Sexual risk behaviors and predictors of inconsistent condom use among crack cocaine users in the French overseas territories in the Americas

Abstract

The French overseas territories in the Americas are the French territories most affected by HIV. Crack cocaine users are particularly impacted. The objective of this study was to describe sexual risk behaviors and inconsistent condom use among crack cocaine users. A total of 640 crack cocaine users were interviewed. The sampling method was non-probabilistic. An anonymous standardized questionnaire of 110 questions was used. Over a third of persons did not use condoms systematically with casual sex partners (36.2%) or commercial sex partners (32.3%), and 64% did not use condoms systematically with regular sex partners. In a context of multiple sexual partnerships, frequent forced sex, and insufficient HIV testing, the lack of systematic condom use may favor the spread of HIV. Different predictive factors of inconsistent condom use were identified, depending on the type of partner, with a log binomial regression. However, among the predictor variables identified, two predictive factors frequently occur among the different type of sex partners: high perceived risk of HIV and self-perceived capacity to persuade a sex partner to use condom. These results pointed towards interventions improving access to rights and raising perceived self-efficacy.

Prevalence and predictors of penile nodules in French Guiana's sole prison facility

“…If 29.6% of detainees have penile nodules this implies that condom use will be difficult and therefore there will be an increased risk for acquiring and transmitting HIV. This is even more likely when factoring in the substance addiction problem[ 21 ], the interruption of antiretroviral treatments by HIV-infected patients. Here, there seemed to be a greater proportion of persons with penile nodules in HIV-infected inmates than in HIV-negative inmates, but this did not reach statistical significance perhaps because the number of HIV-infected patients surveyed was small.…”

“…Psychoses and suicide risk were negatively associated with penile nodules. In a context of high HIV prevalence, this very common practice combined the with behavioral and social consequences of substance abuse may significantly hamper primary and tertiary prevention measures and may thus fuel the HIV epidemic[ 17 , 21 ].…”

High prevalence rates for multiple psychiatric conditions among inmates at French Guiana’s correctional facility: diagnostic and demographic factors associated with violent offending and previous incarceration

“…French Guiana is also a hub for cocaine trafficking towards France and Europe. Drugs are relatively cheap and there are high rates of substance use, impacting on HIV rates [ 2 ]. A quarter of families are single parent families, and one in five families includes four children or more, demographic conditions that further increase social vulnerability ( https://www.insee.fr/fr/statistiques/2011101?geo=DEP-973 ).…”

Penile implants and other high risk practices in French Guiana’s correctional facility: A cause for concern

“…A structured questionnaire of 140 questions was used. The design of the questionnaire was based on several Knowledge, Attitudes, Beliefs and Practices studies (KABP) conducted in the general population and vulnerable populations such as sex workers, crack cocaine users, men who have sex with men and migrants living in French Guiana or mainland France [25,26,27,28,29]. The questions from the KABP studies were adapted to the local inmate population.…”