Heterosexual HIV and Sexual Partnerships Between Injection Drug Users and Noninjection Drug Users

Abstract

Sex partnerships with injection drug users (IDU) are an understudied network-level risk factor for heterosexual HIV infection. Heterosexuals with no history of injection were recruited from high-risk areas in New York City through respondent-driven sampling. We examined the prevalence of IDU sex partnerships among these non-IDU, the factors associated with having a past year IDU partner, and the independent association of HIV infection and IDU sex partnerships in multiple logistic regression. Of the 601 non-IDU in this analysis, 13.8% had a sex partner in the past year with a history of injection. IDU partnerships were significantly more common among women and those with higher levels of unprotected sex and drug and alcohol use. Overall, 7.0% tested positive for HIV. HIV prevalence was higher (p = 0.07) for participants with IDU partners (9.6%) compared to those with no IDU partners (4.6%). In multiple logistic regression, participants with IDU partners were over twice as likely to be HIV-infected (p = 0.08). Sex partnerships with IDU were common and may play an important role in heterosexual HIV transmission in areas with large IDU populations. Prevention interventions to encourage the disclosure of injection history and risk reduction specifically for those with IDU partners are indicated.

Reciprocal Sex Partner Concurrency and STDs among Heterosexuals at High-Risk of HIV Infection

“…31 To assess whether a weighted analysis would influence the estimated effect of RSPC, we conducted a sensitivity analysis for the multivariate model using RDS weights for any STD diagnoses. 38,39 Analyses were conducted using SAS© v9.1 (SAS Institute, Cary, NC, USA).…”

“…31 Personal network size was determined by asking participants how many of their peers, as defined above, they had seen in the last 30 days.…”

“…30 The data are from the high-risk heterosexual cycle conducted in 2006-2007. The NHBS methods for defining high-risk heterosexuals are explained in detail elsewhere. 31 Using NYC HIV surveillance data and the United States Census data on household poverty, NYC zip codes were ranked by combined standardized rates of heterosexual HIV and poverty. The top 30 zip codes, which were clustered in Central Brooklyn, Harlem, and the South Bronx, were considered "high-risk areas" (HRAs).…”

The Relationship Between Alcohol Consumption and Human Immunodeficiency Virus Infection and Risk Behaviour: A Systematic Literature Review of High-Risk Groups, with a Focus on South Africa

“…As greater alcohol consumption is further linked to having more sex partners, a greater risk of HIV infection exists among IDUs (Sander et al, 2010). Among IDUs, alcohol consumption and binge drinking in particular have been found to be associated with needle sharing (Arasteh and Des Jarlais, 2009;Matos et al, 2004;Poudel et al, 2010;Stein et al, 2000), multiple sex partners (Arasteh and Des Jarlais, 2009Chan et al, 2010Matos et al, 2004Poudel et al, 2010), sex under the influence of alcohol and/or drugs (Chan et al, 2010), sex with CSWs (Arasteh and Des Jarlais, 2009), sex with a paying customer (Matos et al, 2004), unprotected sex (Arasteh and Des Jarlais, 2009;Chan et al, 2010;Jenness et al, 2010;Matos et al, 2004), and injecting three or more times a day (Matos et al, 2004). For example, the odds ratio for sharing needles while intoxicated (compared to being sober) was 2.1 (CI 1.1-4.3) in a sample of 557 IDUs (89.4% male) (Matos et al, 2004).…”

Physical Victimization and High-Risk Sexual Partners among Illicit Drug-Using Heterosexual Men in New York City

“…12 Drug users are more likely to have high-risk sexual partners (e.g., IDUs 13 or those who engage in transactional sex, [14][15][16] ) which confers increased HIV risk. [17][18][19][20] However, to our knowledge, no prior studies have examined if violent victimization in adulthood is associated with having a high-risk sexual partner or precedes acquisition of high-risk partner in illicit drug-using men. The examination of acquisition of high-risk partners could provide insight on the temporal ordering of adult victimization and high-risk sexual behavior in men-an important yet understudied area.…”