243982 Social contexts and HIV risk among low-income cocaine-, crack-, and heroin-using WSW/M of color

Tuesday, November 1, 2011: 11:30 AM

Sel J. Hwahng, PhD , Center for the Study of Ethnicity and Race, Columbia University, New York, NY
Introduction: Low-income cocaine-, crack-, and heroin-using WSW/M are women who have sex with women, and also have sex with men. Research has shown that these drug-using WSW/M prefer women as their relational and sexual partners, but often have sex with men out of economic necessity. Low-income drug-using WSW/M are a high-risk HIV population, with HIV seroprevalence ranging from 12.8% to 53%. In randomly selected samples of high HIV risk drug-using women, drug-using WSW/M comprise a sizable portion, and sometimes even a majority of drug-using women. Methods: This presentation is an extensive review of the literature on this population from 1992 to the present, including literature authored by the presenter based on empirical research. Results and Discussion: Several studies indicate that drug-using WSW/M are at higher HIV risk from both distal and proximal factors compared to drug-using women who have sex with men only (WSMO). Compared to drug-using WSMO, drug-using WSW/M are also much more likely to trade sex with men for drugs and/or money, and male partners of drug-using WSW/M tend to be at much more high risk, including MSM/W, IDUs, and/or HIV-positive, compared to the male partners of drug-using WSMO. Drug-using WSW/M are also considered a “bridge” population that can potentially infect men through sexual and IDU transmission and infect other women through IDU transmission. Drug-using WSW/M are more likely to perform “active” social roles compared to drug-using WSMO, which may provide economic, social, and psychological benefits to these women while also placing them at greater HIV risk. Among drug-using women, African American women are more often associated with WSW/M behavior compared to white women, and women of color comprise the majority of drug-using WSW/M. Drug-using WSW/M of color are often not accessed by conventional outreach or programs and have special needs that should be addressed.

Learning Areas:
Advocacy for health and health education
Diversity and culture
Public health or related public policy
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
To define low-income drug-using women of color who have sex with women and men (WSW/M of color) as a high HIV risk population with special needs. To identify distal and proximal HIV risk factors for low-income drug-using WSW/M of color. To demonstrate how low-income drug-using WSW/M are often at greater HIV risk compared to low-income drug-using women who have sex with men only (WSMO).

Keywords: Drug Use, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted an intensive literature review and have published articles based on empirical research on this population.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.