Binge Use of Crack Cocaine and Sexual Risk Behaviors Among African-American, HIV-Positive Users

Abstract

This study describes binge use of crack cocaine, binge users, and their sexual risk behaviors in a sample of 303 African-American, HIV-positive users. Recent binge use was defined as, "using as much crack cocaine as you can, until you run out of crack or are unable to use any more" in the last 30 days. Fifty-one percent reported a recent crack binge. The typical crack binge lasted 3.7 days and involved smoking 40 rocks on average. Nearly two-thirds reported their last binge was in their own or another's home. Seventy-two percent had sex during the last binge, with an average of 3.1 partners. In multivariable logistic regression analyses, recent bingers were more likely than non-bingers to consider themselves homeless, to have any income source, to have used crack longer, and to score higher on risk-taking and need for help with their drug problem. In multivariable ordinal and logistic regression analyses, recent bingers had more sex partners in the last six months and 30 days and were more likely to have never used a condom in the last 30 days. Among male users, recent bingers were more likely to report lifetime and recent exchange of money for sex and drugs for sex. Among both male and female users, recent bingers were more likely to report lifetime trading of sex for drugs. African-American, HIV-positive binge users of crack cocaine appear to be at increased risk for HIV transmission. Further investigations of binge crack use and sexual risk behaviors and interventions targeting and tailored to this group should be considered.

Patterns of cocaine and opioid co-use and polyroutes of administration among street-based cocaine users in Montréal, Canada

“…This result is consistent with an extensive body of literature documenting the link between crack use and high-risk sexual practices, (Booth et al, 2000;Edlin et al, 1994;Harzke et al, 2009;Hudgins, McCusker, & Stoddard, 1995;Inciardi, 1995) sexually transmitted infections (McCoy, Lai, Metsch, Messiah, & Zhao, 2004;Ross, Hwang, Zack, Bull, & William, 2002), and HIV infection (DeBeck et al, 2009). …”

“…Recent evidence suggests a synergistic effect of cocaine and heroin injection on HCV risk . Crack smoking has also been found to increase risks of HIV and HCV infections, mainly via increased unsafe sexual behaviours and multiperson use of crack-smoking implements (Booth, Watter, & Chitwood, 1993;Booth, Kwiatkowski, & Chitwood, 2000;Harzke, Williams, & Bowen, 2009;Inciardi, 1995;Jones et al, 1998;Schönnesson et al, 2008;Tortu, McMahon, Pouget, & Hamid, 2004).…”

Comportamientos sexuales de riesgo en pacientes brasileños dependientes de drogas no inyectables

“…These findings are similar to those presented in the literature (Harzke, Williams, & Bowen, 2009;Pallonen, Timpson, Williams, & Ross, 2009). Evidences show that high level of dependence on alcohol and illegal drugs increased the probability of belonging to the group with the highest sexual risk, independent of gender (Celentano et al, 2008;Dickson-Gomez et al, 2012;Mitchell et al, 2009).…”

A Comparison of the Social and Sexual Networks of Crack-Using and Non-Crack Using African American Men who Have Sex with Men

“…strongly associated with having greater number of sexual partners, [5][6][7] including exchange sex partners, increased sexually transmitted diseases (STIs), and decreased condom use. 8,9 Disparities in HIV incidence, prevalence, and disease progression by race among men who have sex with men (MSM) have been well documented and are persistent, [10][11][12][13][14][15] with African American MSM (AA MSM) having higher HIV rates compared to white MSM (W MSM). These disparities are not explained by riskier sexual or drug-use behaviors.…”