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Published in: AIDS and Behavior 3/2013

01-03-2013 | Original Paper

Non-Injection and Injection Drug Use and STI/HIV Risk in the United States: The Degree to which Sexual Risk Behaviors Versus Sex with an STI-Infected Partner Account for Infection Transmission among Drug Users

Authors: Maria R. Khan, Amanda Berger, Jordana Hemberg, Allison O’Neill, Typhanye Penniman Dyer, Kristina Smyrk

Published in: AIDS and Behavior | Issue 3/2013

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Abstract

We used the National Longitudinal Study of Adolescent Health (N = 14,322) to measure associations between non-injection crack-cocaine and injection drug use and sexually transmitted infection including HIV (STI/HIV) risk among young adults in the United States and to identify factors that mediate the relationship between drug use and infection. Respondents were categorized as injection drug users, non-injection crack-cocaine users, or non-users of crack-cocaine or injection drugs. Non-injection crack-cocaine use remained an independent correlate of STI when adjusting for age at first sex and socio-demographic characteristics (adjusted prevalence ratio (APR): 1.64, 95 % confidence interval (CI): 1.16–2.31) and sexual risk behaviors including multiple partnerships and inconsistent condom use. Injection drug use was strongly associated with STI (APR: 2.62, 95 % CI: 1.29–5.33); this association appeared to be mediated by sex with STI-infected partners rather than by sexual risk behaviors. The results underscore the importance of sexual risk reduction among all drug users including IDUs, who face high sexual as well as parenteral transmission risk.
Literature
1.
go back to reference CDC. Trends in Sexually Transmitted Diseases in the United States: 2009 National Data for Gonorrhea, Chlamydia and Syphilis Atlanta, GA: Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, 2009. CDC. Trends in Sexually Transmitted Diseases in the United States: 2009 National Data for Gonorrhea, Chlamydia and Syphilis Atlanta, GA: Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, 2009.
3.
go back to reference Celentano DD, Latimore AD, Mehta SH. Variations in sexual risks in drug users: emerging themes in a behavioral context. Curr HIV/AIDS Rep. 2008;5(4):212–8.PubMedCrossRef Celentano DD, Latimore AD, Mehta SH. Variations in sexual risks in drug users: emerging themes in a behavioral context. Curr HIV/AIDS Rep. 2008;5(4):212–8.PubMedCrossRef
4.
go back to reference Ross MW, Williams ML. Sexual behavior and illicit drug use. Annu Rev Sex Res. 2001;12:290–310.PubMed Ross MW, Williams ML. Sexual behavior and illicit drug use. Annu Rev Sex Res. 2001;12:290–310.PubMed
5.
go back to reference Hwang LY, Ross MW, Zack C, Bull L, Rickman K, Holleman M. Prevalence of sexually transmitted infections and associated risk factors among populations of drug abusers. Clin Infect Dis. 2000;31(4):920–6.PubMedCrossRef Hwang LY, Ross MW, Zack C, Bull L, Rickman K, Holleman M. Prevalence of sexually transmitted infections and associated risk factors among populations of drug abusers. Clin Infect Dis. 2000;31(4):920–6.PubMedCrossRef
6.
go back to reference Booth RE, Kwiatkowski CF, Chitwood DD. Sex related HIV risk behaviors: differential risks among injection drug users, crack smokers, and injection drug users who smoke crack. Drug Alcohol Depend. 2000;58(3):219–26.PubMedCrossRef Booth RE, Kwiatkowski CF, Chitwood DD. Sex related HIV risk behaviors: differential risks among injection drug users, crack smokers, and injection drug users who smoke crack. Drug Alcohol Depend. 2000;58(3):219–26.PubMedCrossRef
7.
go back to reference McCoy CB, Lai S, Metsch LR, Messiah SE, Zhao W. Injection drug use and crack cocaine smoking: independent and dual risk behaviors for HIV infection. Ann Epidemiol. 2004;14(8):535–42.PubMedCrossRef McCoy CB, Lai S, Metsch LR, Messiah SE, Zhao W. Injection drug use and crack cocaine smoking: independent and dual risk behaviors for HIV infection. Ann Epidemiol. 2004;14(8):535–42.PubMedCrossRef
8.
