Sex Differences in Risk Factors for HIV Seroconversion Among Injection Drug Users

Strathdee, Steffanie A.; Galai, Noya; Safaiean, Mahboobeh; Celentano, David D.; Vlahov, David; Johnson, Lisette; Nelson, Kenrad E.

doi:10.1001/archinte.161.10.1281

Cited by 313 publications

(185 citation statements)

References 44 publications

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“…Like other authors, we found that injection behaviors differ substantially by gender, [6][7][8][9][10][11][13][14][15]17,[38][39][40][41][42][43] with women more likely to be injected by a sexual partner than friends or acquaintances, share needles, and use a greater variety of drugs than men. We found that men experienced HIV risk behaviors as well, with increased homelessness and incarceration relative to women, though these differences were attenuated after adjustment for confounders; indeed, the constellation of psychosocial issues including depression was greater among women than men, as other authors have found.…”

Section: Discussionsupporting

confidence: 78%

Differing HIV Risks and Prevention Needs among Men and Women Injection Drug Users (IDU) in the District of Columbia

et al. 2012

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Washington, DC has among the highest HIV/AIDS rates in the US. Gender differences among injection drug users (IDUs) may be associated with adoption of prevention opportunities including needle exchange programs, HIV testing, psychosocial support, and prevention programming. National HIV Behavioral Surveillance data on current IDUs aged ≥18 were collected from 8/09 to 11/09 via respondent-driven sampling in Washington, DC. HIV status was assessed using oral OraQuick with Western Blot confirmation. Weighted estimates were derived using RDSAT. Stata was used to characterize the sample and differences between male and female IDU, using uni-, bi-, and multivariable methods. Factors associated with HIV risk differed between men and women. Men were more likely than women to have had a history of incarceration (86.6% vs. 66.8%, pG0.01). Women were more likely than men to have depressive symptoms (73.9% vs. 47.4%, pG 0.01), to have been physically or emotionally abused (66.1% vs. 16.1%, pG0.0001), to report childhood sexual abuse (42.7% vs. 4.7%, pG0.0001), and pressured or forced to have sex (62.8% vs. 4.0%, pG0.0001); each of these differences was significant in the multivariable analysis. Despite a decreasing HIV/AIDS epidemic among IDU, there remain significant gender differences with women experiencing multiple threats to psychosocial health, which may in turn affect HIV testing, access, care, and drug use. Diverging needs by gender are critical to consider when implementing HIV prevention strategies.

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Section: Discussionsupporting

confidence: 78%

Differing HIV Risks and Prevention Needs among Men and Women Injection Drug Users (IDU) in the District of Columbia

et al. 2012

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“…In Baltimore, high risk sexual activity surpassed risky drug use practices as the main predictor of HIV infection among women IDUs during the period observed; HIV incidence more than doubled among women IDUs who had an IDU sex partner. 20 This variance is likely due to a greater correlation between women's drug use and high risk sexual practices, 21,22 and to the fact that women are more easily infected through vaginal sex. Some studies have shown that women IDUs' social networks contain more IDUs than those of male injectors and that there is greater overlap between women's sexual and injection networks, perhaps because women's drug use is more stigmatised and thus more isolating than men's.…”

Section: Women Who Inject Drugs Are Especially Vulnerablementioning

confidence: 99%

Women, Harm Reduction and HIV

Pinkham¹,

Malinowska-Sempruch²

2008

Reproductive Health Matters

104

115

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“…Drug use is a determinant of high-risk behavior and infection, [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] and substantial proportions of the US prison population report a history of heavy drug and alcohol use. 48 The effect of incarceration on STI/HIV risk may differ by drug use status.…”

mentioning

confidence: 99%