271279 Clustered Drug and Sexual HIV Risk among a Sample of Older Injection Drug Users, Houston, Texas

Monday, October 29, 2012

Syed Noor, MSS, MA, MPH , School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX
Michael W. Ross, PhD , WHO Center for Health Promotion Research and Development, The University of Texas - Houston School of Public Health, Houston, TX
Dejian Lai, PhD , School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX
Jan Risser, PhD , Department of Epidemiology and Disease Control, University of Texas School of Public Health, Houston, TX
Background: Recent studies reported clustered pattern of high risk drug using and sexual behaviors among younger injection drug users. This analysis examines the interplay and overlap of drug and sexual HIV risk among a sample of older, long-term injection drug users in Houston Texas.

Methods: Our study includes 523 eligible IDUs, recruited into the 2009 National HIV Behavioral Surveillance project. Eight separate multivariable regression models were built to examine the odds of reporting a given risk behavior. We constructed the most parsimonious multivariable model using a manual backward stepwise process.

Results: Participants were mostly male, older, and non-Hispanic Black. A majority of the sample reported needle sharing as well as unprotected sex and exchange partner at last sex. Unsafe injecting practices were associated with high risk sexual behaviors. IDUs who shared needles had higher odds of having anal sex (OR=2.89, 95%CI: 1.69-4.92) and unprotected sex (OR=2.66, 95%CI: 1.38-5.10) at last sex. Additionally, homelessness was associated with needle sharing (OR=2.24, 95% CI: 1.34-3.76) and cocaine use was associated with multiple sex partners (OR=1.82, 95% CI: 1.07-3.11).

Conclusions: Our results show that a majority of the sample IDUs are exposed to both sexual and drug-use modes of HIV transmission. Though temporality cannot be established due to the cross-sectional study design our findings indicate that choice of drug, homelessness and gender are associated with HIV risk. The observed clustering pattern of drug and sexual risk behavior among this population is alarming and deserve attention of HIV policy makers and planners.

Learning Areas:
Epidemiology
Public health or related education
Social and behavioral sciences

Learning Objectives:
Learners will be able to describe drug and sexual risk behaviors associated with HIV risk among injection drug users. list factors contextual to injection drug use as well as sexual behaviors related HIV risk among a sample of injection drug users. compare drug and sexual risk behaviors among injection drug users.

Keywords: HIV/AIDS, Injection Drug Users

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceptualized and conducted this analysis.
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.