go back to reference Lejuez CW, Bornovalova MA, Daughters SB, Curtin JJ. Differences in impulsivity and sexual risk behavior among inner-city crack-cocaine users and heroin users. Drug Alcohol Depend. 2005;77(2):169–75.PubMedCrossRef Lejuez CW, Bornovalova MA, Daughters SB, Curtin JJ. Differences in impulsivity and sexual risk behavior among inner-city crack-cocaine users and heroin users. Drug Alcohol Depend. 2005;77(2):169–75.PubMedCrossRef
9.
go back to reference Khan MR, Bolyard M, Sandoval M, et al. Social and behavioral correlates of sexually transmitted infection- and HIV-discordant sexual partnerships in Bushwick, Brooklyn, New York. J Acquir Immune Defic Syndr. 2009;51(4):470–85.PubMedCrossRef Khan MR, Bolyard M, Sandoval M, et al. Social and behavioral correlates of sexually transmitted infection- and HIV-discordant sexual partnerships in Bushwick, Brooklyn, New York. J Acquir Immune Defic Syndr. 2009;51(4):470–85.PubMedCrossRef
10.
go back to reference Friedman SR, Flom PL, Kottiri BJ, et al. Drug use patterns and infection with sexually transmissible agents among young adults in a high-risk neighbourhood in New York City. Addiction. 2003;98(2):159–69.PubMedCrossRef Friedman SR, Flom PL, Kottiri BJ, et al. Drug use patterns and infection with sexually transmissible agents among young adults in a high-risk neighbourhood in New York City. Addiction. 2003;98(2):159–69.PubMedCrossRef
11.
go back to reference Sena AC, Muth SQ, Heffelfinger JD, O’Dowd JO, Foust E, Leone P. Factors and the sociosexual network associated with a syphilis outbreak in rural North Carolina. Sex Transm Dis. 2007;34(5):280–7.PubMed Sena AC, Muth SQ, Heffelfinger JD, O’Dowd JO, Foust E, Leone P. Factors and the sociosexual network associated with a syphilis outbreak in rural North Carolina. Sex Transm Dis. 2007;34(5):280–7.PubMed
12.
go back to reference Ellen JM, Langer LM, Zimmerman RS, Cabral RJ, Fichtner R. The link between the use of crack cocaine and the sexually transmitted diseases of a clinic population. A comparison of adolescents with adults. Sex Transm Dis. 1996;23(6):511–6.PubMedCrossRef Ellen JM, Langer LM, Zimmerman RS, Cabral RJ, Fichtner R. The link between the use of crack cocaine and the sexually transmitted diseases of a clinic population. A comparison of adolescents with adults. Sex Transm Dis. 1996;23(6):511–6.PubMedCrossRef
13.
go back to reference Adimora AA, Schoenbach VJ, Martinson FE, et al. Heterosexually transmitted HIV infection among African Americans in North Carolina. J Acquir Immune Defic Syndr. 2006;41(5):616–23.PubMedCrossRef Adimora AA, Schoenbach VJ, Martinson FE, et al. Heterosexually transmitted HIV infection among African Americans in North Carolina. J Acquir Immune Defic Syndr. 2006;41(5):616–23.PubMedCrossRef
14.
go back to reference Miller M, Liao Y, Wagner M, Korves C. HIV, the clustering of sexually transmitted infections, and sex risk among African American women who use drugs. Sex Transm Dis. 2008;35(7):696–702.PubMedCrossRef Miller M, Liao Y, Wagner M, Korves C. HIV, the clustering of sexually transmitted infections, and sex risk among African American women who use drugs. Sex Transm Dis. 2008;35(7):696–702.PubMedCrossRef
15.
go back to reference Plitt SS, Sherman SG, Strathdee SA, Taha TE. Herpes simplex virus 2 and syphilis among young drug users in Baltimore, Maryland. Sex Transm Infect. 2005;81(3):248–53.PubMedCrossRef Plitt SS, Sherman SG, Strathdee SA, Taha TE. Herpes simplex virus 2 and syphilis among young drug users in Baltimore, Maryland. Sex Transm Infect. 2005;81(3):248–53.PubMedCrossRef
16.
