Concurrent sexual partnerships among young drug users: An egocentric network study in Yunnan, China

Background/ Objectives: To investigate the patterns of concurrent sexual partnerships among young drug users and sexual transmissibility of HIV in drug-use and sexual networks. Methods: In this egocentric network study, respondent-driven sampling (RDS) was used to recruit 426 young drug users in Yunnan, China. Multiple logistic regressions were performed to analyze the relationships of concurrent sexual partnerships with social network components, HIV risky sexual behaviors, and drug-use practices. Results: The RDS-adjusted prevalence of concurrent sexual partners was 43% among drug users. Drug users with concurrent sexual partnerships were more likely to engage in HIV-related sexual behavior, compared to those without such concurrent partnerships. Specifically, more drug users with concurrent sexual partnerships than those without concurrency reported having had four or more sexual partners (26.3% vs. 2%), having a spouse or boy/girl friends who also had concurrent sexual partnerships (28.1% vs. 8.2%), using drugs to exchange for sex (12.4% vs.3.8%), having sex partners who were non-IDUs (22.6% vs. 10.1%), having sex partners who were IDUs (25.3% vs. 13.5%), and using club drugs (26.3% vs.13.5%). Consistent condom use with regular partners or non-regular partners was very low (between 26%-46%) among drug users with concurrent sex partners as well as those without. Conclusion: The findings suggest that the generalization of the HIV epidemic from risk populations to the general population may be driven by concurrent sexual partnerships. Behavioral interventions targeting safer sex should be integrated in harm reduction programs in China.