and to most dimensions of knowledge about AIDS and the means of HIV transmission. Overall, it appears that the average Paterson female IVDU may be at greater risk for HIV infection as a result of involvement with a drug-using sex partner than because of especially risky needle practices, for females in this sample were significantly more likely than males to report injecting with a sex partner in the previous 6 months, and female IVDUs with one sex partner were more than twice as likely as males with one partner to report that this individual was an IVDU. Condom use was relatively rare, particularly among those with one partner. Moreover, female IVDUs were significantly more likely than males to be daily users of crack cocaine, and significantly more likely to report poorer health. However, current needle and sexual practices were found to be unrelated to HIV seropositivity among both males and females. In logistic regression analysis, only length of IV drug involvement was found to be independently associated with HIV seropositivity for both sexes. Implications of the data for future prevention efforts aimed at female IVDUs are discussed.

Injection Risk Behavior among Women Syringe Exchangers in San Francisco

“…Previous research supports our finding that women's syringe sharing behavior is frequently embedded in sexual relations (Booth, 1995;Davies et al, 1996;Dwyer et al, 1994;Freeman et al, 1994;Gollub et al, 1998;Latkin et al, 1998;MacRae and Aalto, 2000;Sherman et al, 2001;Tortu et al, 2003). As women have historically assumed positions of deference and care-giving in both drug-using networks and the larger society, it is unsurprising that most female syringe sharers in our study reported injecting after their drug-using partners with the same needle.…”

“…Injecting drug use is a major route of transmission for HIV in the United States (Centers for Disease Control and Prevention, 2002;Centers for Disease Control and Prevention, 2003), and women who inject drugs are at significant risk of infection (Davis et al, 1998;Freeman et al, 1994;Hader et al, 2001;Prevots et al, 1996). Of the more than 150,000 AIDS cases reported among women nationwide, through December 2002, injecting drug use accounted directly for 39% of cases (Centers for Disease Control and Prevention, 2003).…”

A Qualitative Exploration of Gender in the Context of Injection Drug Use in Two US–Mexico Border Cities

“…Studies of IDUs in the U.S. indicate that female IDUs were more likely than males to have a sexual partner who also injects (Freeman, Rodriguez, & French, 1994;Gollub, Rey, Obadia, & Moatti, 1998;Latkin et al, 1998;Sherman et al, 2001). Studies from the U.S. and Canada reported that women were often initiated into drug use by male partners, supplied with drugs by their partners and were more likely to be "second on the needle" after their partner had finished injecting himself (Davies, Dominy, Peters, & Richardson, 1996;Dwyer et al, 1994;Gollub et al, 1998;Harvey et al, 1998).…”

Trajectoires de vie et prises de risques chez les femmes usagères de drogues

“…Cette vulnérabilité est principalement liée à leur dépendance financière vis-à-vis des hommes pour se procurer des drogues. Les femmes usagères de drogues sont plus précaires et moins autonomes socialement, leurs ressources consistant plus souvent en prestations sociales [13,14]. Dans la dynamique du couple, le conjoint usager de drogues est souvent le détenteur du produit, l'initiateur aux drogues et à l'injection [15].…”

“…Cette dépendance au conjoint expose les femmes au risque de partage du maté-riel lié à l'injection en raison de leur manque d'autonomie quant au choix des circonstances de consommation. La temporalité de l'acte d'injection qui succède à l'injection du conjoint en utilisant le même matériel expose les femmes de manière importante aux risques de transmission du VIH et du VHC [14]. Tout au long de leurs trajectoires, ces femmes semblent soumises à la contrainte sexuelle à la fois à l'adolescence puis à l'âge adulte.…”