go back to reference Des Jarlais DC, Arasteh K, McKnight C, Hagan H, Perlman D, Friedman SR. Using hepatitis C virus and herpes simplex virus-2 to track HIV among injecting drug users in New York City. Drug Alcohol Depend. 2009;101(1–2):88–91.PubMedCrossRef Des Jarlais DC, Arasteh K, McKnight C, Hagan H, Perlman D, Friedman SR. Using hepatitis C virus and herpes simplex virus-2 to track HIV among injecting drug users in New York City. Drug Alcohol Depend. 2009;101(1–2):88–91.PubMedCrossRef
17.
go back to reference Strathdee SA, Sherman SG. The role of sexual transmission of HIV infection among injection and non-injection drug users. J Urban Health. 2003;80(4 Suppl 3):iii7–14.PubMed Strathdee SA, Sherman SG. The role of sexual transmission of HIV infection among injection and non-injection drug users. J Urban Health. 2003;80(4 Suppl 3):iii7–14.PubMed
18.
go back to reference Kral AH, Bluthenthal RN, Lorvick J, Gee L, Bacchetti P, Edlin BR. Sexual transmission of HIV-1 among injection drug users in San Francisco, USA: risk-factor analysis. Lancet. 2001;357(9266):1397–401.PubMedCrossRef Kral AH, Bluthenthal RN, Lorvick J, Gee L, Bacchetti P, Edlin BR. Sexual transmission of HIV-1 among injection drug users in San Francisco, USA: risk-factor analysis. Lancet. 2001;357(9266):1397–401.PubMedCrossRef
19.
go back to reference Lindenburg CE, Krol A, Smit C, Buster MC, Coutinho RA, Prins M. Decline in HIV incidence and injecting, but not in sexual risk behaviour, seen in drug users in Amsterdam: a 19-year prospective cohort study. AIDS. 2006;20(13):1771–5.PubMedCrossRef Lindenburg CE, Krol A, Smit C, Buster MC, Coutinho RA, Prins M. Decline in HIV incidence and injecting, but not in sexual risk behaviour, seen in drug users in Amsterdam: a 19-year prospective cohort study. AIDS. 2006;20(13):1771–5.PubMedCrossRef
21.
go back to reference SAMHSA. Results from the 2009 national survey on drug use and health: volume I. Summary of national findings. Rockville, MD: Office of Applied Studies, SAMHSA, 2010. SAMHSA. Results from the 2009 national survey on drug use and health: volume I. Summary of national findings. Rockville, MD: Office of Applied Studies, SAMHSA, 2010.
22.
go back to reference SAMHSA. The NSDUH report: injection drug use. Rockville, MD: Office of Applied Studies, SAMHSA, 2003. SAMHSA. The NSDUH report: injection drug use. Rockville, MD: Office of Applied Studies, SAMHSA, 2003.
23.
go back to reference Weinstock H, Berman S, Cates W Jr. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health. 2004;36(1):6–10.PubMedCrossRef Weinstock H, Berman S, Cates W Jr. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health. 2004;36(1):6–10.PubMedCrossRef
24.
go back to reference CDC. Trends in reportable sexually transmitted diseases in the United States, 2006: National Surveillance Data for Chlamydia, Gonorrhea, and Syphilis, 2007. CDC. Trends in reportable sexually transmitted diseases in the United States, 2006: National Surveillance Data for Chlamydia, Gonorrhea, and Syphilis, 2007.
25.
go back to reference Nusbaum MR, Wallace RR, Slatt LM, Kondrad EC. Sexually transmitted infections and increased risk of co-infection with human immunodeficiency virus. J Am Osteopath Assoc. 2004;104(12):527–35.PubMed Nusbaum MR, Wallace RR, Slatt LM, Kondrad EC. Sexually transmitted infections and increased risk of co-infection with human immunodeficiency virus. J Am Osteopath Assoc. 2004;104(12):527–35.PubMed
26.
go back to reference Westrom L, Eschenbach D. Pelvic inflammatory disease. In: Holmes KK, Sparling PF, Mårdh P, editors. Sexually transmitted diseases, 3rd edn. New York: McGraw-Hill; pp. 783–809. Westrom L, Eschenbach D. Pelvic inflammatory disease. In: Holmes KK, Sparling PF, Mårdh P, editors. Sexually transmitted diseases, 3rd edn. New York: McGraw-Hill; pp. 783–809.
