Sexual risk for HIV and STIs among methamphetamine-using women in San Francisco

Background: Links have been established between methamphetamine (meth) use and sexual risk behavior among men who have sex with men. Less is known about women who use meth and their sexual risks for HIV and sexually transmitted infections (STIs). This presentation will address this research gap.

Methods: Participants (n=58 to date) were recruited using respondent-driven sampling. Eligibility criteria were meth use in the past 30 days and sex with 1 or more male partners in the past 6 months. Staff interviewed participants using a structured survey instrument. Testing for HIV and STIs was conducted at time of interview, and results counseling provided 1-2 weeks later.

Results: The sample was diverse in age and race/ethnicity. Meth was primarily used by injection (52%) and smoking (38%). The median number of male sexual partners in the past six months was 5. For vaginal intercourse, 18% reported consistent condom use. One-third of women reported anal intercourse, of whom 20% reported consistent condom use. Anal intercourse occurred with steady, casual and paying partners. Twenty-one percent of women reported bisexual male partners in the past 6 months. Sex for pay was reported by 57% of participants; the median number of paying partners was two. One-third of women reported being sexually assaulted in the past 6 months.

Conclusions: This study uncovers several sources of sexual risk for HIV/STI among meth-using women, including unprotected vaginal and anal intercourse, bisexual male partners and sexual assault.