Association between recreational drug use and sexual practices among people who inject drugs in Southwest China: a cross-sectional study

Abstract

ObjectiveTo describe the differences in sexual practices among individuals with various drug administration patterns.SettingA detoxification centre in Southwest China, a part of the Chinese national sentential surveillance network for hepatitis C virus (HCV), HIV and syphilis infections, was recruited.ParticipantsA total of 610 newly enrolled injection drug users (IDUs) from detoxification centre were included during 2015.Primary and secondary outcome measuresSelf-reported sexual activities, drug-related practices and laboratory-confirmed HCV, HIV and syphilis infection status were collected.ResultsOf the 610 IDU, 295 (48.4%) used heroin only, 277 (45.4%) poly-drug users reported the mixed use of synthetic drugs (SDs) with heroin and 38 (6.2%) used SDs only. The average daily drug injection frequency for poly-drug users (3.3±1.2 times) was the highest, followed by heroin-only (2.2±0.8 times) and SD-only users (1.2±0.4 time). SD-only drug users reported the highest proportion (86.8%) of engaging in sexual activities in the previous month, with more than half (54.5%) reporting any condomless sex. A higher frequency of daily injecting in heroin-only users was significantly correlated with the less likelihood of sex, condomless sex in the past month, having sex with fixed partners, condomless commercial sex in the previous 12 months (all p<0.01). In poly-drug users, who injected drugs two times per day was associated with the highest proportion of people who engaged in sex and commercial sex (p<0.05). For SD-only users, increased drug use was not associated with reducing sexual risk (p>0.05). Different patterns of HCV, HIV and syphilis infections prevalence rates were shown among the IDU depending on the roles and length of exposure.ConclusionsThe daily drug injecting frequency of heroin-only and poly-drug users was negatively associated with sexual activities, but SD-only users kept a high frequent engagement in sex. The interventions for relevant diseases should adapt to characteristics of IDU.

Prevalence and predictors of condom use among people who inject drugs in Georgia

“…The ndings indicate that substantially higher proportion of the interviewed PWID had multiple sex partners (64.9% had ≥ 3 sexual partners) compared to other studies conducted in different countries where this indicator varied between 14-47% [30,31,32,33,34]. We also found a high prevalence of unprotected last sexual intercourse with any type of sexual partner among PWID and this nding is consistent with other studies [35,36,37,38].…”

Estimation of the impact of changing drug-use trend on HIV, hepatitis C and syphilis epidemics among people who use synthetic drug-only, polydrug and heroin-only during 2005–2035 in China: modelling study

“…First, condom use is increasing among people who use heroin and SD, so it has impacts on reducing sexual transmission. Second, as our model considered the transfer trend within three subgroups, long-term SD use is likely to be polydrug use and moving to the polydrug group,6 while long-term heroin users will reduce sexual desire due to the heroin effects,8 so there may be a balance impact on syphilis epidemics during the study period. Thus, it could be efficient to implement interventions on reducing sexual transmission in the SD group to benefit all the people who use drugs.…”

“…Also, our previous model has estimated the number of people who use drugs will increase, and there is a changing trend of drug use that more monodrug use becomes polydrug use,6 and it will likely have impacts on the transmission modes of these infections as well. SDs have different effects from heroin; cumulating evidence has indicated that the common SDs are shown to be associated with higher risk sexual behaviours (eg, multiple sexual partners and condomless sex) 7 8. Furthermore, in order to increase pleasure, heroin is often ingested concurrently with an SD (eg, cocaine or methamphetamine), and it is called polydrug use 9.…”

“…A report in the USA also claimed that 50.0% of people use heroin and 13% of people use methamphetamine by injection 13. However, there is evidence showing an upward trend in people using SD who switched from non-injection of drug intake to injecting route to enhance the drug effects,14 especially for those using heroin concurrently 8. People who inject drugs endure the most considerable health risks; it is estimated that half of the people who inject drugs live with HCV, and one in eight live with HIV worldwide 2.…”

Combating illicit fentanyl: Will increased Chinese regulation generate a public health crisis in India?

“…The infusion of fentanyl into the Indian drug supply will likely produce similar results. Interestingly, Chinese PWID who used SD exclusively engaged in more frequent and risky sexual activity relative to polydrug or heroin-only users (78). If IMF increases sexual activity, increased use in India may contribute to the rise of HIV, HCV, and other sexually transmitted diseases.…”