27.
go back to reference Schulz KF, Cates W Jr, O’Mara PR. Pregnancy loss, infant death, and suffering: legacy of syphilis and gonorrhoea in Africa. Genitourin Med. 1987;63(5):320–5.PubMed Schulz KF, Cates W Jr, O’Mara PR. Pregnancy loss, infant death, and suffering: legacy of syphilis and gonorrhoea in Africa. Genitourin Med. 1987;63(5):320–5.PubMed
28.
go back to reference Gust DA, Levine WC, St Louis ME, Braxton J, Berman SM. Mortality associated with congenital syphilis in the United States, 1992–1998. Pediatrics. 2002;109(5):E79–89.PubMedCrossRef Gust DA, Levine WC, St Louis ME, Braxton J, Berman SM. Mortality associated with congenital syphilis in the United States, 1992–1998. Pediatrics. 2002;109(5):E79–89.PubMedCrossRef
29.
go back to reference Marai W. Lower genital tract infections among pregnant women: a review. East Afr Med J. 2001;78(11):581–5.PubMed Marai W. Lower genital tract infections among pregnant women: a review. East Afr Med J. 2001;78(11):581–5.PubMed
30.
go back to reference Cohen MS. HIV and sexually transmitted diseases: lethal synergy. Top HIV Med. 2004;12(4):104–7.PubMed Cohen MS. HIV and sexually transmitted diseases: lethal synergy. Top HIV Med. 2004;12(4):104–7.PubMed
31.
go back to reference Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect. 1999;75(1):3–17.PubMedCrossRef Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect. 1999;75(1):3–17.PubMedCrossRef
32.
go back to reference Cohen MS. Sexually transmitted diseases enhance HIV transmission: no longer a hypothesis. Lancet. 1998;351(Suppl 3):5–7.PubMedCrossRef Cohen MS. Sexually transmitted diseases enhance HIV transmission: no longer a hypothesis. Lancet. 1998;351(Suppl 3):5–7.PubMedCrossRef
33.
go back to reference Wasserheit JN. Epidemiological synergy. Interrelationships between human immunodeficiency virus infection and other sexually transmitted diseases. Sex Trans Dis. 1992;19(2):61–77. Wasserheit JN. Epidemiological synergy. Interrelationships between human immunodeficiency virus infection and other sexually transmitted diseases. Sex Trans Dis. 1992;19(2):61–77.
34.
go back to reference Cohen MS, Hoffman IF, Royce RA, et al. Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1. AIDSCAP Malawi Research Group. Lancet. 1997;349(9069):1868–73.PubMedCrossRef Cohen MS, Hoffman IF, Royce RA, et al. Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1. AIDSCAP Malawi Research Group. Lancet. 1997;349(9069):1868–73.PubMedCrossRef
37.
go back to reference Resnick MD, Bearman PS, Blum RW, et al. Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health. JAMA. 1997;278(10):823–32.PubMedCrossRef Resnick MD, Bearman PS, Blum RW, et al. Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health. JAMA. 1997;278(10):823–32.PubMedCrossRef
39.
go back to reference Sieving RE, Beuhring T, Resnick MD, et al. Development of adolescent self-report measures from the National Longitudinal Study of Adolescent Health. J Adolesc Health. 2001;28(1):73–81.PubMedCrossRef Sieving RE, Beuhring T, Resnick MD, et al. Development of adolescent self-report measures from the National Longitudinal Study of Adolescent Health. J Adolesc Health. 2001;28(1):73–81.PubMedCrossRef
41.
go back to reference Watson EJ, Templeton A, Russell I, et al. The accuracy and efficacy of screening tests for Chlamydia trachomatis: a systematic review. J Med Microbiol. 2002;51(12):1021–31.PubMed Watson EJ, Templeton A, Russell I, et al. The accuracy and efficacy of screening tests for Chlamydia trachomatis: a systematic review. J Med Microbiol. 2002;51(12):1021–31.PubMed
42.
