AEGiS-NHIVPC: HIV Risk-Taking: IDUs vs. Non-IDUs, and Opiate vs. Stimulant Injectors in Denver, CO

National HIV Prevention Conference

Atlanta, Georgia, USA — July 27 - 30, 2003

HIV Risk-Taking: IDUs vs. Non-IDUs, and Opiate vs. Stimulant Injectors in Denver, CO

Natl HIV Prev Conf 2003 July 27-30:abstract no. T3-A0702
Corsi KF, Mikulich SK, Boooth RE; University of Colorado Health Sciences Center, Denver, CO

BACKGROUND/OBJECTIVES:: Despite recent advances in the prevention of and treatment for HIV, AIDS is still a major problem in the United States, with many cases attributable to injection drug use. This study was designed to compare HIV-related risk behaviors and knowledge among 235 injection drug users (IDUs) and non-IDUs in Denver, CO. Opiate injectors were also compared to stimulant injectors on HIV sex- and needle-related risks, and HIV knowledge.

METHODS: Subjects were recruited through street outreach, using targeted and snowball sampling. Recruitment methods were based on the Indigenous Leader Outreach Model, where outreach workers who were familiar with the drug-using community gained access to IDUs. Questionnaires were conducted with a computer-administered self-interview, with audio (audio-CASI). Questions about HIV-risk behaviors and HIV knowledge were asked. Unadjusted bivariate analyses were conducted to compare responses, and then multivariate analyses were conducted after adjusting for demographics.

RESULTS: Overall, non-IDUs reported more condom use during vaginal sex than IDUs (p<.0005), but IDUs scored higher on HIV knowledge than non-IDUs (p<.050). Opiate injectors reported more sharing of drug paraphernalia (p<.012), but also more safe vaginal sex than stimulant injectors (p<.001). Findings suggest that HIV sex-related risk behaviors differed among non-IDUs and IDUs as well as HIV knowledge. Furthermore, HIV knowledge was not found to be an important marker for risk behavior, as IDUs reported a substantial amount of knowledge (even higher than non-IDUs). Also, the findings showed that stimulant and opiate injectors differed in both the needle-and sex-related risks in which they engaged.

CONCLUSIONS: Findings support prior research examining sex- and drug-related risk behaviors. The observation that IDUs in this study engaged in more unsafe vaginal sex than non-IDUs, despite more HIV knowledge, may mean that IDUs were exposed to those messages but that they did not also have the corresponding appreciation for risk (risk perception) necessary to change behavior. This gap between knowledge and understanding of risk should be addressed in HIV prevention programs. The findings here also suggest that prevention programs should target both sex- and drug-related risks, as well as how these risks vary by drug of choice. Treatment programs have a relatively captive audience of IDUs and could therefore target specific types of injectors and focus on HIV risks, for example needle risks for opiate injectors and sex risks for stimulant injectors. These findings also suggest that, 15 years into the HIV epidemic with many successful prevention programs in place and much HIV knowledge in this population, HIV risk behavior is still occurring among IDUs.

Keywords: Risk-Taking, HIV Infections, HIV Seropositivity, Sex Behavior, Acquired Immunodeficiency Syndrome, Knowledge, Coitus, Safe Sex, Social Behavior, Greece, United States, Female

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T3-A0702