Physical victimization and risky sexual partners among drug users in New York City

Background: Little is known on the impact of physical victimization on the acquisition of risky sexual partners among men and women. Our study utilized a four-year, year-by-year behavioral and social network history collected at baseline to determine if physical victimization predicts high-risk sexual partnerships among injection and non-injection drug users. Methods: Between 2006-2009, 652 heroin/crack/cocaine users, aged 18-40 were recruited through targeted outreach and respondent driven sampling in 36 high drug activity areas in New York City. Respondents reporting no high-risk sex partner four years prior to study entry were included in the analysis (n=240) and assessed yearly to first report of a high-risk sexual partner (i.e., self-reported MSM, heroin injection, crack use, transactional sex, or incarceration history). Physical victimization (i.e., threatened with a knife or gun, beaten up, shot or stabbed), measured yearly, was the primary exposure. GEE was used to account for repeated exposure and outcome measures. Results: The sample was 44% Hispanic, 43% Black, and 85% male. After adjustment, physical victimization significantly predicted ≥ 1 high-risk sexual partnership the following year (AOR=2.6;95%CI=1.3-4.9). This relationship did not differ for men and women. Females (AOR=6.9;95%CI=3.1-15.9) and MSMs (AOR=6.9;95CI%=2.2-21.9) were more likely to report a risky sexual partner. Conclusion: These data suggest that physical victimization may increase the risk of high-risk sexual partnership among drug users. Research is needed among this population to further inform a timely and innovative structural intervention that incorporates the social context of physical violence and subsequent high-risk sexual partnerships to help reduce HIV-related risk.