go back to reference Johnson RE, Green TA, Schachter J, et al. Evaluation of nucleic acid amplification tests as reference tests for Chlamydia trachomatis infections in asymptomatic men. J Clin Microbiol. 2000;38(12):4382–6.PubMed Johnson RE, Green TA, Schachter J, et al. Evaluation of nucleic acid amplification tests as reference tests for Chlamydia trachomatis infections in asymptomatic men. J Clin Microbiol. 2000;38(12):4382–6.PubMed
43.
go back to reference Koumans EH, Johnson RE, Knapp JS, St Louis ME. Laboratory testing for Neisseria gonorrhoeae by recently introduced nonculture tests: a performance review with clinical and public health considerations. Clin Infect Dis. 1998;27(5):1171–80.PubMedCrossRef Koumans EH, Johnson RE, Knapp JS, St Louis ME. Laboratory testing for Neisseria gonorrhoeae by recently introduced nonculture tests: a performance review with clinical and public health considerations. Clin Infect Dis. 1998;27(5):1171–80.PubMedCrossRef
44.
go back to reference McNutt LA, Wu C, Xue X, Hafner JP. Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol. 2003;157(10):940–3.PubMedCrossRef McNutt LA, Wu C, Xue X, Hafner JP. Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol. 2003;157(10):940–3.PubMedCrossRef
45.
go back to reference Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159(7):702–6.PubMedCrossRef Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159(7):702–6.PubMedCrossRef
46.
go back to reference Friedman SR, Bolyard M, Maslow C, Mateu-Gelabert P, Sandoval M. Harnessing the power of social networks to reduce HIV risk. Focus. 2005;20(1):5–6.PubMed Friedman SR, Bolyard M, Maslow C, Mateu-Gelabert P, Sandoval M. Harnessing the power of social networks to reduce HIV risk. Focus. 2005;20(1):5–6.PubMed
47.
go back to reference Darke S, Kaye S, McKetin R, Duflou J. Major physical and psychological harms of methamphetamine use. Drug Alcohol Rev. 2008;27(3):253–62.PubMedCrossRef Darke S, Kaye S, McKetin R, Duflou J. Major physical and psychological harms of methamphetamine use. Drug Alcohol Rev. 2008;27(3):253–62.PubMedCrossRef
48.
go back to reference Gonzales R, Mooney L, Rawson RA. The methamphetamine problem in the United States. Annu Rev Public Health. 31:385–398. Gonzales R, Mooney L, Rawson RA. The methamphetamine problem in the United States. Annu Rev Public Health. 31:385–398.
49.
go back to reference Shrem MT, Halkitis PN. Methamphetamine abuse in the United States: contextual, psychological and sociological considerations. J Health Psychol. 2008;13(5):669–79.PubMedCrossRef Shrem MT, Halkitis PN. Methamphetamine abuse in the United States: contextual, psychological and sociological considerations. J Health Psychol. 2008;13(5):669–79.PubMedCrossRef
50.
go back to reference Molitor F, Truax SR, Ruiz JD, Sun RK. Association of methamphetamine use during sex with risky sexual behaviors and HIV infection among non-injection drug users. West J Med. 1998;168(2):93–7.PubMed Molitor F, Truax SR, Ruiz JD, Sun RK. Association of methamphetamine use during sex with risky sexual behaviors and HIV infection among non-injection drug users. West J Med. 1998;168(2):93–7.PubMed
51.
go back to reference Molitor F, Bell RA, Truax SR, Ruiz JD, Sun RK. Predictors of failure to return for HIV test result and counseling by test site type. AIDS Educ Prev. 1999;11(1):1–13.PubMed Molitor F, Bell RA, Truax SR, Ruiz JD, Sun RK. Predictors of failure to return for HIV test result and counseling by test site type. AIDS Educ Prev. 1999;11(1):1–13.PubMed
Metadata
Title
Non-Injection and Injection Drug Use and STI/HIV Risk in the United States: The Degree to which Sexual Risk Behaviors Versus Sex with an STI-Infected Partner Account for Infection Transmission among Drug Users
Authors
Maria R. Khan
Amanda Berger
Jordana Hemberg
Allison O’Neill
Typhanye Penniman Dyer
Kristina Smyrk
Publication date
01-03-2013
Publisher
Springer US
Published in
AIDS and Behavior / Issue 3/2013
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-012-0276-0

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